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Jung O, Hesse B, Stojanovic S, Seim C, Weitkamp T, Batinic M, Goerke O, Kačarević ŽP, Rider P, Najman S, Barbeck M. Biocompatibility Analyses of HF-Passivated Magnesium Screws for Guided Bone Regeneration (GBR). Int J Mol Sci 2021; 22:ijms222212567. [PMID: 34830451 PMCID: PMC8624161 DOI: 10.3390/ijms222212567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Magnesium (Mg) is one of the most promising materials for human use in surgery due to material characteristics such as its elastic modulus as well as its resorbable and regenerative properties. In this study, HF-coated and uncoated novel bioresorbable magnesium fixation screws for maxillofacial and dental surgical applications were investigated in vitro and in vivo to evaluate the biocompatibility of the HF coating. Methods: Mg alloy screws that had either undergone a surface treatment with hydrofluoric-acid (HF) or left untreated were investigated. In vitro investigation included XTT, BrdU and LDH in accordance with the DIN ISO 10993-5/-12. In vivo, the screws were implanted into the tibia of rabbits. After 3 and 6 weeks, degradation, local tissue reactions and bony integration were analyzed histopathologically and histomorphometrically. Additionally, SEM/EDX analysis and synchrotron phase-contrast microtomography (µCT) measurements were conducted. The in vitro analyses revealed that the Mg screws are cytocompatible, with improved results when the surface had been passivated with HF. In vivo, the HF-treated Mg screws implanted showed a reduction in gas formation, slower biodegradation and a better bony integration in comparison to the untreated Mg screws. Histopathologically, the HF-passivated screws induced a layer of macrophages as part of its biodegradation process, whereas the untreated screws caused a slight fibrous tissue reaction. SEM/EDX analysis showed that both screws formed a similar layer of calcium phosphates on their surfaces and were surrounded by bone. Furthermore, the µCT revealed the presence of a metallic core of the screws, a faster absorbing corrosion front and a slow absorbing region of corroded magnesium. Conclusions: Overall, the HF-passivated Mg fixation screws showed significantly better biocompatibility in vitro and in vivo compared to the untreated screws.
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Affiliation(s)
- Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany;
| | | | - Sanja Stojanovic
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18108 Niš, Serbia; (S.S.); (S.N.)
- Scientific Research Center for Biomedicine, Faculty of Medicine, Department for Cell and Tissue Engineering, University of Niš, 18108 Niš, Serbia
| | | | - Timm Weitkamp
- Synchrotron SOLEIL, Gif-sur-Yvette, 91190 Saint-Aubin, France;
| | - Milijana Batinic
- Department of Ceramic Materials, Chair of Advanced Ceramic Materials, Institute for Materials Science and Technologies, Technical University of Berlin, 10623 Berlin, Germany; (M.B.); (O.G.)
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
| | - Oliver Goerke
- Department of Ceramic Materials, Chair of Advanced Ceramic Materials, Institute for Materials Science and Technologies, Technical University of Berlin, 10623 Berlin, Germany; (M.B.); (O.G.)
| | - Željka Perić Kačarević
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
| | - Patrick Rider
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
| | - Stevo Najman
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18108 Niš, Serbia; (S.S.); (S.N.)
- Scientific Research Center for Biomedicine, Faculty of Medicine, Department for Cell and Tissue Engineering, University of Niš, 18108 Niš, Serbia
| | - Mike Barbeck
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
- Correspondence: ; Tel.: +49-176-810-224-6
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Barbeck M, Kühnel L, Witte F, Pissarek J, Precht C, Xiong X, Krastev R, Wegner N, Walther F, Jung O. Degradation, Bone Regeneration and Tissue Response of an Innovative Volume Stable Magnesium-Supported GBR/GTR Barrier Membrane. Int J Mol Sci 2020; 21:ijms21093098. [PMID: 32353983 PMCID: PMC7247710 DOI: 10.3390/ijms21093098] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction: Bioresorbable collagenous barrier membranes are used to prevent premature soft tissue ingrowth and to allow bone regeneration. For volume stable indications, only non-absorbable synthetic materials are available. This study investigates a new bioresorbable hydrofluoric acid (HF)-treated magnesium (Mg) mesh in a native collagen membrane for volume stable situations. Materials and Methods: HF-treated and untreated Mg were compared in direct and indirect cytocompatibility assays. In vivo, 18 New Zealand White Rabbits received each four 8 mm calvarial defects and were divided into four groups: (a) HF-treated Mg mesh/collagen membrane, (b) untreated Mg mesh/collagen membrane (c) collagen membrane and (d) sham operation. After 6, 12 and 18 weeks, Mg degradation and bone regeneration was measured using radiological and histological methods. Results: In vitro, HF-treated Mg showed higher cytocompatibility. Histopathologically, HF-Mg prevented gas cavities and was degraded by mononuclear cells via phagocytosis up to 12 weeks. Untreated Mg showed partially significant more gas cavities and a fibrous tissue reaction. Bone regeneration was not significantly different between all groups. Discussion and Conclusions: HF-Mg meshes embedded in native collagen membranes represent a volume stable and biocompatible alternative to the non-absorbable synthetic materials. HF-Mg shows less corrosion and is degraded by phagocytosis. However, the application of membranes did not result in higher bone regeneration.
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Affiliation(s)
- Mike Barbeck
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- BerlinAnalytix GmbH, 12109 Berlin, Germany
- Correspondence: ; Tel.: +49-(0)-176-81022467
| | - Lennart Kühnel
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Frank Witte
- Biotrics Bioimplants GmbH, 12109 Berlin, Germany
| | | | - Clarissa Precht
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Xin Xiong
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
| | - Rumen Krastev
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
- Faculty of Applied Chemistry, Reutlingen University, 72762 Reutlingen, Germany
| | - Nils Wegner
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany
| | - Frank Walther
- Department of Materials Test Engineering (WPT), TU Dortmund University, 44227 Dortmund, Germany
| | - Ole Jung
- Department of Oral Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, Study Group: Biomaterials/Surfaces, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
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Guo G, Zhou H, Wang Q, Wang J, Tan J, Li J, Jin P, Shen H. Nano-layered magnesium fluoride reservoirs on biomaterial surfaces strengthen polymorphonuclear leukocyte resistance to bacterial pathogens. NANOSCALE 2017; 9:875-892. [PMID: 27995243 DOI: 10.1039/c6nr07729c] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Biomaterial-related bacterial infections cause patient suffering, mortality and extended periods of hospitalization, imposing a substantial burden on medical systems. In this context, understanding of nanomaterials-bacteria-cells interactions is of both fundamental and clinical significance. Herein, nano-MgF2 films were deposited on titanium substrate via magnetron sputtering. Using this platform, the antibacterial behavior and mechanism of the nano-MgF2 films were investigated in vitro and in vivo. It was found that, for S. aureus (CA-MRSA, USA300) and S. epidermidis (RP62A), the nano-MgF2 films possessed excellent anti-biofilm activity, but poor anti-planktonic bacteria activity in vitro. Nevertheless, both the traditional SD rat osteomyelitis model and the novel stably luminescent mouse infection model demonstrated that nano-MgF2 films exerted superior anti-infection effect in vivo, which cannot be completely explained by the antibacterial activity of the nanomaterial itself. Further, using polymorphonuclear leukocytes (PMNs), the critical immune cells of innate immunity, a complementary investigation of MgF2-bacteria-PMNs co-culturing revealed that the nano-MgF2 films improved the antibacterial effect of PMNs through enhancing their phagocytosis and stability. To our knowledge, this is the first time of exploring the antimicrobial mechanism of nano-MgF2 from the perspective of innate immunity both in vitro and in vivo. Based on the research results, a plausible mechanism is put forward for the predominant antibacterial effect of nano-MgF2in vivo, which may originate from the indirect immune enhancement effect of nano-MgF2 films. In summary, this study of surface antibacterial design using MgF2 nanolayer is a meaningful attempt, which can promote the host innate immune response to bacterial pathogens. This may give us a new understanding towards the antibacterial behavior and mechanism of nano-MgF2 films and pave the way towards their clinical applications.
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Affiliation(s)
- Geyong Guo
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Huaijuan Zhou
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China.
| | - Qiaojie Wang
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Jiaxing Wang
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Jiaqi Tan
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Jinhua Li
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China. and University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ping Jin
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China.
| | - Hao Shen
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
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Willbold E, Weizbauer A, Loos A, Seitz JM, Angrisani N, Windhagen H, Reifenrath J. Magnesium alloys: A stony pathway from intensive research to clinical reality. Different test methods and approval-related considerations. J Biomed Mater Res A 2016; 105:329-347. [PMID: 27596336 DOI: 10.1002/jbm.a.35893] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/29/2016] [Accepted: 09/02/2016] [Indexed: 12/21/2022]
Abstract
The first degradable implant made of a magnesium alloy, a compression screw, was launched to the clinical market in March 2013. Many different complex considerations are required for the marketing authorization of degradable implant materials. This review gives an overview of existing and proposed standards for implant testing for marketing approval. Furthermore, different common in vitro and in vivo testing methods are discussed. In some cases, animal tests are inevitable to investigate the biological safety of a novel medical material. The choice of an appropriate animal model is as important as subsequent histological examination. Furthermore, this review focuses on the results of various mechanical tests to investigate the stability of implants for temporary use. All the above aspects are examined in the context of development and testing of magnesium-based biomaterials and their progress them from bench to bedside. A brief history of the first market launch of a magnesium-based degradable implant is given. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 329-347, 2017.
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Affiliation(s)
- Elmar Willbold
- Department of Orthopedic Surgery, Hannover Medical School, NIFE, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Andreas Weizbauer
- Department of Orthopedic Surgery, Hannover Medical School, NIFE, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Anneke Loos
- Biocompatibility Laboratory BioMedimplant, Stadtfelddamm 34, 30625, Hannover, Germany
| | | | - Nina Angrisani
- Department of Orthopedic Surgery, Hannover Medical School, NIFE, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Henning Windhagen
- Department of Orthopedic Surgery, Hannover Medical School, NIFE, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Janin Reifenrath
- Department of Orthopedic Surgery, Hannover Medical School, NIFE, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
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5
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Durisin M, Reifenrath J, Weber CM, Eifler R, Maier HJ, Lenarz T, Seitz JM. Biodegradable nasal stents (MgF 2 -coated Mg-2 wt %Nd alloy)-A long-term in vivo study. J Biomed Mater Res B Appl Biomater 2015; 105:350-365. [PMID: 26511430 DOI: 10.1002/jbm.b.33559] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 08/28/2015] [Accepted: 10/11/2015] [Indexed: 12/21/2022]
Abstract
Despite innovative surgical techniques and use of current frontal sinus stents from different materials, the problem of treatment failure with consecutive reoperation remains present. The aim of our study is to investigate biocompatibility, degradation kinetics, and functionality of a newly developed fluoride-coated magnesium-based nasal stent. A minipig anatomy of frontal sinus adapted design and an external surgical approach were developed and established. The functionality of the stents was evaluated endoscopically. The stent-tissue blocks were analysed after 90 and 180 days using microcomputed tomography (µ-CT), histology, scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). Functional evaluation revealed an unobstructed stent lumen in all cases. Histological analysis showed moderate mucosal hyperplasia with a mild, nonspecific inflammatory response, and nonosteoconductive effect. Rejection reactions or necrosis did not occur. The volumetric analysis of the stents showed 51% volume loss after 180 days. The EDS analysis did not detect any neodymium (Nd) in the mucosa or bone. The Mg-2 wt % Nd stents are a promising option when treating the narrow passages following paranasal sinus surgery. In particular, its good biocompatibility and good functionality facilitate the re-epithelization of these constricted passages. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 350-365, 2017.
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Affiliation(s)
- Martin Durisin
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, 30625, Germany
| | - Janin Reifenrath
- Department of Orthopedic Surgery, CrossBIT-Center of Biocompatibility and Implant-Immunology, Hannover Medical School, Hannover, 30625, Germany
| | - Constantin M Weber
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, 30625, Germany
| | - Rainer Eifler
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Hannover, 30823, Germany
| | - Hans J Maier
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Hannover, 30823, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, 30625, Germany
| | - Jan-Marten Seitz
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, Hannover, 30823, Germany.,Department of Materials Science and Engineering, Michigan Technological University, Houghton, Michigan, 49931.,Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan, 49931
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6
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Durisin M, Seitz JM, Reifenrath J, Weber CM, Eifler R, Maier HJ, Lenarz T, Klose C. A novel biodegradable frontal sinus stent (MgNd2): a long-term animal study. Eur Arch Otorhinolaryngol 2015; 273:1455-67. [PMID: 26341887 DOI: 10.1007/s00405-015-3774-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/28/2015] [Indexed: 12/27/2022]
Abstract
The frontal sinus recess consists of anatomically narrow passages that are prone to stenosis in endonasal frontal sinus surgery for chronic sinus disease. Over the past 100 years, diverse frontal sinus stents have been developed and evaluated in clinical and animal studies. However, superinfection, formation of granulations tissue, stent dislocation and late stenosis of the duct have remained challenges and subject of debate in the literature. Currently developed biodegradable materials, including rare earth-containing magnesium alloys are promising candidates for application as temporary implant materials. The Mg 2 % wt Nd alloy (MgNd2) was used to design a nasal stent that fit the porcine anatomy. In the current study, we evaluate biocompatibility, biodegradation and functionality of a frontal sinus stent in 16 minipigs over 6 months. Intraoperative endoscopy revealed free stent lumen in all cases. Blood examination and clinical examinations indicated no systematic or local inflammation signs. The histopathology and elements analysis showed a very good biocompatibility. The μ-computed tomography-based volumetric analysis showed substantial stent degradation within 6 months. Our MgNd2 based stent appears to be a promising, solid basis for the development of a frontal sinus stent for clinical use.
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Affiliation(s)
- M Durisin
- Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - J M Seitz
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, An der Universität 2, 30823, Hannover, Germany.,Department of Materials Science and Engineering, Michigan Technological University, 1400 Townsend Dr., Houghton, MI, 49931, USA
| | - J Reifenrath
- Department of Orthopedic Surgery, CrossBIT, Center of Biocompatibility and Implant-Immunology, Hannover Medical School, Feodor-Lynen-Straßee 31, 30625, Hannover, Germany
| | - C M Weber
- Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - R Eifler
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, An der Universität 2, 30823, Hannover, Germany
| | - H J Maier
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, An der Universität 2, 30823, Hannover, Germany
| | - T Lenarz
- Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - C Klose
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, An der Universität 2, 30823, Hannover, Germany
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