Osseointegration behavior of novel Ti-Nb-Zr-Ta-Si alloy for dental implants: an in vivo study

A Review of Past Research and Some Future Perspectives Regarding Titanium Alloys in Biomedical Applications

This review paper provides a comprehensive synthesis of the current advancements in investigations of different titanium-based alloys, including pure titanium, commercially available Ti6Al4V, and modified alloys, such as Ti-Nb-Zr-Fe alloys, for biomedical applications. Several researchers have explored the effects of alloying elements and processing techniques on enhancing the mechanical, chemical, and biological properties of these materials. Ti-Nb-Zr-Fe alloys are of particular interest due to their potential to address critical requirements in medical applications, including reduced Young's modulus, superior corrosion resistance, biocompatibility, and mechanical strength. Despite substantial progress, the detailed mechanisms for optimizing these properties remain underexplored in the current literature. The main objective of the present review paper is to emphasize the importance of ongoing investigations aimed at overcoming challenges such as biocompatibility concerns, fatigue resistance, and wear under biological conditions. By critically analyzing existing data, this study highlights gaps in knowledge and identifies opportunities for advancing research on these alloys. Specifically, this review paper highlights the need for targeted studies to reduce the Young's modulus and improve other critical characteristics of Ti-Nb-Zr-Fe alloys to better meet the demands of orthopedic implants, dental prosthetics, and cardiovascular devices. Even if the current scientific literature is ample on this topic, we consider that through this review we can positively contribute to the collective effort in this field trying to fill some gaps, including some updates on the topic, time frames, advantages, and limitations, and pave the way for further advancements that could revolutionize biomedical implant technology. The review encompasses studies performed over the last 5 decades, specifically from 1975 to 2025, to ensure the inclusion of the most relevant and up-to-date research. This approach aims to highlight the significant progress made while situating the findings within the broader context of ongoing investigations.

Histomorphometric Analysis of Osseointegrated Intraosseous Dental Implants Using Undecalcified Specimens: A Scoping Review

Bone histology and histomorphometry are reliable diagnostic tools for the assessment of the bone-implant interface, material safety and biocompatibility, and tissue response. They allow for the qualitative and quantitative analysis of undecalcified bone specimens. This scoping review aims to identify the most common staining techniques, study models for in vivo experiments, and histomorphometric parameters used for quantitative bone evaluation of osseointegrated dental implants in the last decade. The Web of Science, PubMed, and Scopus databases were searched on 1 July 2024 for relevant articles in English, published in the last ten years, and the data were exported to an MS Excel spreadsheet. A total of 115 studies met the eligibility criteria and were included in the present review. The results indicate that the most common study models are dogs, rabbits, and pigs. Some of the most frequently used methods for the assessment of the bone-implant interface are the Toluidine blue, Stevenel's blue with Van Gieson, and Levai-Laczko stainings. The results from this study demonstrate that the most commonly used histomorphometric parameters in implant dentistry are the bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), bone area (BA), and bone density (BD). This review presents the recent trends in histomorphometric analysis of dental implants and identifies some research gaps that necessitate further research.

Osseointegration behavior of carbon fiber reinforced polyetheretherketone composites modified with amino groups: An in vivo study

Polyetheretherketone (PEEK) has become increasingly popular in dentistry and orthopedics due to its excellent chemical stability, reliable biosafety, and low elastic modulus. However, PEEK's biomechanical strength and bioactivity are limited and need to be increased as an implant material. The previous study in vitro has shown that the amino-functionalized carbon fiber reinforced PEEK (A-30%-CPEEK) possessed enhanced mechanical property and bioactivity. This study aims to evaluate the effect of amino groups modification on the osseointegration behavior of carbon fiber reinforced PEEK (30%-CPEEK) in rabbits. Herein, 30%-CPEEK and A-30%-CPEEK implant discs were implanted in rabbit skulls for 5 weeks, with pure titanium implants serving as a control. The bone-forming ability and osseointegration in vivo were systematically investigated by micro-computed tomography analysis, scanning electron microscope observation, and histological evaluation. Our results showed that all detection parameters were significantly different between the A-30%-CPEEK and 30%-CPEEK groups, favoring those in the A-30%-CPEEK, whose appraisal parameters were equal to or better than pure titanium. Therefore, this study supported the importance of amino groups in facilitating the new bone formation and bone-implant integration, suggesting that A-30%-CPEEK with enhanced osseointegration will be a promising material for dental or orthopedic implants.

Early osseointegration of micro-arc oxidation coated titanium alloy implants containing Ag: a histomorphometric study

BACKGROUND

This study aimed to evaluate bone response to micro-arc oxidation coated titanium alloy implants containing Ag.

METHODS

144 titanium alloy implants were prepared by machine grinding and divided into three treatment groups as following, SLA group: sand-blasting and acid-etched coating; MAO group: micro-arc oxidation without Ag coating; MAO + Ag group: micro-arc oxidation containing Ag coating. Surface characterization of three kind of implants were observed by X-ray diffraction, energy dispersive X-ray spectrometer, scanning electron microscopy, High Resolution Transmission Electron Microscope and roughness analysis. The implants were inserted into dog femurs. 4, 8 and 12 weeks after operation, the bone response to the implant to the bone was evaluated by push-out experiment, histological and fluorescent labeling analysis.

RESULTS

MAO + Ag group consisted of a mixture of anatase and rutile. Ag was found in the form of Ag₂O on the surface. The surface morphology of MAO + Ag group seemed more like a circular crater with upheaved edges and holes than the other two groups. The surface roughness of MAO and MAO + Ag groups were higher than SLA group, but no statistical difference between MAO and MAO + Ag groups. The contact angles in MAO + Ag group was smallest and the surface free energy was the highest among three groups. The maximum push-out strength of MAO and MAO + Ag groups were higher than SLA group at all time point, the value of MAO + Ag group was higher than MAO group at 4 and 8 weeks. Scanning electron microscopy examination for the surface and cross-section of the bone segments and fluorescent labeling analysis showed that the ability of bone formation and osseointegration in MAO + Ag group was higher than that of the other two groups.

CONCLUSION

The micro-arc oxidation combination with Ag coating is an excellent surface modification technique to posse porous surface structure and hydrophilicity on the titanium alloy implants surface and exhibits desirable ability of osseointegration.

Biocompatible High Entropy Alloys with Excellent Degradation Resistance in a Simulated Physiological Environment

Bioimplants are susceptible to simultaneous wear and corrosion degradation in the aggressive physiological environment. High entropy alloys with equimolar proportion of constituent elements represent a unique alloy design strategy for developing bioimplants due to their attractive mechanical properties, superior wear, and corrosion resistance. In this study, the tribo-corrosion behavior of an equiatomic MoNbTaTiZr high entropy alloy consisting of all biocompatible elements was evaluated and compared with 304 stainless steel as a benchmark. The high entropy alloy showed a low wear rate and a friction coefficient as well as quick and stable passivation in simulated body fluid. An increase from room temperature to body temperature showed excellent temperature assisted passivity and nobler surface layer of the high entropy alloy, resulting in four times better wear resistance compared to stainless steel. Stem cells and osteoblast cells displayed proliferation and migratory behavior, indicating in vitro biocompatibility. Several filopodia extensions on the cell periphery indicated early osteogenic commitment, and cell adhesion on the high entropy alloy. These results pave the way for utilizing the unique combination of tribo-corrosion resistance, excellent mechanical properties, and biocompatibility of MoNbTaTiZr high entropy alloy to develop bioimplants with improved service life and lower risk of implant induced cytotoxicity in the host body.

Novel ultrafine-grained β-type Ti-28Nb-2Zr-8Sn alloy for biomedical applications

Titanium alloys are widely accepted as orthopedic or dental implant materials in the medical field. It is important to evaluate the biocompatibility of an implant material prior to use. A new β-type ultrafine-grained Ti-28Nb-2Zr-8Sn (TNZS) alloy with low Young's modulus of 31.6 GPa was fabricated. This study aims to evaluate the biocompatibility of TNZS alloy. In this study, we examined the microstructure, chemical composition and surface wettability of the TNZS alloy. The mouse embryonic osteoblast MC3T3-E1 cells and human umbilical vein endothelial cells (HUVECs) were cultured to study the cytocompatibility of TNZS alloy. Also, we evaluated the proinflammatory response of TNZS alloy in vitro and in vivo. The results show that the TNZS did not cause cytotoxicity, genotoxicity to MC3T3-E1 cells and HUVECs. Whereas, the TNZS alloy could significantly promote the cell proliferation, cell spreading and cell adhesion of MC3T3-E1 cells and HUVECs, as well as facilitate the osteogenic differentiation of MC3T3-E1 cells. Moreover, the TNZS alloy did not induce any remarkable proinflammatory response in vitro and in vivo. Thus, the novel TNZS alloy with an elasticity closer to that of human bone is biologically safe and could be a potential candidate for biomedical implant application. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1628-1639, 2019.