In vitro bioactivity evaluation of titanium and niobium metals with different surface morphologies

Niobium promotes fracture healing in rats by regulating the PI3K-Akt signalling pathway: An in vivo and in vitro study

Background

Stable fixation is crucial in fracture treatment. Currently, optimal fracture fixation devices with osteoinductivity, mechanical compatibility, and corrosion resistance are urgently needed for clinical practice. Niobium (Nb), whose mechanical properties are similar to those of bone tissue, has excellent biocompatibility and corrosion resistance, so it has the potential to be the most appropriate fixation material for internal fracture treatment. However, not much attention has been paid to the use of Nb in the area of clinical implants. Yet its role and mechanism of promoting fracture healing remain unclear. Hence, this study aims at elucidating on the effectiveness of Nb by systematically evaluating its osteogenic performance via in vivo and ex vivo tests.

Methods

Systematic in vivo and in vitro experiments were conducted to evaluate the osteogenic properties of Nb. In vitro experiments, the biocompatibility and osteopromoting activity of Nb were assessed. And the osteoinductive activity of Nb was assessed by alizarin red, ALP staining and PCR test. In vivo experiments, the effectiveness and biosafety of Nb in promoting fracture healing were evaluated using a rat femoral fracture model. Through the analysis of gene sequencing results of bone scab tissues, the upregulation of PI3K-Akt pathway expression was detected and it was verified by histochemical staining and WB experiments.

Results

Experiments in this study had proved that Nb had excellent in-vitro cell adhesion and proliferation-promoting effects without cytotoxicity. In addition, ALP activity, alizarin red staining and semi-quantitative analysis in the Nb group had indicated its profound impact on enhancing osteogenic differentiation of MC3T3-E1 cells. We also found that the use of Nb implants can accelerate fracture healing compared to that with Ti6Al4V using an animal model of femur fracture in rats, and the biosafety of Nb was confirmed in vivo via histological evaluation. Furthermore, we found that the osteogenic effects of Nb were achieved through activation of the PIK/Akt3 signalling pathway.

Conclusion

As is shown in the present research, Nb possessed excellent biosafety in clinical implants and accelerated fracture healing by activating the PI3K-Akt signalling pathway, which had good prospects for clinical translation, and it can replace titanium alloy as a material for new functional implants.

Study on Corrosion Resistance and Biological Properties of the Double Glow Plasma Nb-Zr Biological Implantation Alloying Layers

In order to improve the corrosion resistance of implant materials and understand the corrosion mechanisms, we prepared a biomedical Nb-Zr alloying layer on 316L stainless steel using double-layer glow plasma surface-alloying technology and investigated the effects of gas pressures on its surface structure, mechanical properties, and corrosion behavior. In particular, the surface states of the substrate and alloying layers were investigated using 3D confocal micrographs, the water contact angle, and UV reflectance, which aims to study the effect of the surface quality on corrosion resistance and discuss the corrosion mechanisms. The results show that the working pressure has an effect on the current density, the sputtering amount of the alloying elements, and the diffusion process of the alloying elements during glow discharge. The Nb-Zr alloying layer prepared under a pressure of 40 Pa had a uniform and dense surface structure, and the distribution was island-like. A Nb-Zr alloying layer with a thickness of 15 μm was successfully obtained, including the diffusion layer and the deposition layer. Simultaneously, the elements Nb and Zr were gradually distributed along the depth, and a high Nb concentration formed in the Nb-Zr alloying layer. The solid solution formed by Zr in the Nb layer significantly improved the microhardness and corrosion resistance of the substrate. The Nb-Zr alloying layer prepared under a pressure of 40 Pa had the lowest corrosion current density and excellent corrosion resistance, which originated from the passive film formed by the Nb-Zr alloying layer that could inhibit the invasion of corrosive ions and improve the corrosion resistance. In addition, the Nb-Zr alloying layer could promote cell proliferation during long-term use and had good biocompatibility. Our study provides an efficient, high-quality processing method for the surface modification of biomedical metallic materials to form thicker Nb-Zr alloying layers as a cost-effective alternative to bulk Nb-based alloys.

Comparison of osseointegration of Ti-Al6V4 and Ti-Al6Nb7 implants: An experimental study

Objective

In this study we aimed to investigate bone-implant connections (BICs) with Ti-Al₆V₄ and Ti-Al₆Nb₇ alloys. Two types of surface morphology, resorbable blast material (RBM) and sandblasted and acid-etched surfaces (SLA), were used for implants.

Materials and methods

Thirty female Sprague Dawley rats aged 0.5-1 year were used. The rats were randomly separated into three groups: 1) Ti-Al₆V₄ RBM surface (n = 10), 2), Ti-Al₆Nb₇ RBM surface (n = 10), and 3) Ti-Al₆Nb₇ SLA (n = 10) surface implants were surgically integrated in femoral bones. The average roughness (Ra) values for these implants were 1-2 Ra. The rats were sacrificed four weeks after the surgical procedure. For each section, the BIC ratio (%) was determined as a percentage of the total implant surface that was in direct contact with the bone.

Results

The BIC ratio was found to be higher in the Ti-Al₆Nb₇ RBM and Ti-Al₆Nb₇ SLA groups than in the Ti-Al₆V₄ RBM group (p < 0.05). There was no statistically significant difference in the BIC ratios between the Ti-Al₆Nb₇ RBM and Ti-Al₆Nb₇ SLA groups (p > 0.05).

Conclusion

Ti-Al₆Nb₇ exhibited good biocompatibility with bone cells. Ti-Al₆Nb₇ alloy could be a candidate material for dental implant production.

Biological Response to Nanosurface Modification on Metallic Biomaterials

PURPOSE OF REVIEW

New biomaterials for biomedical applications have been developed over the past few years. This work summarizes the current cell lines investigations regarding nanosurface modifications to improve biocompatibility and osseointegration.

RECENT FINDINGS

Material surfaces presenting biomimetic morphology that provides nanoscale architectures have been shown to alter cell/biomaterial interactions. Topographical and biofunctional surface modifications present a positive effect between material and host response. Nanoscale surfaces on titanium have the potential to provide a successful interface for implantable biomedical devices. Future studies need to directly evaluate how the titanium nanoscale materials will perform in in vivo experiments. Biocompatibility should be determined to identify titanium nanoscale as an excellent option for implant procedures.

Enhanced osteogenic differentiation of human mesenchymal stem cells on Ti surfaces with electrochemical nanopattern formation

Titanium (Ti) and its alloys are mainly used for dental and orthopedic applications due to their excellent biocompatibility and mechanical properties. However, their intrinsic bioinertness often quotes as a common complaint for biomedical applications. Herein, we produced nanopattern Ti surfaces with 10 nm nanopores in 120 nm dimples by electrochemical nanopattern formation (ENF), and evaluated the osteogenic differentiation of human mesenchymal stem cells (hMSCs) on the nanopattern Ti surfaces. The ENF surfaces were obtained by removing the TiO₂ nanotube (NT) layers prepared by an anodization process. To determine the in vitro effects of the ENF surface, cell proliferation assay, alkaline phosphatase activity assay, alizarin red staining, western blotting, and immunocytochemistry were performed. Atomic force microscopy and scanning electron microscopy analysis show that the ENF surface has an ultrafine surface roughness with highly aligned nanoporous morphology. hMSCs on ENF surfaces exhibit increased proliferation and enhanced osteogenic differentiation as compared to the ordered TiO₂ nanotubular and compact TiO₂ surfaces. Surface modification with the ENF process is a promising technique for fabricating osteointegrative implant materials with a highly bioactive, rigid and purified nano surfaces.

A review of nanostructured surfaces and materials for dental implants: surface coating, patterning and functionalization for improved performance

The emerging field of nanostructured implants has enormous scope in the areas of medical science and dental implants. Surface nanofeatures provide significant potential solutions to medical problems by the introduction of better biomaterials, improved implant design, and surface engineering techniques such as coating, patterning, functionalization and molecular grafting at the nanoscale. This review is of an interdisciplinary nature, addressing the history and development of dental implants and the emerging area of nanotechnology in dental implants. After a brief introduction to nanotechnology in dental implants and the main classes of dental implants, an overview of different types of nanomaterials (i.e. metals, metal oxides, ceramics, polymers and hydrides) used in dental implant together with their unique properties, the influence of elemental compositions, and surface morphologies and possible applications are presented from a chemical point of view. In the core of this review, the dental implant materials, physical and chemical fabrication techniques and the role of nanotechnology in achieving ideal dental implants have been discussed. Finally, the critical parameters in dental implant design and available data on the current dental implant surfaces that use nanotopography in clinical dentistry have been discussed.

Influence of surface treatment on PEDOT coatings: surface and electrochemical corrosion aspects of newly developed Ti alloy

Surface treatment of metallic materials prior to the application of polymer coatings plays an important role in providing improved surface features and enhanced corrosion protection. In the current investigation, we aimed to evaluate the effect of surface treatment of newly developed TiNbZr (TNZ) alloys on the surface characteristics, including the surface topography, morphology, hydrophobicity and adhesion strength of subsequent poly(3,4-ethylenedioxythiophene) (PEDOT) coatings. The surface morphology, chemical composition, and surface roughness of both treated and coated alloys were characterized by scanning electron microscopy, energy dispersive spectroscopy, and optical profilometry, respectively. The adhesion strength of the coating was measured using a micro scratch machine. Furthermore, we also evaluated the performance of electrochemically synthesized PEDOT coatings on surface-treated TNZ alloys in terms of the surface protective performance in simulated body fluid (SBF) and in vitro bioactivity in osteoblast MG63 cells. Surface analysis findings indicated that the nature of the PEDOT coating (surface morphology, topography, wettability and adhesion strength) was intensely altered, while the surface treatment performed before electrodeposition facilitated the overall performance of PEDOT coatings as implant coating materials. The obtained corrosion studies confirmed the enhanced corrosion protection performance of PEDOT coatings on treated TNZ substrates. In vitro cell culture studies validated the improved cell adhesion and proliferation rate, further highlighting the important role of surface treatment before electrodeposition.

Surface modification of biomaterials and biomedical devices using additive manufacturing

The demand for synthetic biomaterials in medical devices, pharmaceutical products and, tissue replacement applications are growing steadily due to aging population worldwide. The use for patient matched devices is also increasing due to availability and integration of new technologies. Applications of additive manufacturing (AM) or 3D printing (3DP) in biomaterials have also increased significantly over the past decade towards traditional as well as innovative next generation Class I, II and III devices. In this review, we have focused our attention towards the use of AM in surface modified biomaterials to enhance their in vitro and in vivo performances. Specifically, we have discussed the use of AM to deliberately modify the surfaces of different classes of biomaterials with spatial specificity in a single manufacturing process as well as commented on the future outlook towards surface modification using AM.

STATEMENT OF SIGNIFICANCE

It is widely understood that the success of implanted medical devices depends largely on favorable material-tissue interactions. Additive manufacturing has gained traction as a viable and unique approach to engineered biomaterials, for both bulk and surface properties that improve implant outcomes. This review explores how additive manufacturing techniques have been and can be used to augment the surfaces of biomedical devices for direct clinical applications.

Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review

One of the critical issues in orthopaedic regenerative medicine is the design of bone scaffolds and implants that replicate the biomechanical properties of the host bones. Porous metals have found themselves to be suitable candidates for repairing or replacing the damaged bones since their stiffness and porosity can be adjusted on demands. Another advantage of porous metals lies in their open space for the in-growth of bone tissue, hence accelerating the osseointegration process. The fabrication of porous metals has been extensively explored over decades, however only limited controls over the internal architecture can be achieved by the conventional processes. Recent advances in additive manufacturing have provided unprecedented opportunities for producing complex structures to meet the increasing demands for implants with customized mechanical performance. At the same time, topology optimization techniques have been developed to enable the internal architecture of porous metals to be designed to achieve specified mechanical properties at will. Thus implants designed via the topology optimization approach and produced by additive manufacturing are of great interest. This paper reviews the state-of-the-art of topological design and manufacturing processes of various types of porous metals, in particular for titanium alloys, biodegradable metals and shape memory alloys. This review also identifies the limitations of current techniques and addresses the directions for future investigations.

rBMSC and bacterial responses to isoelastic carbon fiber-reinforced poly(ether-ether-ketone) modified by zirconium implantation

PEEK-based biomaterials have great potential applications as hard tissue substitutes in bone tissue engineering. However, inherent bio-inert properties limited their clinical use. In order to improve the bioactivity, in this work, zirconium ions were implanted into the carbon fiber-reinforced PEEK (CFR-PEEK) using plasma immersion ion implantation (PIII) technology. Surface morphologies and chemical compositions of Zr-PIII treated samples were analyzed by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), respectively. The results indicated that nanostructures and ZrO₂ nanoparticles were formed on the surface of CFR-PEEK after Zr-PIII. Mechanical tests revealed that nanohardness, elastic modulus, and elastic resistance increased after implantation, especially for the elastic modulus with a maximum value of about 14 GPa, which is much close to that of human natural bone. In vitro cellular experiments showed that Zr-PIII treated samples enhanced the initial adhesion of rBMSCs, spreading and proliferation significantly. Moreover, the heightened ALP activity, collagen secretion, and extracellular matrix mineralization suggested that Zr-PIII treatment could greatly lead to an up-regulated osteogenic differentiation of rBMSCs on CFR-PEEK. In addition, antibacterial properties were also investigated and the results showed that Zr-PIII treated CFR-PEEK with nanostructures exhibited obvious antibacterial activity against S. aureus but no effect on E. coli.

Porous niobium coatings fabricated with selective laser melting on titanium substrates: Preparation, characterization, and cell behavior

Nb, an expensive and refractory element with good wear resistance and biocompatibility, is gaining more attention as a new metallic biomaterial. However, the high price of the raw material, as well as the high manufacturing costs because of Nb's strong oxygen affinity and high melting point have limited the widespread use of Nb and its compounds. To overcome these disadvantages, porous Nb coatings of various thicknesses were fabricated on Ti substrate via selective laser melting (SLM), which is a 3D printing technique that uses computer-controlled high-power laser to melt the metal. The morphology and microstructure of the porous Nb coatings, which had pores ranging from 15 to 50 μm in size, were characterized with scanning electron microscopy (SEM). The average hardness of the coating, which was measured with the linear intercept method, was 392±37 HV. In vitro tests of the porous Nb coating which was monitored with SEM, immunofluorescence, and CCK-8 counts of cells, exhibited excellent cell morphology, attachment, and growth. The simulated body fluid test also proved the bioactivity of the Nb coating. Therefore, these new porous Nb coatings could potentially be used for enhanced early biological fixation to bone tissue. In addition, this study has shown that SLM technique could be used to fabricate coatings with individually tailored shapes and/or porosities from group IVB and VB biomedical metals and their alloys on stainless steel, Co-Cr, and other traditional biomedical materials without wasting raw materials.

Mechanical and physicochemical characterization along with biological interactions of a new Ti25Nb21Hf alloy for bone tissue engineering

Nowadays, one of the main challenges in metal implants for bone substitution is the achievement of an elastic modulus close to that of human cortical bone as well as to provide an adequate interaction with the surrounding tissue avoiding in vivo foreign body reaction. From this perspective, a new Ti-based alloy has been developed with Nb and Hf as alloying elements which are known as non-toxic and with good corrosion properties. The microstructure, mechanical behaviour and the physicochemical properties of this novel titanium alloy have been studied. Relationship of surface chemistry and surface electric charge with protein adsorption and cell adhesion has been evaluated due to its role for understanding the mechanism of biological interactions with tissues. The Ti25Nb21Hf alloy presented a lower elastic modulus than commercial alloys with a superior ultimate strength and yield strength than CP-Ti and very close to Ti6Al4V. It also exhibited good corrosion resistance. Furthermore, the results revealed that it had no cytotoxic effect on rat mesenchymal stem cells and allowed protein adsorption and cell adhesion. The experimental results make this alloy a promising material for bone substitution or for biomedical devices.

Bioactive titanate layers formed on titanium and its alloys by simple chemical and heat treatments

To reveal general principles for obtaining bone-bonding bioactive metallic titanium, Ti metal was heat-treated after exposure to a solution with different pH. The material formed an apatite layer at its surface in simulated body fluid when heat-treated after exposure to a strong acid or alkali solution, because it formed a positively charged titanium oxide and negatively charged sodium titanate film on its surface, respectively. Such treated these Ti metals tightly bonded to living bone. Porous Ti metal heat-treated after exposure to an acidic solution exhibited not only osteoconductive, but also osteoinductive behavior. Porous Ti metal exposed to an alkaline solution also exhibits osteoconductivity as well as osteoinductivity, if it was subsequently subjected to acid and heat treatments. These acid and heat treatments were not effective for most Ti-based alloys. However, even those alloys exhibited apatite formation when they were subjected to acid and heat treatment after a NaOH treatment, since the alloying elements were removed from the surface by the latter. The NaOH and heat treatments were also not effective for Ti-Zr-Nb-Ta alloys. These alloys displayed apatite formation when subjected to CaCl₂ treatment after NaOH treatment, forming Ca-deficient calcium titanate at their surfaces after subsequent heat and hot water treatments. The bioactive Ti metal subjected to NaOH and heat treatments has been clinically used as an artificial hip joint material in Japan since 2007. A porous Ti metal subjected to NaOH, HCl and heat treatments has successfully undergone clinical trials as a spinal fusion device.

Improvement of the biomedical properties of titanium using SMAT and thermal oxidation

Titanium and its alloys are excellent candidates for biomedical implant. However, they exhibit relatively poor tribological properties. In this study, a two-step treatment including surface mechanical attrition treatment (SMAT) combined with thermal oxidation process has been developed to improve the tribological properties and biocompatibility of Ti. Ti after two-step treatment shows excellent wear-resistance and biocompatibility among all Ti samples, which can be ascribed to the highest surface energy, well crystallinity of rutile layer on its surface. Overall, the two-step treatment is a prospective method to produce excellent biomedical Ti materials.

Interaction between mesenchymal stem cells and Ti-30Ta alloy after surface treatment

In this study, in vitro cytocompatibility was investigated in the Ti-30Ta alloy after two kinds of surfaces treatments: alkaline and biomimetic treatment. Each condition was evaluated by scanning electron microscopy/energy-dispersive X-ray spectroscopy. Cellular adhesion, viability, protein expression, morphology, and differentiation were evaluated with Bone marrow stromal cells (MSCs) to investigate the short and long-term cellular response by fluorescence microscope imaging and colorimetric assays techniques. Two treatments exhibited similar results with respect to total protein content and enzyme activity as compared with alloy without treatment. However, it was observed improved of the biomineralization, bone matrix formation, enzyme activity, and MSCs functionality after biomimetic treatment. These results indicate that the biomimetic surface treatment has a high potential for enhanced osseointegration.

Surface treatment, corrosion behavior, and apatite-forming ability of Ti-45Nb implant alloy

The low modulus β-type Ti-45Nb alloy is a promising new implant alloy due to its excellent mechanical biocompatibility and composition of non-toxic elements. The effect of surface treatments on the evolution of controlled topography and roughness was investigated by means of scanning electron microscopy and optical profilometry. Severe mechanical treatments, for example sand-blasting, or etching treatments in strongly oxidizing acidic solutions, like HF:HNO(3) (4:1) or H(2)SO(4):H(2)O(2) (1:1) piranha solution were found to be very effective. In particular, the latter generates a nanopatterned surface topography which is expected to be promising for the stimulation of bone tissue growth. Compared to Ti and Ti-6Al-4V, the β-type Ti-45Nb alloy requires significantly longer etching durations due to the high chemical stability of Nb. Severe surface treatments alter the passive film properties, but do not deteriorate the outstanding corrosion resistance of the Ti-45Nb alloy in synthetic body fluid environments. The Ti-45Nb appears to have a lower apatite-formation ability compared to Ti. Etching with H(2)SO(4):H(2)O(2) (1:1) piranha solution inhibits apatite formation on Ti, but not on Ti-45Nb.

The influence of surface energy of titanium-zirconium alloy on osteoblast cell functions in vitro

The success of an implant used for bone regeneration and repair is determined by the events that take place at the cell-material interface. An understanding of these interactions in vitro gives insights into the formulation of ideal conditions for their effective functioning in vivo. Thus, it is not only important to understand the physico-chemical properties of the materials but, also necessary to assess the cellular responses to them to determine their long-term stability and efficacy as implants. In the present study, we have compared the physico-chemical and biological properties of titanium (Ti) and two Ti-based alloys, namely: Ti- Zirconium (TiZr) and Ti-Niobium (TiNb). The morphology, chemical analysis, surface roughness, and contact angle measurements of the alloys were assessed by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), profilometer, and contact angle goniometer, respectively whereas the biological properties of the materials were evaluated by measuring the adhesion, proliferation, and differentiation of MC3T3-E1 osteoblast cells on the surfaces of these alloys. Our results indicate that the biological properties of osteoblasts were better on TiZr surface than on TiNb surface. Furthermore, the surface energy and substrate composition influenced the superior biological activity of the TiZr alloy.

Increased Biocompatibility and Bioactivity after Energetic PVD Surface Treatments

Ion implantation, a common technology in semiconductor processing, has been applied to biomaterials since the 1960s. Using energetic ion bombardment, a general term which includes conventional ion implantation plasma immersion ion implantation (PIII) and ion beam assisted thin film deposition, functionalization of surfaces is possible. By varying and adjusting the process parameters, several surface properties can be attuned simultaneously. Extensive research details improvements in the biocompatibility, mainly by reducing corrosion rates and increasing wear resistance after surface modification. Recently, enhanced bioactivity strongly correlated with the surface topography and less with the surface chemistry has been reported, with an increased roughness on the nanometer scale induced by self-organisation processes during ion bombardment leading to faster cellular adhesion processes.

Enhanced Bioactivity of Sandblasted and Acid-Etched Titanium Surfaces

Two new modified sandblasted and acid etched (SLA) surface methods had been used on commercially pure Ti (Cp-Ti) surface. Scanning electron microscopy investigation showed that modified SLA surfaces had micro- and nano-structure surface topography. Contact angle test showed that surface hydrophilicity was significantly increased after modified SLA surface modification. Human osteoblast-like MG63 cell attachment test showed that modified SLA surfaces would attach more cells than simple SLA surface. The alkaline phosphatase (ALP) activity assay indicated that ALP activity was enhanced on two modified SLA surfaces relative to SLA and mechanically polished Cp-Ti surface at early stage. Thus, subsequent chemical modification of SLA surface seems to be a promising method to generate better bioactive surface properties.

Improving biocompatibility of implantable metals by nanoscale modification of surfaces: an overview of strategies, fabrication methods, and challenges

The human body is an intricate biochemical-mechanical system, with an exceedingly precise hierarchical organization in which all components work together in harmony across a wide range of dimensions. Many fundamental biological processes take place at surfaces and interfaces (e.g., cell-matrix interactions), and these occur on the nanoscale. For this reason, current health-related research is actively following a biomimetic approach in learning how to create new biocompatible materials with nanostructured features. The ultimate aim is to reproduce and enhance the natural nanoscale elements present in the human body and to thereby develop new materials with improved biological activities. Progress in this area requires a multidisciplinary effort at the interface of biology, physics, and chemistry. In this Review, the major techniques that have been adopted to yield novel nanostructured versions of familiar biomaterials, focusing particularly on metals, are presented and the way in which nanometric surface cues can beneficially guide biological processes, exerting influence on cellular behavior, is illustrated.