Pre-treatment of titanium alloy with platelet-rich plasma enhances human osteoblast responses

Impact of autologous platelet concentrates on the osseointegration of dental implants

Osseointegration is defined as the direct deposition of bone onto biomaterial devices, most commonly composed from titanium, for the purpose of anchoring dental prostheses. The use of autologous platelet concentrates (APC) has the potential to enhance this process by modifying the interface between the host and the surface of the titanium implant. The rationale is to modify the implant surface and implant-bone interface via "biomimicry," a process whereby the deposition of the host's own proteins and extracellular matrix enhances the biocompatibility of the implant and hence accelerates the osteogenic healing process. This review of the available evidence reporting on the effect of APC on osseointegration explores in vitro laboratory studies of the interaction of APC with different implant surfaces, as well as the in vivo and clinical effects of APC on osseointegration in animal and human studies. The inherent variability associated with using autologous products, namely the unique composition of each individual's blood plasma, as well as the great variety in APC protocols, combination of biomaterials, and clinical/therapeutic application, makes it is difficult to make any firm conclusions about the in vivo and clinical effects of APC on osseointegration. The available evidence suggests that the clinical benefits of adding PRP and the liquid form of L-PRF (liquid fibrinogen) to any implant surface appear to be limited. The application of L-PRF membranes in the osteotomy site, however, may produce positive clinical effects at the early stage of healing (up to 6 weeks), by promoting early implant stability and reducing marginal bone loss, although no positive longer term effects were observed. Careful interpretation and cautious conclusions should be drawn from these findings as there were various limitations in methodology. Future studies should focus on better understanding of the influence of APCs on the biomaterial surface and designing controlled preclinical and clinical studies using standardized APC preparation and application protocols.

"Dual-functional" strontium titanate nanotubes designed based on fusion peptides simultaneously enhancing anti-infection and osseointegration

Currently, there is an increasing clinical demand for implants that effectively resist bacterial infections while promoting osseointegration. In this study, the fusion peptide technology was used to linearly fuse the antimicrobial peptide (AMP, HHC36) and the bone-promoting peptide (RGD), so that the titanium (Ti)-based implant modified by the polypeptide had the dual function of "antibacterial-promoting bone". Firstly, self-organized vertically-oriented strontium-doped titanium dioxide nanotubes (STN) were manufactured by anodizing and hydrothermal synthesis methods. Secondly, the fusion peptide (HHC36-RGD) was loaded into the tubular structure by a simple vacuum-assisted physical adsorption method. Finally, STN loaded with HHC36-RGD (H-R-STN) was obtained. The characterization results demonstrated that the surface of the H-R-STN had a roughness and hydrophilicity that promoted cell adhesion. Additionally, electrochemical tests showed that H-R-STN coating can reduce the corrosion rate of pure Ti. The fusion peptide and Sr²⁺ in H-R-STN were released in the initial fast and subsequent slow kinetic model. Expected, H-R-STN can kill more than 99% of clinically common pathogenic bacteria (Staphylococcus aureus and Escherichia coli), and significantly inhibit the formation of bacterial biofilms. Simultaneously, under the synergistic effect of RGD in the fusion peptide and strontium in STN, H-R-STN markedly promoted the adhesion and proliferation of mouse osteoblasts, and significantly promoted osteogenic markers (alkaline phosphatase, runt-related transcription, collagen, mineralization) expression. In summary, the bifunctional titanium-based implant constructed by H-R-STN in this article can effectively prevent bacterial infections and promote early osseointegration. The main advantage of the titanium surface treatment method of the study was that its simplicity, low cost, especially its versatility made it a promising anti-infective bone repair material.

Microvascular fragments in microcirculation research and regenerative medicine

Adipose tissue-derived microvascular fragments (MVF) are functional vessel segments, which rapidly reassemble into new microvasculatures under experimental in vitro and in vivo conditions. Accordingly, they have been used for many years in microcirculation research to study basic mechanisms of endothelial cell function, angiogenesis and microvascular network formation in two- and three-dimensional environments. Moreover, they serve as vascularization units for musculoskeletal regeneration and implanted biomaterials as well as for the treatment of myocardial infarction and the generation of prevascularized tissue organoids. Besides, multiple factors determining the vascularization capacity of MVF have been identified, including their tissue origin and cellular composition, the conditions for their short- and long-term storage as well as their implantation site and the general health status and medication of the recipient. The next challenging step is now the successful translation of all these promising experimental findings into clinical practice. If this succeeds, a multitude of future therapeutic applications may significantly benefit from the remarkable properties of MVF.

Hydroxyapatite and β-TCP modified PMMA-TiO2 and PMMA-ZrO2 coatings for bioactive corrosion protection of Ti6Al4V implants

Organic-inorganic hybrid coatings deposited on different types of metallic alloys have shown outstanding anticorrosive performance. The incorporation of osteoconductive additives such as hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) into organic-inorganic hybrid coatings is promising to improve the osseointegration and corrosion resistance of Ti6Al4V alloys, which are the most widely used metallic orthopedic and dental implant materials today. Therefore, this study evaluated the capability of poly(methyl methacrylate) (PMMA)-TiO₂ and PMMA-ZrO₂ hybrid coatings modified with HA and β-TCP to act as bioactive and corrosion protection coatings for Ti6Al4V alloys. In terms of cell growth and mineralization, osteoblast viability, Ca⁺² deposition and alkaline phosphatase assays revealed a significant improvement for the HA and β-TCP modified coatings, compared to the bare alloy. This can be explained by an increase in nanoscale roughness and associated higher surface free energy, which lead to enhanced protein adsorption to promote osteoblast attachment and functions on the coatings. The effect of HA and β-TCP additives on the anticorrosive efficiency was studied by electrochemical impedance spectroscopy (EIS) in a simulated body fluid (SBF) solution. The coatings presented a low-frequency impedance modulus of up to 430 GΩ cm², 5 decades higher than the bare Ti6Al4V alloy. These findings provide clear evidence of the beneficial role of HA and β-TCP modified hybrid coatings, improving both the biocompatibility and corrosion resistance of the Ti6Al4V alloy.

Platelet-Rich Plasma Pretreatment on Grit-Blasted Titanium Alloy for Enhanced Osteogenic Differentiation of Human Adipose-Derived Stem Cells

Background

Adequate bone formation around titanium alloy implants is integral to successful implantation surgery. Stem cell-coated implants may accelerate peri-implant bone formation. This study investigates the effect of platelet-rich plasma (PRP) pretreatment on a titanium-alloy surface in terms of proliferation and osteogenic differentiation of human adipose-derived stem cells (hADSCs).

Methods

Allogenic leukocyte-depleted PRP was obtained from blood supernatants. The hADSCs were isolated from thigh subcutaneous fat tissue. Grit-blasted titanium plugs were used in two different groups. In one group, 200 µL of PRP was added to the grit-blasted titanium plugs. The hADSCs were seeded in two groups: grit-blasted titanium plugs with or without PRP. The number of hADSCs was measured after 4 hours, 3 days, and 7 days of culture using Cell Counting Kit-8. Osteogenesis of hADSCs was measured by using an alkaline phosphatase activity assay on days 7 and 14, and a calcium assay on days 14 and 21. Osteogenic gene expression was measured by using reverse transcription polymerase chain reaction analysis of alkaline phosphatase, osteocalcin, and type I collagen mRNA. The microscopic morphology of grit-blasted titanium plugs with or without PRP was examined with a field-emission scanning electron microscope using a JSM-7401F apparatus on days 1 and 7.

Results

Proliferation and osteogenic differentiation of hADSCs were found to be significantly higher on the grit-blasted titanium alloy preprocessed with PRP than the same alloy without pretreatment. Furthermore, a structural fibrillar mesh developed compactly on the grit-blasted titanium alloy with the PRP pretreatment.

Conclusions

Our results demonstrate that a hADSC-based approach can be used for tissue-engineered peri-implant bone formation and that PRP pretreatment on the grit-blasted titanium alloy can improve proliferation and osteogenic differentiation of hADSCs.