A bioactive titanium foam scaffold for bone repair

3D-ink-extruded titanium scaffolds with porous struts and bioactive supramolecular polymers for orthopedic implants

Porous titanium addresses the longstanding orthopedic challenges of aseptic loosening and stress shielding. This work expands on the evolution of porous Ti with the manufacturing of hierarchically porous, low stiffness, ductile Ti scaffolds via direct-ink write (DIW) extrusion and sintering of inks containing Ti and NaCl particles. Scaffold macrochannels were filled with a subtherapeutic dose of recombinant bone morphogenetic protein-2 (rhBMP-2) alone or co-delivered within a bioactive supramolecular polymer slurry (SPS) composed of peptide amphiphile nanofibrils and collagen, creating four treatment conditions (Ti struts: microporous vs. fully dense; BMP-2 alone or with SPS). The BMP-2-loaded scaffolds were implanted bilaterally across the L4 and L5 transverse processes in a rat posterolateral lumbar fusion model. In-vivo bone growth in these scaffolds is evaluated with synchrotron X-ray computed microtomography (µCT) to study the effects of strut microporosity and added biological signaling agents on the bone formation response. Optical and scanning electron microscopy confirms the ∼100 µm space-holder micropore size, high-curvature morphology, and pore fenestrations within the struts. Uniaxial compression testing shows that the microporous strut scaffolds have low stiffness and high ductility. A significant promotion in bone formation was observed for groups utilizing the SPS, while no significant differences were found for the scaffolds with the incorporation of micropores. STATEMENT OF SIGNIFICANCE: By 2050, the anticipated number of people aged 60 years and older worldwide is anticipated to double to 2.1 billion. This rapid increase in the geriatric population will require a corresponding increase in orthopedic surgeries and more effective materials for longer indwelling times. Titanium alloys have been the gold standard of bone fusion and fixation, but their use has longstanding limitations in bone-implant stiffness mismatch and insufficient osseointegration. We utilize 3D-printing of titanium with NaCl space holders for large- and small-scale porosity and incorporate bioactive supramolecular polymers into the scaffolds to increase bone growth. This work finds no significant change in bone ingrowth via space-holder-induced microporosity but significant increases in bone ingrowth via the bioactive supramolecular polymers in a rat posterolateral fusion model.

Both angled bony-increased offset and metal-augmented baseplates provide satisfactory bone incorporation to the glenoid in reverse total shoulder arthroplasty: a radiographic evaluation using tomosynthesis

BACKGROUND

Angled bony-increased offset and metal-augmented baseplate have recently been used to achieve neutral to inferior inclination of the glenoid implant. Nonetheless, bone incorporation is difficult to evaluate using computed tomography or other conventional methods owing to the presence of metal artifacts; therefore, whether bone incorporation between the grafted bone and glenoid or between the graft and baseplate implant can be achieved remains unclear. Several studies have reported the effectiveness of tomosynthesis in reducing metal artifacts for the evaluation of implant loosening, bone resorption, and spot welds. We aimed to evaluate and compare the bone incorporation rates between angled bony-increased offset and metal-augmented implants using tomosynthesis with metal artifact reduction technology. We hypothesized that a high bone incorporation rate would be obtained with angled bony-increased offset and a metal-augmented baseplate.

METHODS

A total of 52 patients who underwent reverse total shoulder arthroplasty (TSA) with angled bony-increased offset and 42 patients who underwent reverse total shoulder arthroplasty with metal-augmented baseplate were assessed and followed up for a minimum of 2 years. The bone incorporation and implant loosening rates were compared between the 2 groups, and the sites of spot welds and trabeculation were recorded according to zones. Bone incorporation between the bone and prosthesis was defined as a confirmation of spot welds connecting the porous area and bone in more than three zones. Bone incorporation between the native bone and grafted bone was defined as an observation of trabeculation. Glenoid loosening was defined as the presence of at least 1 mm radiolucency around the prosthesis in more than 2 zones.

RESULTS

Both the angled bony-increased offset and metal-augmented baseplate groups achieved sufficient bone incorporation rates (98% [51/52 cases] vs. 100% [42/42 cases], P = 1.0) and low implant loosening rates (2% [1/52 cases] vs. 0% [0/42 cases], P = 1.0). Spot welds and trabeculation were likely to be confirmed in the lower parts of the glenoid.

CONCLUSION

The two groups did not show any significant differences regarding bone incorporation rates. Considering the complexity of performing the procedure with angled bony-increased offset, the use of a metal-augmented baseplate can serve as an alternative treatment to avoid superior inclination in reverse total shoulder arthroplasty.

Biomimetic dental implant production using selective laser powder bed fusion melting: In-vitro results

Instead of a textured surface with irregular pore size and distribution as in conventional dental implants, the use of lattice structures with regular geometric structure and controlled pore size produced by selective laser powder bed fusion melting (LPDF) technique will provide more predictable and successful results regarding osseointegration and mechanics. In this study, biomimetic dental implants with 2 different pore designs were fabricated by LPDF technique and compared with conventional dental implants in terms of surface characterization and resistance to biomechanical forces. Finite element analysis, scanning electron microscopy, computed micro tomography scanning, ISO 14801 tests and detork tests were used for the comparison. The tested biomimetic implants were found to be as durable as conventional implants in terms of mechanical strength and detork values. They were also found to be 40-60% more advantageous than conventional dental implants with respect to surface area and volume. As a result, it was concluded that biomimetic dental implants with sufficient mechanical strength and complex surface geometries can be made as designed without changing the reliable base material and can be produced using a different manufacturing method.

Surface characterization and antibacterial efficiency of well-ordered TiO2 nanotube surfaces fabricated on titanium foams

Titanium (Ti)-based implants are not compatible enough due to their bio-inert character, insufficient antibacterial capabilities and stress-shielding problem for dental and orthopaedic implant applications. Thus, this work focused to fabricate, analyze and improve antibacterial properties titanium dioxide (TiO2) nanotube array surfaces on Ti foam by anodic oxidation (AO) process. The well-ordered nanotube arrays with approximately 75 nm were successfully fabricated at 40 V for 1 h on Ti foams. Ti and O were observed as major elements on AO-coated Ti foam surfaces. In addition, the existence of TiO2 structure was proved on AO-coated foam Ti surfaces. For potential dental and orthopedic implant application, in vitro antibacterial properties were investigated versus Staphylococcus aureus and Escherichia coli. For both bacteria, antibacterial properties of TiO2 nanotube surface were greater than bare Ti foam. The bacterial inhibition versus Staphylococcus aureus and Escherichia coli of TiO2 nanotube surfaces are improved as 53.3% and 69.4% compared to bare Ti foam.

Recent Advances in Processing of Titanium and Titanium Alloys through Metal Injection Molding for Biomedical Applications: 2013-2022

Metal injection molding (MIM) is one of the most widely used manufacturing processes worldwide as it is a cost-effective way of producing a variety of dental and orthopedic implants, surgical instruments, and other important biomedical products. Titanium (Ti) and Ti alloys are popular modern metallic materials that have revamped the biomedical sector as they have superior biocompatibility, excellent corrosion resistance, and high static and fatigue strength. This paper systematically reviews the MIM process parameters that extant studies have used to produce Ti and Ti alloy components between 2013 and 2022 for the medical industry. Moreover, the effect of sintering temperature on the mechanical properties of the MIM-processed sintered components has been reviewed and discussed. It is concluded that by appropriately selecting and implementing the processing parameters at different stages of the MIM process, defect-free Ti and Ti alloy-based biomedical components can be produced. Therefore, this present study could greatly benefit future studies that examine using MIM to develop products for biomedical applications.

Personalized 3D printed bone scaffolds: A review

3D printed bone scaffolds have the potential to replace autografts and allografts because of advantages such as unlimited supply and the ability to tailor the scaffolds' biochemical, biological and biophysical properties. Significant progress has been made over the past decade in additive manufacturing techniques to 3D print bone grafts, but challenges remain in the lack of manufacturing techniques that can recapitulate both mechanical and biological functions of native bones. The purpose of this review is to outline the recent progress and challenges of engineering an ideal synthetic bone scaffold and to provide suggestions for overcoming these challenges through bioinspiration, high-resolution 3D printing, and advanced modeling techniques. The article provides a short overview of the progress in developing the 3D printed scaffolds for the repair and regeneration of critical size bone defects. STATEMENT OF SIGNIFICANCE: Treatment of critical size bone defects is still a tremendous clinical challenge. To address this challenge, diverse sets of advanced manufacturing approaches and materials have been developed for bone tissue scaffolds. 3D printing has sparked much interest because it provides a close control over the scaffold's internal architecture and in turn its mechanical and biological properties. This article provides a critical overview of the relationships between material compositions, printing techniques, and properties of the scaffolds and discusses the current technical challenges facing their successful translation to the clinic. Bioinspiration, high-resolution printing, and advanced modeling techniques are discussed as future directions to address the current challenges.

Bone Regeneration with 3D-Printed Hybrid Bone Scaffolds in a Canine Radial Bone Defect Model

BACKGROUND

The repair of large bone defects remains a significant challenge in clinical practice and requires bone grafts or substitute materials. In this study, we developed a unique hybrid bone scaffold comprising a three dimensional (3D)-printed metal plate for weight bearing and a biodegradable polymer tube serving as bone conduit. We assessed the long-term effect of the hybrid bone scaffold in repairing radial bone defects in a beagle model.

METHODS

Bone defects were created surgically on the radial bone of three beagle dogs and individually-tailored scaffolds were used for reconstruction with or without injection of autologous bone and decellularized extracellular matrix (dECM). The repaired tissue was evaluated by X-ray, micro-computed tomography, and histological observation 6 months after surgery. The functional integrity of hybrid bone scaffold-mediated reconstructions was assessed by gait analysis.

RESULTS

In vivo analysis showed that the hybrid bone scaffolds maintained the physical space and bone conductivity around the defect. New bone was formed adjacent to the scaffolds. Addition of autologous bone and dECM in the polymer tube improved healing by enhancing bone induction and osteoconduction. Furthermore, the beagles' gait appeared normal by 4 months.

CONCLUSION

The future of bone healing and regeneration is closely related to advances in tissue engineering. Bone production using autologous bone and dECM loaded on 3D-printed hybrid bone scaffolds can successfully induce osteogenesis and provide mechanical force for functional bone regeneration, even in large bone defects.

Mechanical and Biocompatibility Properties of Sintered Titanium Powder for Mimetic 3D-Printed Bone Scaffolds

A composite comprising Ti and NaCl powders was sintered similar to a three-dimensional (3D)-printed patient-customized artificial bone scaffold. Additionally, a proper microstructure of the mimetic scaffold and the optimum processing parameters for its development were analyzed. The mechanical properties of the metal-based porous-structured framework used as an artificial bone scaffold were an optimum replacement for the human bone. Thus, it was confirmed that patient-customized scaffolds could be manufactured via 3D printing. The 3D-printed mimetic specimens were fabricated by a powder-sintering method using Ti for the metal parts, NaCl as the pore former, and polylactic acid as the biodegradable binder. Scanning electron microscopy (SEM) images showed that pores were formed homogeneously, while X-ray computed tomography confirmed that open pores were generated. The porosity and pore size distribution were measured using a mercury porosimeter, while the flexural strength and flexural elastic modulus were calculated using the three-point bending test. Based on these measurements, a pore-former content of 15 vol % optimized the density and flexural strength to 2.52 g cm^-2 and 283 MPa, respectively, similar to those of the actual iliac bone. According to the 3D-printing production method, a selective laser-sintering process was applied for the fabrication of the mimetic specimen, and it was determined that the microstructure and properties similar to those of previous metal specimens could be achieved in the as-prepared specimen. Additionally, a decellularized extracellular matrix (dECM) was used to coat the surfaces and interiors of the specimens for evaluating their biocompatibilities. SEM image analysis indicated that the adipose-derived stem cells grew evenly inside the pores of the coated specimens, as compared with the bulky Ti specimens without the dECM coating. The doubling time at 65% was measured at 72, 75, and 83 h for specimens with pore-former contents of 5, 10, and 15 vol %, respectively. The doubling time without the pore former was 116 h. As compared with the specimens without the pore former (73 h), 15% of the dECM-coated specimens showed a doubling time of 64%, measured at 47 h.

Simultaneous Precipitation and Electrodeposition of Hydroxyapatite Coatings at Different Temperatures on Various Metal Substrates

The coating of orthopedic and dental implants with hydroxyapatite (HA) is recognized as a method to increase their integration ability. A new metal coating method, comprising simultaneous precipitation and electrodeposition, is presented. Two studies are described: the first is related to the influence of time/temperature increase on the morpho-structural characteristics of the deposited layer on the Ti substrate, while the second study presents the characteristics of the layers deposited on different metal substrates. For comparison, specimens were obtained using the classical electrochemical deposition under the same experimental conditions. The addition of Ca to the electrolyte creates more compact and more uniform coatings, while the addition of P creates more porous layers. Only a very small quantity of crystalline HA deposited on the C55, Cu, and Ni substrates when the classic electrodeposition method was employed, while using the new approach has clearly led to a larger crystalline HA amount electrodeposited on the same types of metals. With some exceptions, the advantages of using the new method are: better crystallinity, more uniform and continuous surface, higher roughness, and potentially higher anti-corrosion capabilities.

Use of Porous Titanium Trabecular as a Bone Defect Regenerator: In Vivo Study

The application of porous materials is increasingly being used in orthopaedic surgery due to its good results. Bone growth within the pores results in excellent mechanical fixation with the bone, as well as good bone regeneration. The pores, in addition to being colonised by bone, produce a decrease in the modulus of elasticity that favours the transfer of loads to the bone. This research shows the results of an experimental study where we have created critical osteoperiosteal defects of 10 mm on rabbit’s radius diaphysis. In one group of 10 rabbits (experimental group) we have implanted a bioactive porous titanium cylinder, and in another group we have allowed spontaneous regeneration (control group). Mechanical tests were performed to assess the material. Image diagnostic techniques (X-ray, scanner and 3D scan: there are no references on the literature with the use of CT-scan in bone defects) and histological and histomorphometric studies post-op and after 3, 6 and 12 months after the surgery were performed. All the control cases went through a pseudoarthrosis. In 9 of the 10 cases of the experimental group complete regeneration was observed, with a normal cortical-marrow structure established at 6 months, similar to normal bone. Titanium trabecular reached a bone percentage of bone inside the implant of 49.3% on its surface 3 months post-op, 75.6% at 6 months and 81.3% at 12 months. This porous titanium biomaterial has appropriate characteristics to allow bone ingrowth, and it can be proposed as a bone graft substitute to regenerate bone defects, as a scaffold, or as a coating to achieve implant osteointegration.

Production and Properties of the Porous Layer Obtained by the Electrochemical Method on the Surface of Austenitic Steel

The growing demand for implants has seen increasing interest in the introduction of new technologies and surface modification methods of metal biomaterials. This research aimed to produce and characterize a porous layer grown on austenitic stainless steel 316L, obtained via the anodization process near the micro-arc oxidation, i.e., low voltage micro-arc oxidation (LVMAO). The discussed layer significantly influences the properties of metallic biomedical materials. The surface topography, layer thickness, surface roughness, pore diameter, elemental composition, crystal structure, and surface wettability were assessed for all anodized layers, together with the resultant corrosion resistance. Attention was paid to the influence of the process parameters that affect the specification of the produced layer. The obtained results showed surface development and different sized pores in the modified layers, as well as an increase in corrosion resistance in the Ringer’s solution.

Comprehensive Review on Design and Manufacturing of Bio-scaffolds for Bone Reconstruction

Bio-scaffolds are synthetic entities widely employed in bone and soft-tissue regeneration applications. These bio-scaffolds are applied to the defect site to provide support and favor cell attachment and growth, thereby enhancing the regeneration of the defective site. The progressive research in bio-scaffold fabrication has led to identification of biocompatible and mechanically stable materials. The difficulties in obtaining grafts and expenditure incurred in the transplantation procedures have also been overcome by the implantation of bio-scaffolds. Drugs, cells, growth factors, and biomolecules can be embedded with bio-scaffolds to provide localized treatments. The right choice of materials and fabrication approaches can help in developing bio-scaffolds with required properties. This review mostly focuses on the available materials and bio-scaffold techniques for bone and soft-tissue regeneration application. The first part of this review gives insight into the various classes of biomaterials involved in bio-scaffold fabrication followed by design and simulation techniques. The latter discusses the various additive, subtractive, hybrid, and other improved techniques involved in the development of bio-scaffolds for bone regeneration applications. Techniques involving multimaterial printing and multidimensional printing have also been briefly discussed.

Progress of biomaterials for bone tumor therapy

Bone tumors are currently a major clinical challenge. In recent decades, strategies using well-designed versatile biomaterials for the treatment of bone tumors have emerged and attracted extensive research interest. Suitable biomaterials not only facilitate repair for bone defects aroused by surgical intervention but also help deliver antineoplastic drugs to the target site or provide photothermal/magnetothermal therapy to kill bone tumor cells. Thus, the development of biomaterials exhibits a great perspective for future bone tumor treatment.We summarize the recent progress of versatile biomaterials for bone tumor therapy, with an emphasis on photothermal/magnetothermal therapy and drug delivery.With the further understanding and development of biomaterials, multifunctional biomaterials have been proposed for bone tumor treatment. Through the interdisciplinary cooperation from the fields of biomedicine, clinical medicine and engineering, multifunctional biomaterials will perfectly match individual bone defects in the clinic with low cost in the future.

Mechanical response of different types of surface texture for medical application using finite element study

Titanium implants are commonly used in dental and other joint replacements and its several modifications have been taken place to improve the adhesion between bone and implant. Different chemical and physical modifications are generally applied to the titanium surface for improving interlocking between bone and implant materials. The present work has been investigated the shear strength stiffness and stress concentration between Representative Volume Element (RVE) model and coating material while the surface of the RVE model modified with different types of surface textures. The surface topology parameters resulted a significant increase in shear strength by 55% and 45% for straight texture and U-shape texture, respectively compared with plain surface. The stiffness reduced significantly by 18% for U-shape and but to 36% only for X-shape, when compared with plain surface. The stress concentration factor in biaxial case both dome shape and X-shape has 45%and 25% in U-shape lower than that of the plain surface. Therefore, this investigation predicted the interfacial shear strength properties generated for different surface topologies to determine the bonding behavior of the implant materials.

GAKTpore: Stereological Characterisation Methods for Porous Foams in Biomedical Applications

In tissue engineering, scaffolds are a key component that possess a highly elaborate pore structure. Careful characterisation of such porous structures enables the prediction of a variety of large-scale biological responses. In this work, a rapid, efficient, and accurate methodology for 2D bulk porous structure analysis is proposed. The algorithm, "GAKTpore", creates a morphology map allowing quantification and visualisation of spatial feature variation. The software achieves 99.6% and 99.1% mean accuracy for pore diameter and shape factor identification, respectively. There are two main algorithm novelties within this work: (1) feature-dependant homogeneity map; (2) a new waviness function providing insights into the convexity/concavity of pores, important for understanding the influence on cell adhesion and proliferation. The algorithm is applied to foam structures, providing a full characterisation of a 10 mm diameter SEM micrograph (14,784 × 14,915 px) with 190,249 pores in ~9 min and has elucidated new insights into collagen scaffold formation by relating microstructural formation to the bulk formation environment. This novel porosity characterisation algorithm demonstrates its versatility, where accuracy, repeatability, and time are paramount. Thus, GAKTpore offers enormous potential to optimise and enhance scaffolds within tissue engineering.

Prospect of Metal Ceramic (Titanium-Wollastonite) Composite as Permanent Bone Implants: A Narrative Review

This literature review discusses the influence of titanium ceramic composites as a biomaterial towards the fabrication of implants for orthopedic applications. The concept of applying metal-ceramic composites enable many novel combinations in the design and fabrication of complex materials which enhances functionality to improve cell and tissue matrix interactions particularly in the formation of bone. Specific focus is placed on its plethora of materials selected from the metals and ceramic group and identifying the optimal combination that matches them. The prospect of wollastonite as the ceramic counterpart is also highlighted. In this review, we have highlighted the different fabrication methods for such metal-ceramic materials as well as the role that these hybrids play in an in vitro and in vivo environment. Its economic potential as a bone implant material is also discussed.

Multifunctional Properties of Quercitrin-Coated Porous Ti-6Al-4V Implants for Orthopaedic Applications Assessed In Vitro

(1) One strategy to improve the outcome of orthopedic implants is to use porous implants with the addition of a coating with an antibacterial biomolecule. In this study, we aimed to produce and test the biocompatibility, the osteopromotive (both under normal conditions and under a bacterial challenge with lipopolysaccharide (LPS)) and antibacterial activities of a porous Ti-6Al-4V implant coated with the flavonoid quercitrin in vitro. (2) Porous Ti-6Al-4V implants were produced by 3D printing and further functionalized with quercitrin by wet chemistry. Implants were characterized in terms of porosity and mechanical testing, and the coating with quercitrin by fluorescence staining. Implant biocompatibility and bioactivity was tested using MC3T3-E1 preosteoblasts by analyzing cytotoxicity, cell adhesion, osteocalcin production, and alkaline phosphatase (ALP) activity under control and under bacterial challenging conditions using lipopolysaccharide (LPS). Finally, the antibacterial properties of the implants were studied using Staphylococcus epidermidis by measuring bacterial viability and adhesion. (3) Porous implants showed pore size of about 500 µm and a porosity of 52%. The coating was homogeneous over all the 3D surface and did not alter the mechanical properties of the Young modulus. Quercitrin-coated implants showed higher biocompatibility, cell adhesion, and osteocalcin production compared with control implants. Moreover, higher ALP activity was observed for the quercitrin group under both normal and bacterial challenging conditions. Finally, S. epidermidis live/dead ratio and adhesion after 4 h of incubation was lower on quercitrin implants compared with the control. (4) Quercitrin-functionalized porous Ti-6Al-4V implants present a great potential as an orthopedic porous implant that decreases bacterial adhesion and viability while promoting bone cell growth and differentiation.

A Further Analysis on Ti6Al4V Lattice Structures Manufactured by Selective Laser Melting

Mechanical and architectural features play an important role in designing biomedical devices. The use of materials (i.e., Ti6Al4V) with Young's modulus higher than those of natural tissues generally cause stress shielding effects, bone atrophy, and implant loosening. However, porous devices may be designed to reduce the implant stiffness and, consequently, to improve its stability by promoting tissue ingrowth. If porosity increases, mass transport properties, which are crucial for cell behavior and tissue ingrowth, increase, whereas mechanical properties decrease. As reported in the literature, it is always possible to tailor mass transport and mechanical properties of additively manufactured structures by varying the architectural features, as well as pore shape and size. Even though many studies have already been made on different porous structures with controlled morphology, the aim of current study was to provide only a further analysis on Ti6Al4V lattice structures manufactured by selective laser melting. Experimental and theoretical analyses also demonstrated the possibility to vary the architectural features, pore size, and geometry, without dramatically altering the mechanical performance of the structure.

Bone marrow mesenchymal stem cells: Aging and tissue engineering applications to enhance bone healing

Bone has well documented natural healing capacity that normally is sufficient to repair fractures and other common injuries. However, the properties of bone change throughout life, and aging is accompanied by increased incidence of bone diseases and compromised fracture healing capacity, which necessitate effective therapies capable of enhancing bone regeneration. The therapeutic potential of adult mesenchymal stem cells (MSCs) for bone repair has been long proposed and examined. Actions of MSCs may include direct differentiation to become bone cells, attraction and recruitment of other cells, or creation of a regenerative environment via production of trophic growth factors. With systemic aging, MSCs also undergo functional decline, which has been well investigated in a number of recent studies. In this review, we first describe the changes in MSCs during aging and discuss how these alterations can affect bone regeneration. We next review current research findings on bone tissue engineering, which is considered a promising and viable therapeutic solution for structural and functional restoration of bone. In particular, the importance of MSCs and bioscaffolds is highlighted. Finally, potential approaches for the prevention of MSC aging and the rejuvenation of aged MSC are discussed.

Fabrication, Morphology Analysis, and Mechanical Properties of Ti Foams Manufactured Using the Space Holder Method for Bone Substitute Materials

Porous titanium (Ti) offers several key attributes as a biomedical material. Among the known characteristics of Ti relevant to biomedical applications, the mechanical performance and effects of a pore structure on the deformation characteristics under compressive loading were examined. The space holder method was employed to generate Ti foams with target porosities of 60%, 70%, and 80%. A micro-computed to mography analysis and light and scanning electron microscopy were performed to examine the pore morphology and microstructure. The mechanical properties along with the elastic modulus and compressive strength were evaluated via uniaxial compression testing. Ti foam samples with three porosity levels displayed average elastic moduli and compressive strengths comparable with those of human cancellous and cortical bone. All the Ti foam samples had elastic moduli similar to those of cancellous bone with their open porous structures. Although the foam samples with ~60% porosity had compressive strength comparable to that of cortical bone, the samples with ~80% porosity displayed compressive strength similar to that of cancellous bone. The results indicate that Ti foam scaffolds produced using the space holder method have great potential for applications in hard tissue engineering, as their mechanical properties and pore structures are similar to those of bone.

Zero-Dimensional Carbon Dots Enhance Bone Regeneration, Osteosarcoma Ablation, and Clinical Bacterial Eradication

Zero-dimensional carbon dots (CD) and their effects on osteogenesis have been rarely studied in bone repair scaffolds. Here, we fabricate a novel CD doped chitosan/nanohydroxyapatite (CS/nHA/CD) scaffold with full potential to promote bone regeneration by a facile freeze-drying method. The CS/nHA/CD scaffolds enhanced cell adhesion and osteoinductivity in rat bone mesenchymal stem cells by up-regulating genes involved in focal adhesion and osteogenesis in vitro, which significantly improved the formation of vascularized new bone tissue at 4 weeks compared to pure CS/nHA scaffolds in vivo. Inspired by the excellent photothermal effect of CD, the scaffolds were applied in tumor photothermal therapy (PTT) under near-infrared (NIR) irradiation (808 nm, 1 W/cm2). The scaffolds significantly inhibited osteosarcoma cell proliferation in vitro and effectively suppressed tumor growth in vivo. Moreover, the CS/nHA/CD scaffolds possessed distinct antibacterial properties toward clinically collected S. aureus and E. coli, and their antibacterial activity was further enhanced under NIR irradiation. This work demonstrates that zero-dimensional CD can enhance the osteogenesis-inducing property of bone repair scaffolds and that CD doped scaffolds have potential for use in PTT for tumors and infections.

Synthesis, Characterization, Corrosion Resistance and In-Vitro Bioactivity Behavior of Biodegradable Mg⁻Zn⁻Mn⁻(Si⁻HA) Composite for Orthopaedic Applications

Recently, magnesium (Mg) has gained attention as a potential material for orthopedics devices, owing to the combination of its biodegradability and similar mechanical characteristics to those of bones. However, the rapid decay rate of Mg alloy is one of the critical barriers amongst its widespread applications that have provided numerous research scopes to the scientists. In this present, porous Mg-based biodegradable structures have been fabricated through the hybridization of elemental alloying and spark plasma sintering technology. As key alloying elements, the suitable proportions of silicon (Si) and hydroxyapatite (HA) are used to enhance the mechanical, chemical, and geometrical features. It has been found that the addition of HA and Si element results in higher degree of structural porosity with low elastic modulus and hardness of the Mg⁻Zn⁻Mn matrix, respectively. Further, addition of both HA and Si elements has refined the grain structure and improved the hardness of the as-fabricated structures. Moreover, the characterization results validate the formation of various biocompatible phases, which enhances the corrosion performance and biomechanical integrity. Moreover, the fabricated composites show an excellent bioactivity and offer a channel/interface to MG-63 cells for attachment, proliferation and differentiation. The overall results of the present study advocate the usefulness of developed structures for orthopedics applications.

Preparation and characterization of titanium-segmented polyurethane composites for bone tissue engineering

Segmented polyurethanes were prepared with polycaprolactone diol as soft segment and 4,4-methylene-bis cyclohexyl diisocyanate and l-glutamine as the rigid segment. These polyurethanes were filled with 1 wt.% to 5 wt.% titanium particles (Ti), physicochemically characterized and their biocompatibility assessed using human dental pulp stem cells and mice osteoblasts. Physicochemical characterization showed that composites retained the properties of the semicrystalline polyurethane as they exhibited a glass transition temperature (T_g) between -35°C and -45°C, melting temperature (T_m) at 52°C and crystallinity close to 40% as determined by differential scanning calorimetry. In agreement with this, X-ray diffraction showed reflections at 21.3° and 23.6° for polycaprolactone diol and reflections at 35.1°, 38.4°, and 40.2° for Ti particles suggesting that these particles are not acting as nucleating sites. The addition of up to 5 wt.% of Ti reduced both, tensile strength and maximum strain from 1.9 MPa to 1.2 MPa, and from 670% to 172% for pristine and filled polyurethane, respectively. Although there were differences between composites at low strain rates, no significant differences in mechanical behavior were observed at higher strain rate where a tensile stress of 8.5 MPa and strain of 223% were observed for 5 wt.% composites. The addition to titanium particles had a beneficial effect on both human dental pulp stem cells and osteoblasts viability, as it increased with the amount of titanium in composites up to 10 days of incubation.

Micro-CT based modelling for characterising injection-moulded porous titanium implants

Design of prosthetic implants to ensure rapid and stable osseointegration remains a significant challenge, and continuous efforts have been directed to new implant materials, structures and morphology. This paper aims to develop and characterise a porous titanium dental implant fabricated by metallic powder injection-moulding. The surface morphology of the specimens was first examined with a scanning electron microscope (SEM), followed by microscopic computerised tomography (μ-CT) scanning to capture its 3D microscopic features non-destructively. The nature of porosity and pore sizes were determined statistically. A homogenisation technique based on the Hills-energy theorem was adopted to evaluate its directional elastic moduli, and the conservation of mass theorem was employed to quantify the oxygen diffusivity for bio-transportation feature. This porous medium was found to have pore sizes varying from 50 to 400 µm and the average porosity of 46.90 ± 1.83%. The anisotropic principal elastic moduli were found fairly close to the upper range of cortical bone, and the directional diffusivities could potentially enable radial osseous tissue ingrowth and vascularisation. This porous titanium successfully reduces the elastic modulus mismatch between implant and bone for dental and orthopaedic applications, and provides improved capacity for transporting oxygen, nutrient and waste for pre-vascular network formation. Copyright © 2016 John Wiley & Sons, Ltd.

Microstructure and Characteristics of Calcium Phosphate Layers on Bioactive Oxide Surfaces of Air-Sintered Titanium Foams after Immersion in Simulated Body Fluid

We propose a simple and low-cost process for the preparation of porous Ti foams through a sponge replication method using single-step air sintering at various temperatures. In this study, the apatite-forming ability of air-sintered Ti samples after 21 days of immersion in simulated body fluid (SBF) was investigated. The microstructures of the prepared Ca-P deposits were examined by X-ray diffraction (XRD), field-emission scanning electron microscopy (FE-SEM), Fourier transform infrared (FTIR) spectroscopy, and cross-sectional transmission electron microscopy (TEM). In contrast to the control sample sintered in vacuum, which was found to have the simple hexagonal α-Ti phase, the air-sintered samples contained only the rutile phase. High intensities of XRD peaks for rutile TiO₂ were obtained with samples sintered at 1000 °C. Moreover, the air-sintered Ti samples had a greater apatite-forming ability than that of the Ti sample sintered in vacuum. Ti samples sintered at 900 and 1000 °C had large aggregated spheroidal particles on their surfaces after immersion in SBF for 21 days. Combined XRD, energy-dispersive X-ray spectroscopy, FTIR spectroscopy, and TEM results suggest that the calcium phosphate deposited on the rutile TiO₂ surfaces consist of carbonated calcium-deficient hydroxyapatite instead of octacalcium phosphate.

Randomized controlled clinical trial of 2 types of hydroxyapatite-coated implants on moderate periodontitis patients

Purpose

The aim of this study was to compare and analyze the peri-implant tissue conditions and prospective clinical outcomes associated with 2 types of hydroxyapatite (HA)-coated implants: (1) fully HA-coated implants and (2) partially HA-coated implants with resorbable blast medium on the coronal portion of the threads.

Methods

Forty-four partially edentulous patients were randomly assigned to undergo the placement of 62 HA-coated implants, and were classified as the control group (partially HA-coated, n=30) and the test group (fully HA-coated, n=32). All patients had chronic periodontitis with moderate crestal bone loss around the edentulous area. The stability and clinical outcomes of the implants were evaluated using the primary and secondary implant stability quotient (ISQ), as well as radiographic, mobility, and peri-implant soft tissue assessments around the implants. The Wilcoxon signed-rank test and the Mann-Whitney test were used to evaluate differences between and within the 2 groups, with P values <0.05 considered to indicate statistical significance.

Results

The fully HA-coated implants displayed good retention of crestal bone, and insignificant differences were found in annual marginal bone loss between the 2 types of HA-coated implants (P>0.05). No significant differences were found in the survival rate (group I, 100%; group II, 100%) or the success rate (group I, 93.3%; group II, 93.8%). The fully HA-coated implants also did not significantly increase the risk of peri-implantitis (P>0.05).

Conclusions

The fully HA-coated implants did not lead to an increased risk of peri-implantitis and showed good retention of the crestal bone, as well as good survival and success rates. Our study suggests that fully HA-coated implants could become a reliable treatment alternative for edentulous posterior sites and are capable of providing good retention of the crestal bone.

Bioactive macroporous titanium implants highly interconnected

Intervertebral implants should be designed with low load requirements, high friction coefficient and low elastic modulus in order to avoid the stress shielding effect on bone. Furthermore, the presence of a highly interconnected porous structure allows stimulating bone in-growth and enhancing implant-bone fixation. The aim of this study was to obtain bioactive porous titanium implants with highly interconnected pores with a total porosity of approximately 57 %. Porous Titanium implants were produced by powder sintering route using the space holder technique with a binder phase and were then evaluated in an in vivo study. The size of the interconnection diameter between the macropores was about 210 μm in order to guarantee bone in-growth through osteblastic cell penetration. Surface roughness and mechanical properties were analyzed. Stiffness was reduced as a result of the powder sintering technique which allowed the formation of a porous network. Compression and fatigue tests exhibited suitable properties in order to guarantee a proper compromise between mechanical properties and pore interconnectivity. Bioactivity treatment effect in novel sintered porous titanium materials was studied by thermo-chemical treatments and were compared with the same material that had undergone different bioactive treatments. Bioactive thermo-chemical treatment was confirmed by the presence of sodium titanates on the surface of the implants as well as inside the porous network. Raman spectroscopy results suggested that the identified titanate structures would enhance in vivo apatite formation by promoting ion exchange for the apatite formation process. In vivo results demonstrated that the bioactive titanium achieved over 75 % tissue colonization compared to the 40 % value for the untreated titanium.

Fabrication of Mechanically Tunable and Bioactive Metal Scaffolds for Biomedical Applications

Biometal systems have been widely used for biomedical applications, in particular, as load-bearing materials. However, major challenges are high stiffness and low bioactivity of metals. In this study, we have developed a new method towards fabricating a new type of bioactive and mechanically reliable porous metal scaffolds-densified porous Ti scaffolds. The method consists of two fabrication processes, 1) the fabrication of porous Ti scaffolds by dynamic freeze casting, and 2) coating and densification of the porous scaffolds. The dynamic freeze casting method to fabricate porous Ti scaffolds allowed the densification of porous scaffolds by minimizing the chemical contamination and structural defects. The densification process is distinctive for three reasons. First, the densification process is simple, because it requires a control of only one parameter (degree of densification). Second, it is effective, as it achieves mechanical enhancement and sustainable release of biomolecules from porous scaffolds. Third, it has broad applications, as it is also applicable to the fabrication of functionally graded porous scaffolds by spatially varied strain during densification.

Surface treatments for controlling corrosion rate of biodegradable Mg and Mg-based alloy implants

Due to their excellent biodegradability characteristics, Mg and Mg-based alloys have become an emerging material in biomedical implants, notably for repair of bone as well as coronary arterial stents. However, the main problem with Mg-based alloys is their rapid corrosion in aggressive environments such as human bodily fluids. Previously, many approaches such as control of alloying materials, composition and surface treatments, have been attempted to regulate the corrosion rate. This article presents a comprehensive review of recent research focusing on surface treatment techniques utilised to control the corrosion rate and surface integrity of Mg-based alloys in both in vitro and in vivo environments. Surface treatments generally involve the controlled deposition of thin film coatings using various coating processes, and mechanical surfacing such as machining, deep rolling or low plasticity burnishing. The aim is to either make a protective thin layer of a material or to change the micro-structure and mechanical properties at the surface and sub-surface levels, which will prevent rapid corrosion and thus delay the degradation of the alloys. We have organised the review of past works on coatings by categorising the coatings into two classes-conversion and deposition coatings-while works on mechanical treatments are reviewed based on the tool-based processes which affect the sub-surface microstructure and mechanical properties of the material. Various types of coatings and their processing techniques under two classes of coating and mechanical treatment approaches have been analysed and discussed to investigate their impact on the corrosion performance, biomechanical integrity, biocompatibility and cell viability. Potential challenges and future directions in designing and developing the improved biodegradable Mg/Mg-based alloy implants were addressed and discussed. The literature reveals that no solutions are yet complete and hence new and innovative approaches are required to leverage the benefit of Mg-based alloys. Hybrid treatments combining innovative biomimetic coating and mechanical processing would be regarded as a potentially promising way to tackle the corrosion problem. Synergetic cutting-burnishing integrated with cryogenic cooling may be another encouraging approach in this regard. More studies focusing on rigorous testing, evaluation and characterisation are needed to assess the efficacy of the methods.

Beta-Sheet-Forming, Self-Assembled Peptide Nanomaterials towards Optical, Energy, and Healthcare Applications

Peptide self-assembly is an attractive route for the synthesis of intricate organic nanostructures that possess remarkable structural variety and biocompatibility. Recent studies on peptide-based, self-assembled materials have expanded beyond the construction of high-order architectures; they are now reporting new functional materials that have application in the emerging fields such as artificial photosynthesis and rechargeable batteries. Nevertheless, there have been few reviews particularly concentrating on such versatile, emerging applications. Herein, recent advances in the synthesis of self-assembled peptide nanomaterials (e.g., cross β-sheet-based amyloid nanostructures, peptide amphiphiles) are selectively reviewed and their new applications in diverse, interdisciplinary fields are described, ranging from optics and energy storage/conversion to healthcare. The applications of peptide-based self-assembled materials in unconventional fields are also highlighted, such as photoluminescent peptide nanostructures, artificial photosynthetic peptide nanomaterials, and lithium-ion battery components. The relation of such functional materials to the rapidly progressing biomedical applications of peptide self-assembly, which include biosensors/chips and regenerative medicine, are discussed. The combination of strategies shown in these applications would further promote the discovery of novel, functional, small materials.

Nanostructured Titanium-10 wt% 45S5 Bioglass-Ag Composite Foams for Medical Applications

The article presents an investigation on the effectiveness of nanostructured titanium-10 wt% 45S5 Bioglass-1 wt% Ag composite foams as a novel class of antibacterial materials for medical applications. The Ti-based composite foams were prepared by the combination of mechanical alloying and a "space-holder" sintering process. In the first step, the Ti-10 wt% 45S5 Bioglass-1 wt% Ag powder synthesized by mechanical alloying and annealing mixed with 1.0 mm diameter of saccharose crystals was finally compacted in the form of pellets. In the next step, the saccharose crystals were dissolved in water, leaving open spaces surrounded by metallic-bioceramic scaffold. The sintering of the scaffold leads to foam formation. It was found that 1:1 Ti-10 wt% 45S5 Bioglass-1 wt% Ag/sugar ratio leads to porosities of about 70% with pore diameter of about 0.3-1.1 mm. The microstructure, corrosion resistance in Ringer's solution of the produced foams were investigated. The value of the compression strength for the Ti-10 wt% 45S5 Bioglass-1 wt% Ag foam with 70% porosity was 1.5 MPa and the Young's modulus was 34 MPa. Silver modified Ti-10 wt% 45S5 Bioglass composites possess excellent antibacterial activities against Staphylococcus aureus. Porous Ti-10 wt% 45S5 Bioglass-1 wt% foam could be a possible candidate for medical implants applications.

Biological strategies for improved osseointegration and osteoinduction of porous metal orthopedic implants

The biological interface between an orthopedic implant and the surrounding host tissue may have a dramatic effect upon clinical outcome. Desired effects include bony ingrowth (osseointegration), stimulation of osteogenesis (osteoinduction), increased vascularization, and improved mechanical stability. Implant loosening, fibrous encapsulation, corrosion, infection, and inflammation, as well as physical mismatch may have deleterious clinical effects. This is particularly true of implants used in the reconstruction of load-bearing synovial joints such as the knee, hip, and the shoulder. The surfaces of orthopedic implants have evolved from solid-smooth to roughened-coarse and most recently, to porous in an effort to create a three-dimensional architecture for bone apposition and osseointegration. Total joint surgeries are increasingly performed in younger individuals with a longer life expectancy, and therefore, the postimplantation lifespan of devices must increase commensurately. This review discusses advancements in biomaterials science and cell-based therapies that may further improve orthopedic success rates. We focus on material and biological properties of orthopedic implants fabricated from porous metal and highlight some relevant developments in stem-cell research. We posit that the ideal primary and revision orthopedic load-bearing metal implants are highly porous and may be chemically modified to induce stem cell growth and osteogenic differentiation, while minimizing inflammation and infection. We conclude that integration of new biological, chemical, and mechanical methods is likely to yield more effective strategies to control and modify the implant-bone interface and thereby improve long-term clinical outcomes.

Pore Geometry Optimization of Titanium (Ti6Al4V) Alloy, for Its Application in the Fabrication of Customized Hip Implants

The present study investigates the mechanical response of representative volume elements of porous Ti-6Al-4V alloy, to arrive at a desired range of pore geometries that would optimize the reduction in stiffness necessary for biocompatibility with the stress concentration arising around the pore periphery, under physiological loading conditions with respect to orthopedic hip implants. A comparative study of the two is performed with the aid of a newly defined optimizing parameter called pore efficiency that takes into consideration both the stiffness quantity and the stress localization around pores. To perform a detailed analysis of the response of the porous structure over the entire spectrum of loading conditions that a hip implant is subjected to in vivo, the mechanical responses of 3D finite element models of cubic and rectangular parallelepiped geometries, with porosities varying over a range of 10% to 60%, are simulated under representative compressive, flexural as well as combined loading conditions. The results that are obtained are used to suggest a range of pore diameters that lower the effective stiffness and modulus of the implant to around 60% of the stiffness and modulus of dense solid implants while keeping the stress levels within permissible limits.

A Porous TiAl6V4 Implant Material for Medical Application

Increased durability of permanent TiAl6V4 implants still remains a requirement for the patient's well-being. One way to achieve a better bone-material connection is to enable bone “ingrowth” into the implant. Therefore, a new porous TiAl6V4 material was produced via metal injection moulding (MIM). Specimens with four different porosities were produced using gas-atomised spherical TiAl6V4 with different powder particle diameters, namely, “Small” (<45 μm), “Medium” (45–63 μm), “Mix” (90% 125–180 μm + 10% <45 μm), and “Large” (125–180 μm). Tensile tests, compression tests, and resonant ultrasound spectroscopy (RUS) were used to analyse mechanical properties. These tests revealed an increasing Young's modulus with decreasing porosity; that is, “Large” and “Mix” exhibit mechanical properties closer to bone than to bulk material. By applying X-ray tomography (3D volume) and optical metallographic methods (2D volume and dimensions) the pores were dissected. The pore analysis of the “Mix” and “Large” samples showed pore volumes between 29% and 34%, respectively, with pore diameters ranging up to 175 μm and even above 200 μm for “Large.” Material cytotoxicity on bone cell lines (SaOs-2 and MG-63) and primary cells (human bone-derived cells, HBDC) was studied by MTT assays and highlighted an increasing viability with higher porosity.

Application of Titanium Metal Materials and Bone Tissue Engineering in Exercise-Induced Bone Injury Repair

Find a good biological characteristic of repair material of bone tissue engineering has been a hot research in the Department of orthopedics. Although there are various kinds of bone repair materials and methods, but no one can perfectly replace the human bone. Especially in the sports competition fierce, sports injury is one of the most common damages. Repair the damage of the traditional method of bone often because of their poor biocompatibility, lack of materials, not with the individual growth and other problems. It greatly reduced the effects of restoration. And titanium mesh and bone graft has the advantages of simple operation, low rejection, shapeable, implantation can close bone combined with host bone formation, and have fixed a support function, bone defect repair and can obtain satisfactory.

Fabrication and characterization of porous Ti-7.5Mo alloy scaffolds for biomedical applications

Porous titanium and titanium alloys are promising scaffolds for bone tissue engineering, since they have the potential to provide new bone tissue ingrowth abilities and low elastic modulus to match that of natural bone. In the present study, porous Ti-7.5Mo alloy scaffolds with various porosities from 30 to 75 % were successfully prepared through a space-holder sintering method. The yield strength and elastic modulus of a Ti-7.5Mo scaffold with a porosity of 50 % are 127 MPa and 4.2 GPa, respectively, being relatively comparable to the reported mechanical properties of natural bone. In addition, the porous Ti-7.5Mo alloy exhibited improved apatite-forming abilities after pretreatment (with NaOH or NaOH + water) and subsequent immersion in simulated body fluid (SBF) at 37 °C. After soaking in an SBF solution for 21 days, a dense apatite layer covered the inner and outer surfaces of the pretreated porous Ti-7.5Mo substrates, thereby providing favorable bioactive conditions for bone bonding and growth. The preliminary cell culturing result revealed that the porous Ti-7.5Mo alloy supported cell attachment.

Bioactivity of porous titanium with hydrogen peroxide solution with or without tantalum chloride treatment at a low temperature

In this study, porous titanium was treated by a hydrogen peroxide solution with (HT) or without (HO) tantalum chloride at a low temperature to endow its bioactivity. The microstructure, film stability and in vitro and in vivo bioactivity of HT-treated and HO-treated porous titanium were investigated, and the non-treated one was used as control. After HT treatment, a well-crystallized titania nanoparticle film consisting of anatase phase with good film stability was formed on the surface of porous titanium, and the tantalum element appeared in the film, while the HO-treated porous titanium surface showed a dual structure with well-aligned nanorods as an outer layer and condensed nanoparticles as an inner layer consisting of a mixture of well-crystallized anatase and rutile phases. In vitro bioactivity assessment showed that both HT- and HO-treated porous titanium possessed high apatite-forming ability. More importantly, after implantation in the dorsal muscles of dogs, the HT- and HO-treated implants induced ectopic bone formation in its inner pores after 5 months, while the non-treated one did not. The present study showed that HT-treated porous titanium possessed good film stability and bioactivity to be used as bone repair materials in clinic under load-bearing conditions.

Investigation on Osteoblast Growth on the Modified Surface of Porous Titanium

Three methods have been used to modify the porous titanium surface, which is the alkali heat treatment, alkali heat treatment + SBF solution soak and alkali heat treatment + precalcidied + SBF solution soak. The morphology of different surfaces was observed by scanning electron microscopy (SEM). The MC3T3-E1 osteoblast cell was cultured on the modified and unmodified surface of porous titanium with 3days and 7days, the morphology of osteoblast adhesion and growth on different surface was observed. The results showed that osteoblast adhere on the modified and unmodified surface of the porous titanium. Osteoblast on AHS and HA modified surface can grow and spread, but it cannot grow and spread on unmodified and AH modified surface of the porous titanium. Osteoblast can grow across the different titanium fibers of on HA modified surface of porous titanium. Osteoblast on the HA surface has the very good biological suitability, which is beneficial to the combination of bone tissue and porous titanium.

Self-assembly of biomolecular soft matter

Self-assembly programmed by molecular structure and guided dynamically by energy dissipation is a ubiquitous phenomenon in biological systems that build functional structures from the nanoscale to macroscopic dimensions. This paper describes examples of one-dimensional self-assembly of peptide amphiphiles and the consequent biological functions that emerge in these systems. We also discuss here hierarchical self-assembly of supramolecular peptide nanostructures and polysaccharides, and some new results are reported on supramolecular crystals formed by highly charged peptide amphiphiles. Reflecting on presentations at this Faraday Discussion, the paper ends with a discussion of some of the future opportunities and challenges of the field.

Gamma ray treatment enhances bioactivity and osseointegration capability of titanium

The time-dependent degradation of titanium bioactivity (i.e., the biological aging of titanium) has been reported in previous studies. This phenomenon is caused by the loss of hydrophilicity and the inevitable occurrence of progressive contamination of titanium surfaces by hydrocarbons. In this study, we tested the hypothesis that gamma ray treatment, owing to its high energy to decompose and remove organic contaminants, enhances the bioactivity and osteoconductivity of titanium. Titanium disks were acid-etched and stored for 4 weeks. Rat bone marrow-derived osteoblasts (BMOs) were cultured on titanium disks with or without gamma ray treatment (30 kGy) immediately before experiments. The cell density at day 2 increased by 50% on gamma-treated surfaces, which reflected the 25% higher rate of cell proliferation. Osteoblasts on gamma-treated surfaces showed 30% higher alkaline phosphatase activity at day 5 and 60% higher calcium deposition at day 20. The strength of in vivo bone-implant integration increased by 40% at the early healing stage of week 2 for gamma-treated implants. Gamma ray-treated surfaces regained hydrophilicity and showed a lower percentage of carbon (35%) as opposed to 48% on untreated aged surfaces. The data indicated that gamma ray pretreatment of titanium substantially enhances its bioactivity and osteoconductivity, in association with the significant reduction in surface carbon and the recovery of hydrophilicity. The results suggest that gamma ray treatment could be an effective surface enhancement technology to overcome biological aging of titanium and improve the biological properties of titanium implants.

The Effect of Structural Design on Mechanical Properties and Cellular Response of Additive Manufactured Titanium Scaffolds

Restoration of segmental defects in long bones remains a challenging task in orthopedic surgery. Although autologous bone is still the ‘Gold Standard’ because of its high biocompatibility, it has nevertheless been associated with several disadvantages. Consequently, artificial materials, such as calcium phosphate and titanium, have been considered for the treatment of bone defects. In the present study, the mechanical properties of three different scaffold designs were investigated. The scaffolds were made of titanium alloy (Ti6Al4V), fabricated by means of an additive manufacturing process with defined pore geometry and porosities of approximately 70%. Two scaffolds exhibited rectangular struts, orientated in the direction of loading. The struts for the third scaffold were orientated diagonal to the load direction, and featured a circular cross-section. Material properties were calculated from stress-strain relationships under axial compression testing. In vitro cell testing was undertaken with human osteoblasts on scaffolds fabricated using the same manufacturing process. Although the scaffolds exhibited different strut geometry, the mechanical properties of ultimate compressive strength were similar (145–164 MPa) and in the range of human cortical bone. Test results for elastic modulus revealed values between 3.7 and 6.7 GPa. In vitro testing demonstrated proliferation and spreading of bone cells on the scaffold surface.