In vitro degradation behavior and cytocompatibility of Mg-Zn-Zr alloys

Fluoride-treated rare earth-free magnesium alloy ZK30: An inert and bioresorbable material for bone fracture treatment devices

Bone fractures represent a common health problem, particularly in an increasingly aging population. Bioresorbable magnesium (Mg) alloy-based implants offer promising alternatives to traditional metallic implants for the treatment of bone fractures because they eliminate the need for implant removal after healing. The Mg-Y-rare-earth (RE)-Zr alloy WE43, designed for orthopedic implants, has received European Conformity mark approval. However, currently, WE43 is not clinically used in certain countries possibly because of concerns related to RE metals. In this study, we investigated the use of a RE-free alloy, namely, Mg-Zn-Zr alloy (ZK30), as an implant for bone fractures. Hydrofluoric acid (HF) treatment was performed to improve the corrosion resistance of ZK30. HF-treated ZK30 (HF-ZK30) exhibited lower corrosion rate and higher biocompatibility than those of WE43 in in vitro experiments. After implanting a rod of HF-ZK30 into the fractured femoral bones of mice, HF-ZK30 held the bones and healed the fracture without deformation. Treatment results of HF-ZK30 were comparable to those of WE43, indicating the potential of HF-ZK30 as a bioresorbable and safe implant for bone repair.

The Effectiveness Mechanisms of Carbon Nanotubes (CNTs) as Reinforcements for Magnesium-Based Composites for Biomedical Applications: A Review

As a smart implant, magnesium (Mg) is highly biocompatible and non-toxic. In addition, the elastic modulus of Mg relative to other biodegradable metals (iron and zinc) is close to the elastic modulus of natural bone, making Mg an attractive alternative to hard tissues. However, high corrosion rates and low strength under load relative to bone are some challenges for the widespread use of Mg in orthopedics. Composite fabrication has proven to be an excellent way to improve the mechanical performance and corrosion control of Mg. As a result, their composites emerge as an innovative biodegradable material. Carbon nanotubes (CNTs) have superb properties like low density, high tensile strength, high strength-to-volume ratio, high thermal conductivity, and relatively good antibacterial properties. Therefore, using CNTs as reinforcements for the Mg matrix has been proposed as an essential option. However, the lack of understanding of the mechanisms of effectiveness in mechanical, corrosion, antibacterial, and cellular fields through the presence of CNTs as Mg matrix reinforcements is a challenge for their application. This review focuses on recent findings on Mg/CNT composites fabricated for biological applications. The literature mentions effective mechanisms for mechanical, corrosion, antimicrobial, and cellular domains with the presence of CNTs as reinforcements for Mg-based nanobiocomposites.

The Characterization of a Biodegradable Mg Alloy after Powder Bed Fusion with Laser Beam/Metal Processing for Custom Shaped Implants

A new Mg-Zn-Zr-Ca alloy in a powder state, intended to be used for custom shaped implants, was obtained via a mechanical alloying method from pure elemental powder. Further, the obtained powder alloy was processed by a PBF-LB/M (powder bed fusion with laser beam/of metal) procedure to obtain additive manufactured samples for small biodegradable implants. A series of microstructural, mechanical and corrosion analyses were performed. The SEM (scanning electron microscopy) analysis of the powder alloy revealed a good dimensional homogeneity, with a uniform colour, no agglutination and almost rounded particles, suitable for the powder bed fusion procedure. Further, the PBF-LB/M samples revealed a robust and unbreakable morphology, with a suitable porosity (that can reproduce that of cortical bone) and without an undesirable balling effect. The tested Young's modulus of the PBF-LB/M samples, which was 42 GPa, is close to that of cortical bone, 30 GPa. The corrosion tests that were performed in PBS (Phosphate-buffered saline) solution, with three different pH values, show that the corrosion parameters have a satisfactory evolution comparative to the commercial ZK 60 alloy.

Polysaccharide-based (kappa carrageenan/carboxymethyl chitosan) nanofibrous membrane loaded with antifibrinolytic drug for rapid hemostasis- in vitro and in vivo evaluation

This work aimed to establish a novel membrane consisting of hemostatic polysaccharides, kappa-carrageenan (KC), and carboxymethyl chitosan (CMC) in tandem with polyvinyl alcohol that spun together as a matrix and loaded with tranexamic acid (TXA) as antifibrinolytic agent for further coagulation effect during and after oral surgeries. The electrospinning of KC was done for the first time and in comparison of CMC has better hemostatic efficacy. The effect of the hemostat was investigated by its surface morphology (SEM), FTIR/ATR analysis, swelling behavior in both PBS and blood, hydrophilicity, porosity, mechanical properties, and cumulative release rate. The effect of materials and the drug concentration ratio were considered. The effect of acetic acid percent in aqueous solutions of CMC/PVA and KC/PVA on morphology was investigated. The cell culture assay showed that all membranes interacted well (98 %) with fibroblast cells attached and grown on the fabricated substrate. Furthermore, the membranes are evaluated by clotting time, whole blood clotting, hemocompatibility, and platelet and RBC adhesion tests. Also, the hemostatic performance of the membrane was analyzed in vivo, using the tail and liver bleeding model in rats. Therefore, TXA loading into CMC and KC dressing could be an attractive hemostatic system for various clinical applications.

Biodegradable Magnesium Alloys for Personalised Temporary Implants

The objective of this experimental work was to examine and characterise the route for obtaining demonstrative temporary biodegradable personalised implants from the Mg alloy Mg-10Zn-0.5Zr-0.8Ca (wt.%). This studied Mg alloy was obtained in its powder state using the mechanical alloying method, with shape and size characteristics suitable for ensuing 3D additive manufacturing using the SLM (selective laser melting) procedure. The SLM procedure was applied to various processing parameters. All obtained samples were characterised microstructurally (using XRD-X-ray diffraction, and SEM-scanning electron microscopy); mechanically, by applying a compression test; and, finally, from a corrosion resistance viewpoint. Using the optimal test processing parameters, a few demonstrative temporary implants of small dimensions were made via the SLM method. Our conclusion is that mechanical alloying combined with SLM processing has good potential to manage 3D additive manufacturing for personalised temporary biodegradable implants of magnesium alloys. The compression tests show results closer to those of human bones compared to other potential metallic alloys. The applied corrosion test shows result comparable with that of the commercial magnesium alloy ZK60.

Effect of Fluoride Coatings on the Corrosion Behavior of Mg-Zn-Ca-Mn Alloys for Medical Application

The most critical shortcoming of magnesium alloys from the point of view of medical devices is the high corrosion rate, which is not well-correlated with clinical needs. It is well- known that rapid degradation occurs when an implant made of Mg-based alloys is placed inside the human body. Consequently, the implant loses its mechanical properties and failure can occur even if it is not completely degraded. The corrosion products that appear after Mg-based alloy degradation, such as H₂ and OH^- can have an essential role in decreasing biocompatibility due to the H₂ accumulation process in the tissues near the implant. In order to control the degradation process of the Mg-based alloys, different coatings could be applied. The aim of the current paper is to evaluate the effect of fluoride coatings on the corrosion behavior of magnesium alloys from the system Mg-Zn-Ca-Mn potentially used for orthopedic trauma implants. The main functional properties required for the magnesium alloys to be used as implant materials, such as surface properties and corrosion behavior, were studied before and after surface modifications by fluoride conversion, with and without preliminary sandblasting, of two magnesium alloys from the system Mg-Zn-Ca-Mn. The experimental results showed that chemical conversion treatment with hydrofluoric acid is useful as a method of increasing corrosion resistance for the experimental magnesium alloys from the Mg-Zn-Ca-Mn system. Also, high surface free energy values obtained for the alloys treated with hydrofluoric acid correlated with wettability lead to the conclusion that there is an increased chance for biological factor adsorption and cell proliferation. Chemical conversion treatment with hydrofluoric acid is useful as a method of increasing corrosion resistance for the experimental Mg-Zn-Ca-Mn alloys.

In vitrocellular biocompatibility andin vivodegradation behavior of calcium phosphate-coated ZK60 magnesium alloy

Calcium phosphate (Ca-P) surface coating is a simple but effective way to enhance both corrosion resistance and biocompatibility of ZK60 magnesium alloy. However, cell compatibility on different Ca-P layers coated on ZK60 alloy has seldom been investigated. In this study, the effects of type, morphology and corrosion protection of several Ca-P coatings formed at pH 6.5, 7.8 and 10.2 on cell behavior were examined by using an osteoblastic cell line MC3T3-E1. Furthermore,in vivobehavior in rabbits of the alloy coated with the optimum Ca-P layer was also studied. It was found that the surface factors governed the cell morphology and density. The coating morphology plays a dominant role in these surface factors. The sample coated at pH 7.8 showed the best cellular biocompatibility, suggesting that the hydroxyapatite (HAp) layer formed at pH 7.8 was the optimum coating. In rabbits, this optimum coating enhanced remarkably the corrosion resistance of the alloy. During implantation, the outermost crystals of the HAp coating were shortened and thinned due to the dissolution of HAp caused by the body fluid of the rabbits. It is indicated that ZK60 alloy coated at pH 7.8 can be applied as a biodegradable implant.

Mg-based materials diminish tumor spreading and cancer metastases

Cancer metastases are the most common causes of cancer-related deaths. The formation of secondary tumors at different sites in the human body can impair multiple organ function and dramatically decrease the survival of the patients. In this stage, it is difficulty to treat tumor growth and spreading due to arising therapy resistances. Therefore, it is important to prevent cancer metastases and to increase subsequent cancer therapy success. Cancer metastases are conventionally treated with radiation or chemotherapy. However, these treatments elicit lots of side effects, wherefore novel local treatment approaches are currently discussed. Recent studies already showed anticancer activity of specially designed degradable magnesium (Mg) alloys by reducing the cancer cell proliferation. In this work, we investigated the impact of these Mg-based materials on different steps of the metastatic cascade including cancer cell migration, invasion, and cancer-induced angiogenesis. Both, Mg and Mg–6Ag reduced cell migration and invasion of osteosarcoma cells in coculture with fibroblasts. Furthermore, the Mg-based materials used in this study diminished the cancer-induced angiogenesis. Endothelial cells incubated with conditioned media obtained from these Mg and Mg–6Ag showed a reduced cell layer permeability, a reduced proliferation and inhibited cell migration. The tube formation as a last step of angiogenesis was stimulated with the presence of Mg under normoxia and diminished under hypoxia.

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Magnesium (Mg)-based material degradation decrease cell migration and invasion of an osteosarcoma coculture.

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Mg-based material degradation products reduce cancer-induced angiogenesis at an early stage.

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These materials may reduce secondary tumor formation and metastases.

The effect of medical biodegradable magnesium alloy in vivo degradation and bone response in a rat femur model with long-term fixation

BACKGROUND

It is of great significance to understand the effect of the different corrosion behaviors of magnesium (Mg) alloys manufactured using different casting methods and implanted with different methods on the long-term implantation to expand the application of Mg-based biomedical implants.

OBJECTIVE

The effects of four different casting and rolling speeds on the microstructure of an Mg-rare earth (Mg-Re) alloy were analyzed using electron backscatter diffraction (EBSD).

METHOD

Four Mg alloys were obtained using vertical two-roll casting (TRC) at 10 m/min, 16 m/min, 24 m/min, and 30 m/min, and their microstructure, corrosion behavior and bone reaction in vivo were studied.

RESULTS

The corrosion resistance of the alloy increases with an increase in casting speed and finer grain size of the cast-rolled parts. The Mg-Re alloys with TRC-10 m/min and TRC-30 m/min were selected for animal experiments. The two Mg alloys were made into metal rods and inserted into the rat femur to simulate the effect of Mg-Re on femoral healing under an injury condition. The rods were implanted for a long time to judge the effects of the Mg-Re alloy on the body. The TRC-30 m/min implants obtained highly mature new bone tissue in the case of bone injury.

CONCLUSION

The in vivo experiments showed that the corrosion resistance of the TRC-30 m/min implant was better than that of the TRC-10 m/min implant. After 32 weeks of implantation, there were no pathological changes in the liver, heart, or kidney of rats in the TRC-30 m/min group, and the cell structure was normal.

In-vivo bone remodeling potential of Sr-d-Ca-P /PLLA-HAp coated biodegradable ZK60 alloy bone plate

Magnesium and its alloys are widely applied biomaterials due to their biodegradability and biocompatibility. However, rapid degradation and hydrogen gas evolution hinder its applicability on a commercial scale. In this study, we developed an Mg alloy bone plate for bone remodeling and support after a fracture. We further coated the Mg alloy plate with Sr-D-Ca-P (Sr dopped Ca-P coating) and Sr-D-Ca-P/PLLA-HAp to evaluate and compare their biodegradability and biocompatibility in both in vitro and in vivo experiments. Chemical immersion and dip coating were employed for the formation of Sr-D-Ca-P and PLLA-HAp layers, respectively. In vitro evaluation depicted that both coatings delayed the degradation process and exhibited excellent biocompatibility. MC3T3-E1cells proliferation and osteogenic markers expression were also promoted. In vivo results showed that both Sr-D-Ca-P and Sr-D-Ca-P/PLLA-HAp coated bone plates had slower degradation rate as compared to Mg alloy. Remarkable bone remodeling was observed around the Sr-D-Ca-P/PLLA-HAp coated bone plate than bare Mg alloy and Sr-D-Ca-P coated bone plate. These results suggest that Sr-D-Ca-P/PLLA-HAp coated Mg alloy bone plate with lower degradation and enhanced biocompatibility can be applied as an orthopedic implant.

Dry Wear Behaviour of the New ZK60/AlN/SiC Particle Reinforced Composites

This study deals with the microstructure, mechanical, and wear properties of the extruded ZK60 matrix composites strengthened with 45 µm, 15% silicon carbide particle (SiC) and 760 nm, 0.2-0.5% aluminium nitride (AlN) nanoparticle reinforcements. First, the reinforcement elements of the composites, SiC and AlN mixtures were prepared in master-magnesium powder, and compacts were formed under 450 MPa pressure and then sintered. Second, the compacted reinforcing elements were placed into the ZK60 alloy matrix at the semi-solid melt temperature, and the melt was mixed by mechanical mixing. After the melts were mixed for 30 min and a homogeneous mixture was formed, the mixtures were poured into metal moulds and composite samples were obtained. After being homogenized for 24 h at 400 °C, the alloys were extruded with a 16:1 deformation ratio at 310 °C and a ram speed of 0.3 mm/s to create final composite samples. After microstructure characterization and hardness analysis, the dry friction behavior of all composite samples was investigated. Depending on the percentage ratios of SIC and AlN reinforcement elements in the matrix, it was seen that the compressive strength and hardness of the composites increased, and the friction coefficient decreased. While the wear rate of the unreinforced ZK60 alloy was 3.89 × 10^-5 g/m, this value decreased by 26.2 percent to 2.87 × 10^-5 g/m in the 0.5% AlN + 15% SiC reinforced ZK 60 alloy.

Laser Powder Bed Fusion Applied to a New Biodegradable Mg-Zn-Zr-Ca Alloy

The aim of the present paper is to apply the laser powder bed fusion process to a new biodegradable Mg-Zn-Zr-Ca alloy powder prepared via a mechanical alloying method from powder pure components. This additive manufacturing method is expected to allow for the obtaining of high biomechanical and biochemical performance. Various processing parameters for laser powder bed fusion are tested, with a special focus on laser energy density—E [J/mm³]—which is calculated for all experiment variants, and which represents an important processing parameter, dependent upon all the rest. The goal of all the trials is to find the most efficient schema for the production of small biodegradable parts for the medical domain, meaning the selection of optimal processing parameters. An important observation is that the most robust and homogeneous samples without cracks are obtained for lower values of the E, around 100 J/mm³. Thus, the most performant samples are analyzed by scanning electron microscopy, X-ray diffraction and by compression mechanical test.

Magnesium-Based Alloys Used in Orthopedic Surgery

Magnesium (Mg)-based alloys have become an important category of materials that is attracting more and more attention due to their high potential use as orthopedic temporary implants. These alloys are a viable alternative to nondegradable metals implants in orthopedics. In this paper, a detailed overview covering alloy development and manufacturing techniques is described. Further, important attributes for Mg-based alloys involved in orthopedic implants fabrication, physiological and toxicological effects of each alloying element, mechanical properties, osteogenesis, and angiogenesis of Mg are presented. A section detailing the main biocompatible Mg-based alloys, with examples of mechanical properties, degradation behavior, and cytotoxicity tests related to in vitro experiments, is also provided. Special attention is given to animal testing, and the clinical translation is also reviewed, focusing on the main clinical cases that were conducted under human use approval.

Fabrication and Properties of Zn-3Mg-1Ti Alloy as a Potential Biodegradable Implant Material

A Zn-3Mg-1Ti alloy was fabricated by ultrasonic treatment of Zn-Mg alloy melt using a Ti ultrasonic radiation rod. The microstructure, phase structure, mechanical properties, degradation property, and in vitro cytotoxicity were investigated systematically. The obtained Zn-3Mg-1Ti alloy is composed of the Zn, Mg₂Zn₁₁, and TiZn₁₆. Owing to the grain refinement and second phase reinforcement, the mechanical properties of Zn-3Mg-1Ti alloy is improved. In addition, the Zn-3Mg-1Ti alloy exhibits minimal cytotoxicity compared to pure Zn and Zn-1Ti alloy. Electrochemical tests show that the Zn-3Mg-1Ti alloy has an appropriate degradation rate in Hank’s solution.

On the Corrosion Fatigue of Magnesium Alloys Aimed at Biomedical Applications: New Insights from the Influence of Testing Frequency and Surface Modification of the Alloy ZK60

Magnesium alloys are contemporary candidates for many structural applications of which medical applications, such as bioresorbable implants, are of significant interest to the community and a challenge to materials scientists. The generally poor resistance of magnesium alloys to environmentally assisted fracture, resulting, in particular, in faster-than-desired bio-corrosion degradation in body fluids, strongly impedes their broad uptake in clinical practice. Since temporary structures implanted to support osteosynthesis or healing tissues may experience variable loading, the resistance to bio-corrosion fatigue is a critical issue that has yet to be understood in order to maintain the structural integrity and to prevent the premature failure of implants. In the present communication, we address several aspects of the corrosion fatigue behaviour of magnesium alloys, using the popular commercial ZK60 Mg-Zn-Zr alloy as a representative example. Specifically, the effects of the testing frequency, surface roughness and metallic coatings are discussed in conjunction with the fatigue fractography after the testing of miniature specimens in air and simulated body fluid. It is demonstrated that accelerated environmentally assisted degradation under cyclic loading occurs due to a complicated interplay between corrosion damage, stress corrosion cracking and cyclic loads. The occurrence of corrosion fatigue in Mg alloys is exaggerated by the significant sensitivity to the testing frequency. The fatigue life or strength reduced remarkably with a decrease in the test frequency.

In vitro and in vivo assessment of biocompatibility of AZ31 alloy as biliary stents: a preclinical approach

INTRODUCTION

Biomaterial technology due to its lack of or minimal side effects in tissues has great potential. Traditionally biomaterials used were cobalt-chromium, stainless steel and nitinol alloys. Biomaterials such as magnesium (Mg) and zinc (Zn) have good biocompatibility and consequently can be a potential material for medical implants. To date, the effects of AZ31 alloy stent on cell apoptosis are still unclear. The current investigation was designed to determine the effect of AZ31 alloy stent on necrosis and apoptosis of common bile duct (CBD) epithelial cells.

MATERIAL AND METHODS

We experimented with application of different concentrations of AZ31 alloy stent to primary mouse extrahepatic bile epithelial cells (MEBECs) and estimated the effect on apoptosis and necrotic cells. Apoptosis and pro-apoptosis expression were estimated through real-time PCR. For in vivo protocol, we used rabbits, implanted the AZ31 bile stent, and estimated its effect on the CBD. AZ31 (40%) concentration showed an effect on the apoptotic and necrotic cells.

RESULTS

Real-time PCR revealed that AZ31 (40%) concentration increased the apoptotic genes such as NF-κB, caspase-3, Bax and Bax/Bcl-2 ratio as compared to the control group. In the in vivo experiment, AZ31 alloy stents were implanted into the CBD and showed an effect on the alteration the hematological, hepatic and non-hepatic parameters.

CONCLUSIONS

To conclude, it can be stated that AZ31 induces apoptosis via alteration in genes including nuclear factor kappa-B (NF-κB), caspase-3, Bax and Bax/Bcl-2 ratio and improved the hematological, hepatic and non-hepatic parameters.

Laser machined micropatterns as corrosion protection of both hydrophobic and hydrophilic magnesium

Magnesium and its alloys are promising candidate materials for medical implants because they possess excellent biocompatibility and mechanical properties comparable to bone. Furthermore, secondary surgical operations for removal could be eliminated due to magnesium's biodegradability. However, magnesium's degradation rate in aqueous environments is too high for most applications. It has been reported that hydrophobic textured surfaces can trap a surface gas layer which acts as a protective barrier against corrosion. However, prior studies have not investigated separately the role of the texture and hydrophobic treatments on magnesium corrosion rates. In this study, pillar-shaped microstructure patterns were fabricated on polished high purity magnesium surfaces by ablation with a picosecond laser. Some micropatterned samples were further processed by stearic acid modification (SAM). Micropatterned surfaces with SAM had hydrophobic properties with water droplet contact angles greater than 130°, while the micropatterned surfaces without SAM remained hydrophilic. The corrosion properties of textured and smooth magnesium surfaces in saline solution were investigated using electrochemical impedance spectroscopy (EIS) and optical microscopy. Corrosion rates on both hydrophobic and hydrophilic laser machined surfaces were reduced ∼90% relative to polished surfaces. Surprisingly, corrosion rates were similar for both hydrophobic and hydrophilic surfaces. Indirect evidence of local alkalization near microstructures was found and was hypothesized to stabilize the Mg(OH)₂ layer, thereby inhibiting corrosion on hydrophilic surfaces. This is different than the corrosion resistance mechanism for superhydrophobic surfaces which makes use of gas adhesion at the liquid solid interface. These results suggest additional processing to render the magnesium hydrophobic is not necessary since it does not significantly enhance the corrosion resistance beyond what is conferred by micropatterned textures.

Biodegradable shape memory alloys: Progress and prospects

Shape memory alloys (SMAs) have a wide range of potential novel medical applications due to their superelastic properties and ability to restore and retain a 'memorised' shape. However, most SMAs are permanent and do not degrade in the body when used in implantable devices. The use of non-degrading metals may lead to the requirement for secondary removal surgery and this in turn may introduce both short and long-term health risks, or additional waste disposal requirements. Biodegradable SMAs can effectively eliminate these issues by gradually degrading inside the human body while providing the necessary support for healing purposes, therefore significantly alleviating patient discomfort and improving healing efficiency. This paper reviews the current progress in biodegradable SMAs from the perspective of biodegradability, mechanical properties, and biocompatibility. By providing insights into the status of SMAs and biodegradation mechanisms, the prospects for Mg- and Fe-based biodegradable SMAs to advance biodegradable SMA-based medical devices are explored. Finally, the remaining challenges and potential solutions in the biodegradable SMAs area are discussed, providing suggestions and research frameworks for future studies on this topic.

Enhanced Corrosion Resistance and In Vitro Biocompatibility of Mg-Zn Alloys by Carbonate Apatite Coating

B-type carbonate apatite (CAp) coatings were formed on as-cast and T4-treated Mg-xZn (x = 1, 5, and 7 wt %) alloys containing various sized Zn-rich second phase to improve the corrosion resistance and biocompatibility. The CAp coating grew uniformly on the alloys with a thickness of 1.1-1.3 μm and did not show cracks or pores on 30 μm-sized second-phase particles. The CAp coating retarded corrosion of Mg-Zn substrates for the first 3-5 days in Hanks' solution. Polarization resistance of the CAp-coated alloys was 10-90 and 1-70 times higher than the uncoated and hydroxyapatite (HAp)-coated alloys, respectively. The corrosion rate of CAp-coated alloys was greatly affected by the substrate alloys once the coatings were partly broken. The CAp-coated alloys showed 40-60 and 25-45% lower 14-day average corrosion rates than the uncoated and HAp-coated alloys, respectively, in the immersion test. The CAp coating significantly enhanced the viability of osteoblastic MC3T3-E1 cells on the Mg-Zn alloys for 72 h compared to the uncoated and HAp-coated alloys. The cell densities on CAp-coated alloys were similar for 72 h regardless of substrate alloys. Therefore, the CAp coating can be a superior coating candidate for corrosion-control and biocompatibility improvement for biodegradable Mg alloys.

In vitro and in vivo degradation assessment and preventive measures of biodegradable Mg alloys for biomedical applications

Magnesium (Mg) and its alloys have been widely explored as a potential biodegradable implant material. However, the fast degradation of Mg-based alloys under physiological environment has hindered their widespread use for implant applications till date. The present review focuses on in vitro and in vivo degradation of biodegradable Mg alloys, and preventive measures for biomedical applications. Initially, the corrosion assessment approaches to predict the degradation behavior of Mg alloys are discussed along with the measures to control rapid corrosion. Furthermore, this review attempts to explore the correlation between in vitro and in vivo corrosion behavior of different Mg alloys. It was found that the corrosion depends on experimental conditions, materials and the results of different assessment procedures hardly matches with each other. It has been demonstrated the corrosion rate of magnesium can be tailored by alloying elements, surface treatments and heat treatments. Various researches also studied different biocompatible coatings such as dicalcium phosphate dihydrate (DCPD), β-tricalcium phosphate (β-TCP), hydroxyapatite (HA), polycaprolactone (PCL), polylactic acid (PLA), and so on, on Mg alloys to suppress rapid degradation and examine their influence on new bone regeneration as well. This review shows the need for a standard method of corrosion assessment to predict the in vivo corrosion rate based on in vitro data, and thus reducing the in vivo experimentation.

Zinc and cerium synergistically enhance the mechanical properties, corrosion resistance, and osteogenic activity of magnesium as resorbable biomaterials

Magnesium and its alloys have the potential to serve as a revolutionary class of biodegradable materials, specifically in the field of degradable implants for orthopedics. However, the corrosion rate of commercially pure magnesium is high and does not match the rate of regeneration of bone tissues. In this work, magnesium alloys containing zinc and cerium, either alone or in combination, were investigated and compared with commercially-pure magnesium as biomaterials. The microstructure, mechanical properties, corrosion resistance, and response of osteoblastsin vitrowere systematically assessed. Results reveal that alloying with Ce results in grain refinement and weakening of texture. The tensile test revealed that the ternary alloy offered the best combination of elastic modulus (41.1 ± 0.5 GPa), tensile strength (234.5 ± 4.5 MPa), and elongation to break (17.1 ± 0.4%). The ternary alloy was also the most resistant to corrosion (current of 0.85 ± 0.05 × 10^-4A cm^-2) in simulated body fluid than the other alloys. The response of MC3T3-E1 cellsin vitrorevealed that the ternary alloy imparts minimal cytotoxicity. Interestingly, the ternary alloy was highly efficient in supporting osteogenic differentiation, as revealed by the expression of alkaline phosphatase and calcium deposition. In summary, the extruded Mg alloy containing both Zn and Ce exhibits a combination of mechanical properties, corrosion resistance, and cell response that is highly attractive for engineering biodegradable orthopedic implants.

Microstructure and Corrosion of Cast Magnesium Alloy ZK60 in NaCl Solution

In this work, the effects of the microstructure and phase constitution of cast magnesium alloy ZK60 (Mg-5.8Zn-0.57Zr, element concentration in wt.%) on the corrosion behavior in aqueous NaCl (0.1 mol dm⁻³) were investigated by weight-loss measurements, hydrogen evolution tests, and electrochemical techniques. The alloy was found to be composed of α-Mg matrix, with large second-phase particles of MgZn₂ deposited along grain boundaries and a Zr-rich region in the central area of the grains. The large second-phase particles and the Zr-rich regions were more stable than the Mg matrix, resulting in a strong micro-galvanic effect. A filiform corrosion was found. It originated from the second-phase particles in the grain boundary regions in the early corrosion period. The filaments gradually occupied most areas of the alloy surface, and the general corrosion rate decreased significantly. Corrosion pits were developed under filaments. The pit growth rate decreased over time; however, it was about eight times larger than the general corrosion rate. A schematic model is presented to illustrate the corrosion mechanism.

Bioabsorbable Osteofixation Materials for Maxillofacial Bone Surgery: A Review on Polymers and Magnesium-Based Materials

Clinical application of osteofixation materials is essential in performing maxillofacial surgeries requiring rigid fixation of bone such as trauma surgery, orthognathic surgery, and skeletal reconstruction. In addition to the use of titanium plates and screws, clinical applications and attempts using bioabsorbable materials for osteofixation surgery are increasing with demands to avoid secondary surgery for the removal of plates and screws. Synthetic polymeric plates and screws were developed, reaching satisfactory physical properties comparable to those made with titanium. Although these polymeric materials are actively used in clinical practice, there remain some limitations to be improved. Due to questionable physical strength and cumbersome molding procedures, interests in resorbable metal materials for osteofixation emerged. Magnesium (Mg) gained attention again in the last decade as a new metallic alternative, and numerous animal studies to evaluate the possibility of clinical application of Mg-based materials are being conducted. Thanks to these researches and studies, vascular application of Mg-based biomaterials was successful; however, further studies are required for the clinical application of Mg-based biomaterials for osteofixation, especially in the facial skeleton. The review provides an overview of bioabsorbable osteofixation materials in maxillofacial bone surgery from polymer to Mg.

Recent Developments in Magnesium Metal-Matrix Composites for Biomedical Applications: A Review

Recently, there is a growing interest in developing magnesium (Mg) based degradable biomaterial. Although corrosion is a concern for Mg, other physical properties, such as low density and Young's modulus, combined with good biocompatibility, lead to significant research and development in this area. To address the issues of corrosion and low yield strength of pure Mg, several approaches have been adopted, such as, composite preparation with suitable bioactive reinforcements, alloying, or surface modifications. This review specifically focuses on recent developments in Mg-based metal matrix composites (MMCs) for biomedical applications. Much effort has gone into finding suitable bioactive, bioresorbable reinforcements and processing techniques that can improve upon existing materials. In summary, this review provides a comprehensive overview of existing Mg-based composite preparation and their mechanical and corrosion properties and biological responses and future perspectives on the development of Mg-based composite biomaterials.

Optimizing an Osteosarcoma-Fibroblast Coculture Model to Study Antitumoral Activity of Magnesium-Based Biomaterials

Osteosarcoma is among the most common cancers in young patients and is responsible for one-tenth of all cancer-related deaths in children. Surgery often leads to bone defects in excised tissue, while residual cancer cells may remain. Degradable magnesium alloys get increasing attention as orthopedic implants, and some studies have reported potential antitumor activity. However, most of the studies do not take the complex interaction between malignant cells and their surrounding stroma into account. Here, we applied a coculture model consisting of green fluorescent osteosarcoma cells and red fluorescent fibroblasts on extruded Mg and Mg-6Ag with a tailored degradation rate. In contrast to non-degrading Ti-based material, both Mg-based materials reduced relative tumor cell numbers. Comparing the influence of the material on a sparse and dense coculture, relative cell numbers were found to be statistically different, thus relevant, while magnesium alloy degradations were observed as cell density-independent. We concluded that the sparse coculture model is a suitable mechanistic system to further study the antitumor effects of Mg-based material.

Biodegradable Magnesium Alloy (ZK60) with a Poly(l-lactic)-Acid Polymer Coating for Maxillofacial Surgery

The purpose of this study was to evaluate the mechanical strength and biodegradation of a ZK60 plate coated with poly(l-lactic)-acid polymer (PLLA) in a LeFort I osteotomy canine model for maxillofacial applications. The PLLA-coated ZK60 plate and screw were evaluated using a LeFort I osteotomy canine model based on five beagles. The presence of wound dehiscence, plate exposure, gas formation, inflammation, pus formation, occlusion, food intake, and fistula formation were evaluated. After 12 weeks, these dogs were sacrificed, and an X-ray micro-computed tomography (µCT) was conducted. Plate exposure, gas formation, and external fistula were not observed, and the occlusion remained stable. Wound dehiscence did not heal for 12 weeks. CT images did not show plates in all the five dogs. A few screw bodies fixed in the bone remained, and screw heads were completely absorbed after 12 weeks. These findings may be attributed to the inability to optimize the absorption rate with PLLA coating. Rapid biodegradation of the PLLA-coated ZK60 occurred due to the formation of microcracks during the bending process. Further improvement to the plate system with PLLA-coated ZK60 is required using other surface coating methods or alternative Mg alloys.

In vitro immunomodulation of magnesium on monocytic cell toward anti-inflammatory macrophages

Biodegradable magnesium (Mg) has shown great potential advantages over current bone fixation devices and vascular scaffold technologies; however, there are few reports on the immunomodulation of corrosive Mg products, the micron-sized Mg particles (MgMPs). Human monocytic leukemia cell line THP-1 was set as the in vitro cell model to estimate the immunomodulation of MgMPs on cell proliferation, apoptosis, polarization and inflammatory reaction. Our results indicated high-concentration of Mg²⁺ demoted the proliferation of the THP-1 cells and, especially, THP-1-derived macrophages, which was a potential factor that could affect cell function, but meanwhile, cell apoptosis was almost not affected by Mg²⁺. In particular, the inflammation regulatory effects of MgMPs were investigated. Macrophages exposed to Mg²⁺ exhibited down-regulated expressions of M1 subtype markers and secretions of pro-inflammatory cytokines, up-regulated expression of M2 subtype marker and secretion of anti-inflammatory cytokine. These results indicated Mg²⁺ could convert macrophages from M0 to M2 phenotype, and the bioeffects of MgMPs on human inflammatory cells were most likely due to the Mg²⁺-induced NF-κB activation reduction. Together, our results proved Mg²⁺ could be used as a new anti-inflammatory agent to suppress inflammation in clinical applications, which may provide new ideas for studying the immunomodulation of Mg-based implants on human immune system.

Enhanced corrosion resistance and bioactivity of Mg alloy modified by Zn-doped nanowhisker hydroxyapatite coatings

In this work, Zn is doped into a hydroxyapatite coating on the surface of ZK60 magnesium alloys using a one-pot hydrothermal method to obtain a corrosion-resistant implant with abilities of osteogenic differentiation and bacterial inhibition. With the addition of Zn, the morphology changes with a nanowhisker structure appearing on the coating. Electrochemical measurements show that the nanowhisker hydroxyapatite coating provides a high corrosion resistance. Compared with hydroxyapatite coating, the nanowhisker coating not only effectively inhibits bacteria, but also promotes the adhesion and differentiation of rat bone marrow mesenchymal stem cells at appropriate Zn concentrations. In conclusion, a novel nanowhisker structure prepared by a single variable Zn doping can significantly improve the corrosion resistance and biological activity of hydroxyapatite coatings.

Response of inflammatory cells to biodegradable ultra-fine grained Mg-based composites

Ultra-fine grained biodegradable Mg-based Mg1Zn1Mn0.3 Zr - HA and Mg4Y5.5Dy0.5 Zr - 45S5 Bioglass composites have shown great medical potential. Two types of these Mg-based biomaterials subjected to different treatments were tested and as shown earlier they are biocompatible. The aim of the study is to determine how much culture media incubated with these ultra-fine trained Mg-based composites can cause inflammatory reactions and /or periodontal cell death. The incubation of composites in the medium releases metal ions into the solution. It can be assumed that this process is permanent and also occurs in the human body. The results have shown that the effect of proinflammatory IL-6 and TNF- cytokines results in the strongest production of the acute phase proteins in the first day on the Mg1Zn1Mn0.3 Zr-5 wt.% HA-1 wt. % Ag HF-treated biocomposite after immersion for 2 h in 40 % HF and then the fastest decrease in these processes on the third day. In turn, the inflammatory process induced on the Mg1Zn1Mn0.3 Zr-5 wt.% HA-1 wt. % Ag biomaterial, in BAX / BCL ratio assessment, is the strongest on the third day and maintains a significantly high level on the following day, which, at the same time, confirms its persistence and development. In addition, these results confirm the successively generated necrotic processes. Ions can induce inflammatory reactions, which in the case of the implant may take a long time, which results in the loss of the implant. Even if the material is biocompatible in rapid in-vitro tests, it can induce inflammation in the body after some time due to the release of ions. Not every treatment improves the material's properties in terms of subsequent safety.

Microstructure, mechanical, corrosion properties and cytotoxicity of beta‑calcium polyphosphate reinforced ZK61 magnesium alloy composite by spark plasma sintering

Magnesium alloy (ZK61) and beta-tricalcium phosphate (β-TCP) composite ZK61/xβ-TCP (x = 0, 5, 10, 15 wt%) are fabricated using spark plasma sintering (SPS). In this study, the microstructure, mechanical properties, degradation behavior in simulated body fluid and cytotoxicity tests of composite were investigated. The results show that when the content of β-TCP was 5 wt%, which could be evenly distributed on the boundary of ZK61 particles. But agglomeration phenomenon appeared when the content of β-TCP reached 15 wt%. The hardness and the compressive strength increase with increasing of β-TCP content, and ZK61/15β-TCP achieves a maximum Vickers hardness of 94.81 HV_0.1 and compressive strength of 402 ± 9 MPa. The immersion tests indicate that corrosion resistance of the composites are better than that of ZK61 matrix, especially ZK61/5β-TCP. Corrosion products of the composite surface are mainly Mg(OH)₂, HA and Ca₃(PO₄)₂. The cytotoxicity tests indicate that composite extracts have no toxicity to L-929 cells. These results suggest that ZK61/xβ-TCP composites are promising candidate for degradable implant materials.

In vitro and in vivo analysis of the biodegradable behavior of a magnesium alloy for biomedical applications

The present study was designed to investigate the biodegradation behavior of Mg alloy plates in the maxillofacial region. For in vitro analysis, the plates were immersed in saline solution and simulated body fluid. For in vivo, the plates were implanted into the tibia, head, back, abdominal cavity, and femur and assessed at 1, 2, and 4 weeks after implantation. After implantation, the plate volumes and the formed insoluble salt were measured via micro-computed tomography. SEM/EDX analysis of the insoluble salt and histological analysis of the surrounding tissues were performed. The volume loss of plates in the in vitro groups was higher than that in the in vivo groups. The volume loss was fastest in the abdomen, followed by the head, back, tibia, and femur. There were no statistically significant differences in the insoluble salt volume of the all implanted sites. The corrosion of the Mg alloy will be affected to the surrounding tissue responses. The material for the plate should be selected based on the characteristic that Mg alloys are decomposed relatively easily in the maxillofacial region.

The current trends of Mg alloys in biomedical applications-A review

Magnesium (Mg) has emerged as an ideal alternative to the permanent implant materials owing to its enhanced properties such as biodegradation, better mechanical strengths than polymeric biodegradable materials and biocompatibility. It has been under investigation as an implant material both in cardiovascular and orthopedic applications. The use of Mg as an implant material reduces the risk of long-term incompatible interaction of implant with tissues and eliminates the second surgical procedure to remove the implant, thus minimizes the complications. The hurdle in the extensive use of Mg implants is its fast degradation rate, which consequently reduces the mechanical strength to support the implant site. Alloy development, surface treatment, and design modification of implants are the routes that can lead to the improved corrosion resistance of Mg implants and extensive research is going on in all three directions. In this review, the recent trends in the alloying and surface treatment of Mg have been discussed in detail. Additionally, the recent progress in the use of computational models to analyze Mg bioimplants has been given special consideration. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1970-1996, 2019.

Ag-Introduced Antibacterial Ability and Corrosion Resistance for Bio-Mg Alloys

Bone implants are expected to possess antibacterial ability and favorable biodegradability. Ag possesses broad-spectrum antibacterial effects through destroying the respiration and substance transport of bacteria. In this study, Ag was introduced into Mg-3Zn-0.5Zr (ZK30) via selective laser melting technology. Results showed that ZK30-Ag exhibited a strong and stable antibacterial activity against the bacterium Escherichia coli. Moreover, the degradation resistance was enhanced due to the comprehensive effect of positive shifted corrosion potential (from -1.64 to -1.53 V) and grains refinement. The positive shifted corrosion potential reduced the severe galvanic corrosion by lowering the corrosion potential difference between the matrix and the second phase. Meanwhile, the introduction of Ag caused the grain refinement strengthening and precipitated-phase strengthening, resulting in improved compressive yield strength and hardness. Furthermore, ZK30-0.5Ag exhibited good biocompatibility. It was suggested that Ag-modified ZK30 was potential candidate for bone implants.

Magnesium degradation under physiological conditions - Best practice

This review focusses on the application of physiological conditions for the mechanistic understanding of magnesium degradation. Despite the undisputed relevance of simplified laboratory setups for alloy screening purposes, realistic and predictive in vitro setups are needed. Due to the complexity of these systems, the review gives an overview about technical measures, defines some caveats and can be used as a guideline for the establishment of harmonized laboratory approaches.

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Physiological conditions are mandatory for mechanistic understanding of magnesium degradation.

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Guidelines and caveats for experimental setups are reviewed.

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Media composition is essential for reliable experiments.

A feasibility study of using biodegradable magnesium alloy in glaucoma drainage device

Technological advances in glaucoma have challenged the traditional treatment paradigm. Historically incisional surgery has been used in cases of advanced disease and/or uncontrolled intraocular pressures resistant to medical or laser interventions. More recently, perhaps due to advancements in imaging, surgery has been suggested to be beneficial earlier in the treatment paradigm. Despite these trends, surgical manipulation of the tissues and unpredictability of wound healing continue to result in surgical failure. Magnesium is an essential element for human body and plays a critically important role in maintaining the functional and structural integrity of several tissues, including the eye. Due to several of its advantageous properties such as non-toxicity, biodegradability, and high biological compatibility, magnesium alloy has attracted great attention as a novel biomaterial. Biodegradable cardiovascular stents made of magnesium alloy have already been introduced into clinical practice. The purpose of this review is to determine if bioabsorbable magnesium alloys can be utilized as a promising candidate for the development of a new generation of glaucoma surgical assistive devices.

The influence of biodegradable magnesium implants on the growth plate

Mg-based biodegradable materials are considered promising candidates in the paediatric field due to their favourable mechanical and biological properties and their biodegrading potential that makes a second surgery for implant removal unnecessary. In many cases the surgical fixation technique requires a crossing of the growth plate by the implant in order to achieve an adequate fragment replacement or fracture stabilisation. This study investigates the kinetics of slowly and rapidly degrading Mg alloys in a transphyseal rat model, and also reports on their dynamics in the context of the physis and consecutive bone growth. Twenty-six male Sprague-Dawley rats received either a rapidly degrading (ZX50; n = 13) or a slowly degrading (WZ21; n = 13) Mg alloy, implanted transphyseal into the distal femur. The contralateral leg was drilled in the same manner and served as a direct sham specimen. Degradation behaviour, gas formation, and leg length were measured by continuous in vivo micro CT for up to 52 weeks, and additional high-resolution µCT (HRS) scans and histomorphological analyses of the growth plate were performed. The growth plate was locally destroyed and bone growth was significantly diminished by the fast degradation of ZX50 implants and the accompanying release of large amounts of hydrogen gas. In contrast, WZ21 implants showed homogenous and moderate degradation performance, and the effect on bone growth did not differ significantly from a single drill-hole defect.

STATEMENT OF SIGNIFICANCE

This study is the first that reports on the effects of degrading magnesium implants on the growth plate in a living animal model. The results show that high evolution of hydrogen gas due to rapid Mg degradation can damage the growth plate substantially. Slow degradation, however, such as seen for WZ21 alloys, does not affect the growth plate more than drilling alone, thus meeting one important prerequisite for deployment in paediatric osteosynthesis.

Biodegradable Magnesium Alloys Developed as Bone Repair Materials: A Review

Bone repair materials are rapidly becoming a hot topic in the field of biomedical materials due to being an important means of repairing human bony deficiencies and replacing hard tissue. Magnesium (Mg) alloys are potentially biocompatible, osteoconductive, and biodegradable metallic materials that can be used in bone repair due to their in situ degradation in the body, mechanical properties similar to those of bones, and ability to positively stimulate the formation of new bones. However, rapid degradation of these materials in physiological environments may lead to gas cavities, hemolysis, and osteolysis and thus, hinder their clinical orthopedic applications. This paper reviews recent work on the use of Mg alloy implants in bone repair. Research to date on alloy design, surface modification, and biological performance of Mg alloys is comprehensively summarized. Future challenges for and developments in biomedical Mg alloys for use in bone repair are also discussed.

Biodegradation behavior of magnesium and ZK60 alloy in artificial urine and rat models

In this work, the biodegradable and histocompatibility properties of pure Mg and ZK60 alloy were investigated as new temporary implants for urinary applications. The corrosion mechanism in artificial urine was proposed using electrochemical impedance spectroscopy and potentiodynamic polarization tests. The corrosion potential of pure magnesium and ZK60 alloy were −1820 and −1561 mV, respectively, and the corrosion current densities were 59.66 ± 6.41 and 41.94 ± 0.53 μA cm⁻², respectively. The in vitro degradation rates for pure Mg and ZK60 alloy in artificial urine were 0.382 and 1.023 mm/y, respectively, determined from immersion tests. The ZK60 alloy degraded faster than the pure Mg in both artificial urine and in rat bladders (the implants of both samples are ø 3 mm × 5 mm). Histocompatibility evaluations showed good histocompatibility for the pure Mg and ZK60 alloy during the 3 weeks post-implantation in rat bladders, and no harm was observed in the bladder, liver and kidney tissues. The results provide key information on the degradation properties and corrosion mechanism of pure Mg and ZK60 alloy in the urinary system.

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ZK60 obtained loose corrosion product layer with poor corrosion resistance in AU.

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ZK60 showed a faster degradation rate than Mg in artificial urine and bladder of rat.

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Mg and ZK60 alloy showed good histocompatibility for the bladder model of rat.

Magnesium-based biodegradable alloys: Degradation, application, and alloying elements

In recent years, the paradigm about the metal with improved corrosion resistance for application in surgery and orthopedy was broken. The new class of biodegradable metal emerges as an alternative for biomedical implants. These metals corrode gradually with an appropriate host response and release of corrosion products. And it is absolutely necessary to use essential metals metabolized by hosting organism with local and general nontoxic effect. Magnesium serves this aim best; it plays the essential role in body metabolism and should be completely excreted within a few days after degradation. This review summarizes data from Mg discovery and its first experimental and clinical application of modern concept of Mg alloy development. We focused on biodegradable metal application in general surgery and orthopedic practice and showed the advantages and disadvantages Mg alloys offer. We focused on methods of in vitro and in vivo investigation of degradable Mg alloys and correlation between these methods. Based on the observed data, a better way for new alloy pre-clinical investigation is suggested. This review analyzes possible alloying elements that improve corrosion rate, mechanical properties, and gives the appropriate host response.

Magnesium-based biodegradable alloys: Degradation, application, and alloying elements

In recent years, the paradigm about the metal with improved corrosion resistance for application in surgery and orthopedy was broken. The new class of biodegradable metal emerges as an alternative for biomedical implants. These metals corrode gradually with an appropriate host response and release of corrosion products. And it is absolutely necessary to use essential metals metabolized by hosting organism with local and general nontoxic effect. Magnesium serves this aim best; it plays the essential role in body metabolism and should be completely excreted within a few days after degradation. This review summarizes data from Mg discovery and its first experimental and clinical application of modern concept of Mg alloy development. We focused on biodegradable metal application in general surgery and orthopedic practice and showed the advantages and disadvantages Mg alloys offer. We focused on methods of in vitro and in vivo investigation of degradable Mg alloys and correlation between these methods. Based on the observed data, a better way for new alloy pre-clinical investigation is suggested. This review analyzes possible alloying elements that improve corrosion rate, mechanical properties, and gives the appropriate host response.

Cytocompatibility and early inflammatory response of human endothelial cells in direct culture with Mg-Zn-Sr alloys

Crystalline Mg-Zinc (Zn)-Strontium (Sr) ternary alloys consist of elements naturally present in the human body and provide attractive mechanical and biodegradable properties for a variety of biomedical applications. The first objective of this study was to investigate the degradation and cytocompatibility of four Mg-4Zn-xSr alloys (x=0.15, 0.5, 1.0, 1.5wt%; designated as ZSr41A, B, C, and D respectively) in the direct culture with human umbilical vein endothelial cells (HUVEC) in vitro. The second objective was to investigate, for the first time, the early-stage inflammatory response in cultured HUVECs as indicated by the induction of vascular cellular adhesion molecule-1 (VCAM-1). The results showed that the 24-h in vitro degradation of the ZSr41 alloys containing a β-phase with a Zn/Sr at% ratio ∼1.5 was significantly faster than the ZSr41 alloys with Zn/Sr at% ∼1. Additionally, the adhesion density of HUVECs in the direct culture but not in direct contact with the ZSr41 alloys for up to 24h was not adversely affected by the degradation of the alloys. Importantly, neither culture media supplemented with up to 27.6mM Mg2+ ions nor media intentionally adjusted up to alkaline pH 9 induced any detectable adverse effects on HUVEC responses. In contrast, the significantly higher, yet non-cytotoxic, Zn2+ ion concentration from the degradation of ZSr41D alloy was likely the cause for the initially higher VCAM-1 expression on cultured HUVECs. Lastly, analysis of the HUVEC-ZSr41 interface showed near-complete absence of cell adhesion directly on the sample surface, most likely caused by either a high local alkalinity, change in surface topography, and/or surface composition. The direct culture method used in this study was proposed as a valuable tool for studying the design aspects of Zn-containing Mg-based biomaterials in vitro, in order to engineer solutions to address current shortcomings of Mg alloys for vascular device applications.

STATEMENT OF SIGNIFICANCE

Magnesium (Mg) alloys specifically designed for biodegradable implant applications have been the focus of biomedical research since the early 2000s. Physicochemical properties of Mg alloys make these metallic biomaterials excellent candidates for temporary biodegradable implants in orthopedic and cardiovascular applications. As Mg alloys continue to be investigated for biomedical applications, it is necessary to understand whether Mg-based materials or the alloying elements have the intrinsic ability to direct an immune response to improve implant integration while avoiding cell-biomaterial interactions leading to chronic inflammation and/or foreign body reactions. The present study utilized the direct culture method to investigate for the first time the in vitro transient inflammatory activation of endothelial cells induced by the degradation products of Zn-containing Mg alloys.

Cytocompatibility of magnesium and AZ31 alloy with three types of cell lines using a direct in vitro method

Magnesium alloys have been investigated by many researchers as a new absorbable biomaterial owing to their excellent degradability with non-maleficence or low-maleficence in living tissues. In the present work, the in vitro cytocompatibility of an Magnesium alloy was investigated by culturing cells directly on it. Investigations were carried out in terms of the cell viability along with the use of scanning electron microscopy to observe its morphology. The cell lines used were derived from fibroblast, endothelial, and smooth muscle cells. Pure magnesium and AZ31 alloy composed of magnesium (96 %), aluminum (3 %), and zinc (1 %) were adopted as models. The viability of cells on the metal samples and on the margin area of a multi-well plate was investigated. For direct culturing on metal, a depression in the viability and morphologically stressed cells were observed. In addition, the cell viability was also depressed for the margin area. To clarify the factors causing the negative effects, the amount of eluted metal ions and pH changes in the medium because of the erosion of the Magnesium samples were investigated, together with the cytotoxicity of sole metal ions corresponding to the composition of the metals. It was found that Mg(2+), Zn(2+), and Al(3+) ions were less toxic at the investigated concentrations, and that these factors will not produce negative effects on cells. Consequently, these factors cannot fully explain the results.

In vivo assessment of a new multifunctional coating architecture for improved Mg alloy biocompatibility

Magnesium alloys are regarded as potential biodegradable load-bearing biomaterials for orthopedic applications due to their physico-chemical and biomechanical properties. However, their clinical applicability is restricted by their high degradation rate, which limits the physiological reconstruction of the neighbouring tissues. In this work, a multifunctional coating architecture was developed on an AZ31 alloy by conjoining an anodization process with the deposition of a polymeric-based layer consisting of polyether imine reinforced with hydroxyapatite nanoparticles, aiming at improved control of the corrosion activity and biological performance of the Mg substrate. Anodization and coating protocols were evaluated either independently or combined for corrosion resistance and biological behaviour, i.e. the irritation potential and angiogenic capability within a chicken chorioallantoic membrane assay, and bone tissue response following tibia implantation within a rabbit model. Electrochemical impedance spectroscopy (EIS) analysis showed that coated Mg constructs, particularly anodized plus coated with AZ31, exhibited excellent stability compared to the anodized alloy and, particularly, to the bare AZ31. Microtomographic evaluation of the implanted samples correlated with these degradation results. Mg constructs displayed a non-irritating behaviour, and were associated with high levels of vascular ingrowth. Bone ingrowth neighbouring the implanted constructs was observed for all samples, with coated and anodized plus coated samples presenting the highest bone formation. Gene expression analysis suggested that the enhanced bone tissue formation was associated with the boost in osteogenic activity through Runx2 upregulation, following the activation of PGC-1α/ERRα signaling. Overall, the developed multifunctional coatings appear to be a promising strategy to obtain safe and bioactive biodegradable Mg-based implants with potential applications within bone tissue.