Relationship between unit cell type and porosity and the fatigue behavior of selective laser melted meta-biomaterials

Biodegradation-affected fatigue behavior of extrusion-based additively manufactured porous iron-manganese scaffolds

Additively manufactured (AM) biodegradable porous iron-manganese (FeMn) alloys have recently been developed as promising bone-substituting biomaterials. However, their corrosion fatigue behavior has not yet been studied. Here, we present the first study on the corrosion fatigue behavior of an extrusion-based AM porous Fe35Mn alloy under cyclic loading in air and in the revised simulated body fluid (r-SBF), including the fatigue crack morphology and distribution in the porous structure. We hypothesized that the fatigue behavior of the architected AM Fe35Mn alloy would be strongly affected by the simultaneous biodegradation process. We defined the endurance limit as the maximum stress at which the scaffolds could undergo 3 million loading cycles without failure. The endurance limit of the scaffolds was determined to be 90 % of their yield strength in air, but only 60 % in r-SBF. No notable crack formation in the specimens tested in air was observed even after loading up to 90 % of their yield strength. As for the specimens tested in r-SBF, however, cracks formed in the specimens subjected to loads exceeding 60 % of their yield strength appeared to initiate on the periphery and propagate toward the internal struts. Altogether, the results show that the extrusion-based AM porous Fe35Mn alloy is capable of tolerating up to 60 % of its yield strength for up to 3 million cycles, which corresponds to 1.5 years of use of load-bearing implants subjected to repetitive gait cycles. The fatigue performance of the alloy thus further enhances its potential for trabecular bone substitution subjected to cyclic compressive loading. STATEMENT OF SIGNIFICANCE: Fatigue behavior of extrusion-based AM porous Fe35Mn alloy scaffolds in air and revised simulated body fluid was studied. The Fe35Mn alloy scaffolds endured 90 % of their yield strength for up to 3 × 106 loading cycles in air. Moreover, the scaffolds tolerated 3 × 106 loading cycles at 60 % of their yield strength in revised simulated body fluid. The Fe35Mn alloy scaffolds exhibited a capacity of withstanding 1.5-year physiological loading when used as bone implants.

Orthopedic meta-implants

Meta-biomaterials, engineered materials with distinctive combinations of mechanical, physical, and biological properties stemming from their micro-architecture, have emerged as a promising domain within biomedical engineering. Correspondingly, meta-implants, which serve as the device counterparts of meta-biomaterials, offer exceptional functionalities, holding great potential for addressing complex skeletal diseases. This paper presents a comprehensive overview of the various types of meta-implants, including hybrid, shape-morphing, metallic clay, and deployable meta-implants, highlighting their unprecedented properties and recent achievement in the field. This paper also delves into the potential future developments of meta-implants, addressing the exploration of multi-functionalities in meta-biomaterials and their applications in diverse biomedical fields.

Deep Learning for Size-Agnostic Inverse Design of Random-Network 3D Printed Mechanical Metamaterials

Practical applications of mechanical metamaterials often involve solving inverse problems aimed at finding microarchitectures that give rise to certain properties. The limited resolution of additive manufacturing techniques often requires solving such inverse problems for specific specimen sizes. Moreover, the candidate microarchitectures should be resistant to fatigue and fracture. Such a multi-objective inverse design problem is formidably difficult to solve but its solution is the key to real-world applications of mechanical metamaterials. Here, a modular approach titled "Deep-DRAM" that combines four decoupled models is proposed, including two deep learning (DL) models, a deep generative model based on conditional variational autoencoders, and direct finite element (FE) simulations. Deep-DRAM integrates these models into a framework capable of finding many solutions to the posed multi-objective inverse design problem based on random-network unit cells. Using an extensive set of simulations as well as experiments performed on 3D printed specimens, it is demonstrate that: 1) the predictions of the DL models are in agreement with FE simulations and experimental observations, 2) an enlarged envelope of achievable elastic properties (e.g., rare combinations of double auxeticity and high stiffness) is realized using the proposed approach, and 3) Deep-DRAM can provide many solutions to the considered multi-objective inverse design problem.

Titanium Multi-Topology Metamaterials with Exceptional Strength

Additively manufactured metamaterials are architectured cellular materials that can be engineered through structural innovations to achieve unusual mechanical and multifunctional properties. Among these, hollow-strut lattice (HSL) metamaterials have proven to allow outstanding structural efficiency, with a multifunctional architecture ideal for lightweight, biomedical, microfluidic, and thermal engineering. To capitalize on their structural efficiency and significantly extend their mechanical envelope, a thin-plate lattice topology is seamlessly integrated into the inner hollow space of an HSL topology. This integration serves a dual purpose: to radically enhance the resistance of the irregular HSL nodes to deformation and to uniformly distribute the applied stresses in the new topology for unparalleled strength. Fabricated in titanium alloy Ti-6Al-4V with densities of 1.0-1.8 g cm-3 , this thin-plate integrated hollow-strut lattice (TP-HSL) metamaterials achieve relative yield strength that well surpasses the empirical upper limit of all cellular metals, including HSL and solid-strut lattice (SSL) metamaterials made from various metallic alloys. Furthermore, their absolute yield strength drastically exceeds that of magnesium alloys with comparable densities while inheriting the high corrosion resistance, biocompatibility, heat resistance, and other unique attributes of Ti-6Al-4V. Titanium multi-topology metamaterials expand the boundaries of lightweight multifunctional metallic materials.

Titanium Alloy Implants with Lattice Structures for Mandibular Reconstruction

In recent years, the field of mandibular reconstruction has made great strides in terms of hardware innovations and their clinical applications. There has been considerable interest in using computer-aided design, finite element modelling, and additive manufacturing techniques to build patient-specific surgical implants. Moreover, lattice implants can mimic mandibular bone's mechanical and structural properties. This article reviews current approaches for mandibular reconstruction, their applications, and their drawbacks. Then, we discuss the potential of mandibular devices with lattice structures, their development and applications, and the challenges for their use in clinical settings.

Surface Nanostructures Enhanced Biocompatibility and Osteoinductivity of Laser-Additively Manufactured CoCrMo Alloys

Cobalt-chromium-molybdenum (CoCrMo) alloys are widely used in orthopedic implants due to their excellent corrosion and wear resistance and superior mechanical properties. However, their limited capability to promote cell adhesion and new bone tissue formation, poor blood compatibility, and risk of microbial infection can lead to implant failure or reduced implant lifespan. Surface structure modification has been used to improve the cytocompatibility and blood compatibility of implant materials and reduce the risk of infection. In this study, we prepared CoCrMo alloys with surface nanostructures of various aspect ratios (AR) using laser-directed energy deposition (L-DED) and biocorrosion. Our results showed that medium and high AR nanostructures reduced platelet adhesion, while all of the alloys demonstrated good blood compatibility and antibacterial properties. Moreover, the medium and high AR nanostructures promoted cell adhesion and spreading of both preosteoblast MC3T3 cells and human bone marrow mesenchymal stem cells (hMSCs). Furthermore, the nanostructure promoted the osteogenic differentiation of both cell types compared with the flat control surface, with a substantial enhancing effect for the medium and high ARs. Our study proposes a promising approach for developing implant materials with improved clinical outcomes.

Process-structure-biofunctional paradigm in cellular structured implants: an overview and perspective on the synergy between additive manufacturing, bio-mechanical behaviour and biological functions

The overview describes the synergy between biological sciences and cellular structures processed by additive manufacturing to elucidate the significance of cellular structured implants in eliminating stress shielding and in meeting the bio-mechanical property requirements of elastic modulus, impact resistance, and fatigue strength in conjunction with the biological functionality. The convergence of additive manufacturing, computer-aided design, and structure-property relationships is envisaged to provide the solution to the current day challenges in the biomedical arena. The traditional methods of fabrication of biomedical devices including casting and mechanical forming have limitations because of the mismatch in micro/microstructure, mechanical, and physical properties with the host site. Additive manufacturing of cellular structured alloys via electron beam melting and laser powder bed fusion has benefits of fabricating patient-specific design that is obtained from the computed tomography scan of the defect site. The discussion in the overview consists of two aspects - the first one describes the underlying reason that motivated 3D printing of implants from the perspective of minimising stress shielding together with the mechanical property requirements, where the mechanical properties of cellular structured implants depend on the cellular architecture and percentage cellular porosity. The second aspect focuses on the biological response of cellular structured devices.

Advancement in total hip implant: a comprehensive review of mechanics and performance parameters across diverse novelties

The UK's National Joint Registry (NJR) and the American Joint Replacement Registry (AJRR) of 2022 revealed that total hip replacement (THR) is the most common orthopaedic joint procedure. The NJR also noted that 10-20% of hip implants require revision within 1 to 10 years. Most of these revisions are a result of aseptic loosening, dislocation, implant wear, implant fracture, and joint incompatibility, which are all caused by implant geometry disparity. The primary purpose of this review article is to analyze and evaluate the mechanics and performance factors of advancement in hip implants with novel geometries. The existing hip implants can be categorized based on two parts: the hip stem and the joint of the implant. Insufficient stress distribution from implants to the femur can cause stress shielding, bone loss, excessive micromotion, and ultimately, implant aseptic loosening due to inflammation. Researchers are designing hip implants with a porous lattice and functionally graded material (FGM) stems, femur resurfacing, short-stem, and collared stems, all aimed at achieving uniform stress distribution and promoting adequate bone remodeling. Designing hip implants with a porous lattice FGM structure requires maintaining stiffness, strength, isotropy, and bone development potential. Mechanical stability is still an issue with hip implants, femur resurfacing, collared stems, and short stems. Hip implants are being developed with a variety of joint geometries to decrease wear, improve an angular range of motion, and strengthen mechanical stability at the joint interface. Dual mobility and reverse femoral head-liner hip implants reduce the hip joint's dislocation limits. In addition, researchers reveal that femoral headliner joints with unidirectional motion have a lower wear rate than traditional ball-and-socket joints. Based on research findings and gaps, a hypothesis is formulated by the authors proposing a hip implant with a collared stem and porous lattice FGM structure to address stress shielding and micromotion issues. A hypothesis is also formulated by the authors suggesting that the utilization of a spiral or gear-shaped thread with a matched contact point at the tapered joint of a hip implant could be a viable option for reducing wear and enhancing stability. The literature analysis underscores substantial research opportunities in developing a hip implant joint that addresses both dislocation and increased wear rates. Finally, this review explores potential solutions to existing obstacles in developing a better hip implant system.

Selective Laser Melting and Spark Plasma Sintering: A Perspective on Functional Biomaterials

Achieving lightweight, high-strength, and biocompatible composites is a crucial objective in the field of tissue engineering. Intricate porous metallic structures, such as lattices, scaffolds, or triply periodic minimal surfaces (TPMSs), created via the selective laser melting (SLM) technique, are utilized as load-bearing matrices for filled ceramics. The primary metal alloys in this category are titanium-based Ti6Al4V and iron-based 316L, which can have either a uniform cell or a gradient structure. Well-known ceramics used in biomaterial applications include titanium dioxide (TiO2), zirconium dioxide (ZrO2), aluminum oxide (Al2O3), hydroxyapatite (HA), wollastonite (W), and tricalcium phosphate (TCP). To fill the structures fabricated by SLM, an appropriate ceramic is employed through the spark plasma sintering (SPS) method, making them suitable for in vitro or in vivo applications following minor post-processing. The combined SLM-SPS approach offers advantages, such as rapid design and prototyping, as well as assured densification and consolidation, although challenges persist in terms of large-scale structure and molding design. The individual or combined application of SLM and SPS processes can be implemented based on the specific requirements for fabricated sample size, shape complexity, densification, and mass productivity. This flexibility is a notable advantage offered by the combined processes of SLM and SPS. The present article provides an overview of metal-ceramic composites produced through SLM-SPS techniques. Mg-W-HA demonstrates promise for load-bearing biomedical applications, while Cu-TiO2-Ag exhibits potential for virucidal activities. Moreover, a functionally graded lattice (FGL) structure, either in radial or longitudinal directions, offers enhanced advantages by allowing adjustability and control over porosity, roughness, strength, and material proportions within the composite.

In vitro fatigue behavior and in vivo osseointegration of the auxetic porous bone screw

The incidence of screw loosening, migration, and pullout caused by the insufficient screw-bone fixation stability is relatively high in clinical practice. To solve this issue, the auxetic unit-based porous bone screw (AS) has been put forward in our previous work. Its favorable auxetic effect can improve the primary screw-bone fixation stability after implantation. However, porous structure affected the fatigue behavior and in vivo longevity of bone screw. In this study, in vitro fatigue behaviors and in vivo osseointegration performance of the re-entrant unit-based titanium auxetic bone screw were studied. The tensile-tensile fatigue behaviors of AS and nonauxetic bone screw (NS) with the same porosity (51%) were compared via fatigue experiments, fracture analysis, and numerical simulation. The in vivo osseointegration of AS and NS were compared via animal experiment and biomechanical analysis. Additionally, the effects of in vivo dynamic tensile loading on the osseointegration of AS and NS were investigated and analyzed. The fatigue strength of AS was approximately 43% lower while its osseointegration performance was better than NS. Under in vivo dynamic tensile loading, the osseointegration of AS and NS both improved significantly, with the maximum increase of approximately 15%. Preferrable osseointegration of AS might compensate for the shortage of fatigue resistance, ensuring its long-term stability in vivo. Adequate auxetic effect and long-term stability of the AS was supposed to provide enough screw-bone fixation stability to overcome the shortages of the solid bone screw, developing the success of surgery and showing significant clinical application prospects in orthopedic surgery. STATEMENT OF SIGNIFICANCE: This research investigated the high-cycle fatigue behavior of re-entrant unit-based auxetic bone screw under tensile-tensile cyclic loading and its osseointegration performance, which has not been focused on in existing studies. The fatigue strength of auxetic bone screw was lower while the osseointegration was better than non-auxetic bone screw, especially under in vivo tensile loading. Favorable osseointegration of auxetic bone screw might compensate for the shortage of fatigue resistance, ensuring its long-term stability and longevity in vivo. This suggested that with adequate auxetic effect and long-term stability, the auxetic bone screw had significant application prospects in orthopedic surgery. Findings of this study will provide a theoretical guidance for design optimization and clinical application of the auxetic bone screw.

Topology optimization on metamaterial cells for replacement possibility in non-pneumatic tire and the capability of 3D-printing

One of the applications of mechanical metamaterials is in car tires, as a non-pneumatic tire (NPT). Therefore, to find a suitable cell to replace the pneumatic part of the tire, three different solution methods were used, including topology optimization of the cubic unit cell, cylindrical unit cell, and fatigue testing cylindrical sample (FTCS). First, to find the mechanical properties, a tensile test was conducted for materials made of polylactic acid (PLA) and then, the optimization was done based on the weight and overhang control for the possibility of manufacturing with 3D printers, as constraints, besides, the objective of minimum compliance. In the optimization of the cubic unit cell, the sample with a minimum remaining weight of 35% was selected as the optimal sample. However, for the cylindrical unit cell, a sample with a weight limit of 20% was the most optimal state. In contrast, in the FTCS optimization, a specimen with lower remaining weight equal to 60% of the initial weight was selected. After obtaining the answer, five cells in the FTCS and two mentioned cells were evaluated under compressive testing. The samples were also subjected to bending fatigue loadings. The results demonstrated that cellular structures with 15% of lower weight than the optimized samples had the same fatigue lifetime. In the compressive test, the line slope of the specimens with cellular structures in the elastic region of the force-displacement diagram was reduced by 37%, compared to the completely solid samples. However, the weight of these samples decreased by 59%. Furthermore, the fracture surface was also investigated by field-emission scanning electron microscopy. It was observed that a weak connection between the layers was the cause of failure.

Automated Defect Recognition for Additive Manufactured Parts Using Machine Perception and Visual Saliency

Metal additive manufacturing (AM) is known to produce internal defects that can impact performance. As the technology becomes more mainstream, there is a growing need to establish nondestructive inspection technologies that can assess and quantify build quality with high confidence. This article presents a complete, three-dimensional (3D) solution for automated defect recognition in AM parts using X-ray computed tomography (CT) scans. The algorithm uses a machine perception framework to automatically separate visually salient regions, that is, anomalous voxels, from the CT background. Compared with supervised approaches, the proposed concept relies solely on visual cues in 3D similar to those used by human operators in two-dimensional (2D) assuming no a priori information about defect appearance, size, and/or shape. To ingest any arbitrary part geometry, a binary mask is generated using statistical measures that separate lighter, material voxels from darker, background voxels. Therefore, no additional part or scan information, such as CAD files, STL models, or laser scan vector data, is needed. Visual saliency is established using multiscale, symmetric, and separable 3D convolution kernels. Separability of the convolution kernels is paramount when processing CT scans with potentially billions of voxels because it allows for parallel processing and thus faster execution of the convolution operation in single dimensions. Based on the CT scan resolution, kernel sizes may be adjusted to identify defects of different sizes. All adjacent anomalous voxels are subsequently merged to form defect clusters, which in turn reveals additional information regarding defect size, morphology, and orientation to the user, information that may be linked to mechanical properties, such as fatigue response. The algorithm was implemented in MATLAB™ using hardware acceleration, that is, graphics processing unit support, and tested on CT scans of AM components available at the Center for Innovative Materials Processing through Direct Digital Deposition (CIMP-3D) at Penn State's Applied Research Laboratory. Initial results show adequate processing times of just a few minutes and very low false-positive rates, especially when addressing highly salient and larger defects. All developed analytic tools can be simplified to accommodate 2D images.

Design Optimization of Additive Manufactured Edgeless Simple Cubic Lattice Structures under Compression

This study proposed an optimization framework and methodologies to design edgeless lattice structures featuring fillet and multipipe functions. Conventional lattice structures typically experience stress concentration at the sharp edges of strut joints, resulting in reduced mechanical performance and premature failure. The proposed approach aimed to improve the compression behavior of lattice structures by introducing edgeless features. Through finite element analysis, the optimized fillet edgeless simple cubic unit cell with a fillet radius to strut radius ratio of 0.753 showed a 12.1% improvement in yield stress and a 144% reduction in stress concentration. To validate the finite element analysis, experimental compressive tests were conducted, confirming that the introduction of edgeless functions improved the compressive strength of lattice structures manufactured through additive manufacturing. The optimized fillet edgeless simple cubic lattice structure exhibited the most effective improvement. This approach has promising potential for lattice structure applications.

Mechanical Properties of Internally Hierarchical Multiphase Lattices Inspired by Precipitation Strengthening Mechanisms

In metal metallurgy, precipitation strengthening is widely used to increase material strength by utilizing the impediment effect of the second-phase particles on dislocation movements. Inspired by this mechanism, in this paper, novel multiphase heterogeneous lattice materials are developed with enhanced mechanical properties utilizing a similar hindering effect of second-phase lattice cells on the shear band propagation. For this purpose, biphase and triphase lattice samples are fabricated using high-speed multi jet fusion (MJF) and digital light processing (DLP) additive manufacturing techniques, and a parametric study is carried out to investigate their mechanical properties. Different from the conventional random distribution, the second-phase and third-phase cells in this work are continuously distributed along the regular pattern of a larger-scale lattice to form internal hierarchical lattice structures. The results show that the triphase lattices possess balanced mechanical properties. Interestingly, this indicates that introducing a relatively weak phase also has the potential to improve the stiffness and plateau stress, which is distinct from the common mixed rule. This work is aimed at providing new references for the heterogeneous lattice design with outstanding mechanical properties through material microstructure inspiration.

Design and performance analysis of 3D-printed stiffness gradient femoral scaffold

Studies on 3D-printed porous bone scaffolds mostly focus on materials or structural parameters, while the repair of large femoral defects needs to select appropriate structural parameters according to the needs of different parts. In this paper, a kind of stiffness gradient scaffold design idea is proposed. Different structures are selected according to the different functions of different parts of the scaffold. At the same time, an integrated fixation device is designed to fix the scaffold. Finite element method was used to analyze the stress and strain of homogeneous scaffolds and the stiffness gradient scaffolds, and the relative displacement and stress between stiffness gradient scaffolds and bone in the case of integrated fixation and steel plate fixation. The results showed that the stress distribution of the stiffness gradient scaffolds was more uniform, and the strain of host bone tissue was changed greatly, which was beneficial to the growth of bone tissue. The integrated fixation method is more stable, less stress and evenly distributed. Therefore, the integrated fixation device combined with the design of stiffness gradient can repair the large femoral bone defect well.

New Class of Multifunctional Bioinspired Microlattice with Excellent Sound Absorption, Damage Tolerance, and High Specific Strength

Although mutually independent, simultaneous sound absorption and superior mechanical properties are often sought after in a material. One main challenge in achieving such a material will be on how to design it. Herein, we propose a bamboo-inspired design strategy to overcome the aforementioned challenges. Building on top of the basic octet-truss design, we introduce a hollow-tube architecture to achieve lightweight property and mechanical robustness and a septum-chamber architecture to introduce acoustic resonant cells. The concept is experimentally verified through samples fabricated using selective laser melting with the Inconel 718 alloy. High sound absorption coefficients (>0.99) with broadband spectra, damage-tolerant behavior, high specific strength (up to 81.2 MPa·cm3/g), and high specific energy absorption of 40.1 J/g have been realized in this design. The sound absorption capability is attributed to Helmholtz resonance through the pore-and-cavity morphology of the structure. Microscopically speaking, dissipation primarily occurs via the viscous frictional flow and thermal boundary layers on the air and microlattice interactions at the narrow pores. The high strength is in turn attributed to the near-membrane state of stress in the plate structures and the excellent strength of the base material. Overall, this work presents a new design concept for developing multifunctional metamaterials.

A review on in vitro/in vivo response of additively manufactured Ti-6Al-4V alloy

Bone replacement using porous and solid metallic implants, such as Ti-alloy implants, is regarded as one of the most practical therapeutic approaches in biomedical engineering. The bone is a complex tissue with various mechanical properties based on the site of action. Patient-specific Ti-6Al-4V constructs may address the key needs in bone treatment for having customized implants that mimic the complex structure of the natural tissue and diminish the risk of implant failure. This review focuses on the most promising methods of fabricating such patient-specific Ti-6Al-4V implants using additive manufacturing (AM) with a specific emphasis on the popular subcategory, which is powder bed fusion (PBF). Characteristics of the ideal implant to promote optimized tissue-implant interactions, as well as physical, mechanical/chemical treatments and modifications will be discussed. Accordingly, such investigations will be classified into 3B-based approaches (Biofunctionality, Bioactivity, and Biostability), which mainly govern native body response and ultimately the success in implantation.

Additive Manufacturing of Biomaterials-Design Principles and Their Implementation

Additive manufacturing (AM, also known as 3D printing) is an advanced manufacturing technique that has enabled progress in the design and fabrication of customised or patient-specific (meta-)biomaterials and biomedical devices (e.g., implants, prosthetics, and orthotics) with complex internal microstructures and tuneable properties. In the past few decades, several design guidelines have been proposed for creating porous lattice structures, particularly for biomedical applications. Meanwhile, the capabilities of AM to fabricate a wide range of biomaterials, including metals and their alloys, polymers, and ceramics, have been exploited, offering unprecedented benefits to medical professionals and patients alike. In this review article, we provide an overview of the design principles that have been developed and used for the AM of biomaterials as well as those dealing with three major categories of biomaterials, i.e., metals (and their alloys), polymers, and ceramics. The design strategies can be categorised as: library-based design, topology optimisation, bio-inspired design, and meta-biomaterials. Recent developments related to the biomedical applications and fabrication methods of AM aimed at enhancing the quality of final 3D-printed biomaterials and improving their physical, mechanical, and biological characteristics are also highlighted. Finally, examples of 3D-printed biomaterials with tuned properties and functionalities are presented.

3D Printed Biomimetic Metamaterials with Graded Porosity and Tapering Topology for Improved Cell Seeding and Bone Regeneration

Biomimetic metallic biomaterials prepared for bone scaffolds have drawn more and more attention in recent years. However, the topological design of scaffolds is critical to cater to multi-physical requirements for efficient cell seeding and bone regeneration, yet remains a big scientific challenge owing to the coupling of mechanical and mass-transport properties in conventional scaffolds that lead to poor control towards favorable modulus and permeability combinations. Herein, inspired by the microstructure of natural sea urchin spines, biomimetic scaffolds constructed by pentamode metamaterials (PMs) with hierarchical structural tunability were additively manufactured via selective laser melting. The mechanical and mass-transport properties of scaffolds could be simultaneously tuned by the graded porosity (B/T ratio) and the tapering level (D/d ratio). Compared with traditional metallic biomaterials, our biomimetic PM scaffolds possess graded pore distribution, suitable strength, and significant improvements to cell seeding efficiency, permeability, and impact-tolerant capacity, and they also promote in vivo osteogenesis, indicating promising application for cell proliferation and bone regeneration using a structural innovation.

Design and Analysis of Biomedical Scaffolds Using TPMS-Based Porous Structures Inspired from Additive Manufacturing

Gyroid (G) and primitive (P) porous structures have multiple application areas, ranging from thermal to mechanical, and fall in the complex triply periodic minimal surface (TPMS) category. Such intricate bioinspired constructs are gaining attention because they meet both biological and mechanical requirements for osseous reconstruction. The study aimed to develop G and P structures with varying porosity levels from 40% to 80% by modulating the strut thickness to proportionally resemble the stiffness of host tissue. The performance characteristics were evaluated using Ti6Al4V and important relationships between feature dimension, strut thickness, porosity, and stiffness were established. Numerical results showed that the studied porous structures could decrease stiffness from 107 GPa (stiffness of Ti6Al4V) to the range between 4.21 GPa to 29.63 GPa of varying porosities, which matches the human bone stiffness range. Furthermore, using this foundation, a subject-specific scaffold (made of P unit cells with an 80% porosity) was developed to reconstruct segmental bone defect (SBD) of the human femur, demonstrating a significant decrease in the stress shielding effect. Stress transfer on the bone surrounded by a P scaffold was compared with a solid implant which showed a net increase of stress transfer of 76% with the use of P scaffold. In the conclusion, future concerns and recommendations are suggested.

A novel CKIP-1 SiRNA slow-release coating on porous titanium implants for enhanced osseointegration

Osseointegration between implants and bone tissue lays the foundation for the long-term stability of implants. The incorporation of a porous structure and local slow release of siRNA to silence casein kinase-2 interacting protein-1 (CKIP-1), a downregulator of bone formation, is expected to promote osseointegration. Here, porous implants with a porous outer layer and dense inner core were prepared by metal coinjection molding (MIM). Mg-doped calcium phosphate nanoparticles (CaPNPs)-grafted arginine-glycine-aspartate cell adhesion sequence (RGD) and transcribed activator (TAT) (MCPRT)/CKIP-1 siRNA complex and polylysine (PLL) were coated onto the surface of the porous implants by layer-by-layer (LBL) self-deposition. The in vitro results showed that the MCPRT-siRNA coating promoted MG63 cell adhesion and proliferation, enhanced the protein expressions (ALP and OC) and bone formation-related gene expression (OPN, OC and COL-1α) in vitro. The in vivo results demonstrated that the porous structure enhanced bone ingrowth and that the local slow release of MCPRT-siRNA accelerated new bone formation at the early stage. The porous structure coupled with local CKIP-1 siRNA delivery constitutes a promising approach to achieve faster and stronger osseointegration for dental implants.

Mechanical and Fatigue Behavior of Cellular Structure Ti-6Al-4V Alloy Femoral Stems: A Finite Element Analysis

Repetitive loads acting on the hip joint fluctuate according to the type of activities produced by the human body. Repetitive loading is one of the factors that leads to fatigue failure of the implanted stems. The objective of this study is to develop lightweight femoral stems with cubic porous structures that will survive under fatigue loading. Cubic porous structures with different volumetric porosities were designed and subjected to compressive loading using finite element analysis (FEA) to measure the elastic moduli, yield strength, and ultimate tensile strength. These porous structures were employed to design femoral stems containing mechanical properties under compressive loading close to the intact bone. Several arrangements of radial geometrical porous functionally graded (FG) and homogenous Ti-6Al-4V porous femoral stems were designed and grouped under three average porosities of 30%, 50%, and 70% respectively. The designed stems were simulated inside the femoral bone with physiological loads demonstrating three walking speeds of 1, 3, and 5 km/h using ABAQUS. Stresses at the layers of the functionally graded stem were measured and compared with the yield strength of the relevant porous structure to check the possibility of yielding under the subjected load. The Soderberg approach is employed to compute the safety factor (Nf > 1.0) for each design under each loading condition. Several designs were shortlisted as potential candidates for orthopedic implants.

Additive Manufacturing in Orthopedics: A Review

Additive manufacturing is an advanced manufacturing manner that seems like the industrial revolution. It has the inborn benefit of producing complex formations, which are distinct from traditional machining technology. Its manufacturing strategy is flexible, including a wide range of materials, and its manufacturing cycle is short. Additive manufacturing techniques are progressively used in bone research and orthopedic operation as more innovative materials are developed. This Review lists the recent research results, analyzes the strengths and weaknesses of diverse three-dimensional printing strategies in orthopedics, and sums up the use of varying 3D printing strategies in surgical guides, surgical implants, surgical predictive models, and bone tissue engineering. Moreover, various postprocessing methods for additive manufacturing for orthopedics are described.

Effect of different structures fabricated by additive manufacturing on bone ingrowth

OBJECTIVE

To study the effects of different structures (solid/hollow) and pore diameters (300/600 μm) on bone ingrowth.

METHODS

Porous titanium alloy scaffolds (3.2 * 10.5 mm) were printed using electron beam melting. The implants were divided into either Hollow or Solid Group. The upper half of each implant was printed with a pore diameter of 600 μm while the bottom half was printed with a pore diameter of 300 μm. Visualization of the structural morphology was done using Scanning Electron Microscope (SEM). Cell proliferation was evaluated with the cell counting kit-8 assay and live/dead staining assay. The different lateral femoral condyles of 15 New Zealand rabbits were implanted with different groups of scaffolds. The rabbits were randomly sacrificed at the 4th, 8th, and 12th week postoperatively. Bone mineral density (BMD) and bone volume fraction (BV/TV) evaluation was completed by quantitative Micro-Computed Tomography (Micro-CT). Tissue histology were stained with toluidine blue to observe bone ingrowth under an optical microscope, and the percentage of new bone area were calculated using Image Pro-Plus 6.0.

RESULTS

SEM images showed a significant decrease in residual powder in the hollow implant and cell studies showed no obvious cytotoxicity for the Ti₆Al₄V scaffolds. Micro-CT reconstruction revealed high levels of new bone formation around the scaffolds. The trabeculae around the implants showed a gradual increase with each week, and new bone filled the scaffold pores gradually. BMD, BV/TV, and tissue histology revealed the 300 μm pore diameter is more conducive to bone ingrowth than the 600 μm (p < .05).

CONCLUSION

Our study revealed that Ti₆Al₄V implants with hollow structure could reduce the residual metal powder and implants with 300 μm pore diameter were more effective on bone formation than a 600 μm.

Mechanisms of fatigue crack initiation and propagation in auxetic meta-biomaterials

The fatigue performance of additively manufactured auxetic meta-biomaterials made from commercially pure titanium has been studied only recently. While certain assumptions have been made regarding the mechanisms underlying their fatigue failure, the exact mechanisms are not researched yet. Here, we studied the mechanisms of crack formation and propagation in cyclically loaded auxetic meta-biomaterials. Twelve different designs were subjected to compression-compression fatigue testing while performing full-field strain measurement using digital image correlation (DIC). The fatigue tests were stopped at different points before complete specimen failure to study the evolution of damage in the micro-architecture of the specimens using micro-computed tomography (micro-CT). Furthermore, finite element models were made to study the presence of stress concentrations. Structural weak spots were found in the inverted nodes and the vertical struts located along the outer rim of the specimens, matching the maximum principal strain concentrations and fracture sites in the DIC and micro-CT data. Cracks were often found to originate from internal void spaces or from sites susceptible to mode-I cracking. Many specimens maintained their structural integrity and exhibited no signs of rapid strain accumulation despite the presence of substantial crack growth. This observation underlines the importance of such microscale studies to identify accumulated damage that otherwise goes unnoticed. The potential release of powder particles from damaged lattices could elicit a foreign body response, adversely affecting the implant success. Finding the right failure criterion, therefore, requires more data than only those pertaining to macroscopic measurements and should always include damage assessment at the microscale. STATEMENT OF SIGNIFICANCE: The negative Poisson's ratio of auxetic meta-biomaterials makes them expand laterally in response to axial tension. This extraordinary property has great potential in the field of orthopedics, where it could enhance bone-implant contact. The fatigue performance of additively manufactured auxetic meta-biomaterials has only recently been studied and was found to be superior to many other bending- and stretch-dominated micro-architectures. In this study, we go beyond these macroscopic measurements and focus on the crack initiation and propagation. Full-field strain measurements and 3D imaging are used to paint a detailed picture of the mechanisms underlying fatigue. Using these data, specific aspects of the design and/or printing process can be targeted to improve the performance of auxetic meta-biomaterials in load-bearing applications.

The antibacterial and wear-resistant nano-ZnO/PEEK composites were constructed by a simple two-step method

Although the polyether ether ketone (PEEK) has excellent comprehensive properties, its non-antibacterial and low wear-resistant limit the wide application in the field of artificial joint materials. In this paper, Nano-ZnO was generated in situ on the surface of PEEK powder by one-step hydrothermal method, which improved the binding force of Nano-ZnO and PEEK matrix. Then the PEEK-based nanocomposites were prepared by melt blending with the synthesized Nano-ZnO-PEEK powders and PEEK powders. The microstructure, mechanical, biological and tribological properties of PEEK-based nanocomposites were studied. The results showed that the compressive strength of PEEK-based nanocomposites can reach up to 319.2 ± 2.4 MPa. Both PEEK and PEEK-based nanocomposites were non-toxic to cells. Meanwhile, PEEK-based nanocomposites showed good antibacterial activity against E.coli and Staphylococcus aureus, and the antibacterial activity was better with the increase of Nano-ZnO content. In addition, when the Nano-ZnO content was 5%, the wear rate of PEEK-based nanocomposites was about 68% lower than that of pure PEEK materials. Thus, PEEK-based nanocomposites has a dual function of good antibacterial property and excellent wear resistance.

Fatigue and dynamic biodegradation behavior of additively manufactured Mg scaffolds

Additive manufacturing (AM) has enabled the fabrication of biodegradable porous metals to satisfy the desired characteristics for orthopedic applications. The geometrical design on AM biodegradable metallic scaffolds has been found to offer a favorable opportunity to regulate their mechanical and degradation performance in previous studies, however mostly confined to static responses. In this study, we presented the effect of the geometrical design on the dynamic responses of AM Mg scaffolds for the first time. Three different types of porous structures, based on various unit cells (i.e., biomimetic, diamond, and sheet-based gyroid), were established and then subjected to selective laser melting (SLM) process using group-developed Mg-Nd-Zn-Zr alloy (JDBM) powders. The topology after dynamic electropolishing, dynamic compressive properties, and dynamic biodegradation behavior of the AM Mg scaffolds were comprehensively evaluated. It was found that dynamic electropolishing effectively removed the excessive adhered powders on the surfaces and resulted in similar geometrical deviations amongst the AM Mg scaffolds, independent of their porous structures. The geometrical design significantly affected the compressive fatigue properties of the AM Mg scaffolds, of which the sheeted-based gyroid structure demonstrated a superior fatigue endurance limit of 0.85 at 10⁶ cycles. Furthermore, in vitro dynamic immersion behaviors of the AM Mg scaffolds revealed a decent dependence on local architectures, where the sheeted-based gyroid scaffold experienced the lowest structural loss with a relatively uniform degradation mode. The obtained results indicate that the geometrical design could provide a promising strategy to develop desirable bone substitutes for the treatment of critical-size load-bearing defects. STATEMENT OF SIGNIFICANCE: Additive manufacturing (AM) has provided unprecedented opportunities to fabricate geometrically complex biodegradable scaffolds where the topological design becomes a key determinant on comprehensive performance. In this paper, we fabricate 3 AM biodegradable Mg scaffolds (i.e., biomimetic, diamond, and sheet-based gyroid) and report the effect of the geometrical design on the dynamic responses of AM Mg scaffolds for the first time. The results revealed that the sheeted-based gyroid scaffold exhibited the best combination of superior compressive fatigue properties and relatively uniform dynamic biodegradation mode, suggesting that the regulation of the porous structures could be an effective approach for the optimization of AM Mg scaffolds as to satisfy clinical requirements in orthopedic applications.

Morphological and mechanical characterisation of three-dimensional gyroid structures fabricated by electron beam melting for the use as a porous biomaterial

Additive manufactured porous biomaterials based on triply periodic minimal surfaces (TPMS) are a highly discussed topic in the literature. With their unique properties in terms of open porosity, large surface area and surface curvature, they are considered to have bone mimicking properties and remarkable osteogenic potential. In this study, scaffolds of gyroid unit cells of different sizes consisting of a Ti6Al4V alloy were manufactured additively by electron beam melting (EBM). The scaffolds were analysed by micro-computed tomography (micro-CT) to determine their morphological characteristics and, subsequently, subjected to mechanical tests to investigate their quasi-static compressive properties and fatigue resistance. All scaffolds showed an average open porosity of 71-81%, with an average pore size of 0.64-1.41 mm, depending on the investigated design. The design with the smallest unit cell shows the highest quasi-elastic gradient (QEG) as well as the highest compressive offset stress and compression strength. Furthermore, the fatigue resistance of all unit cell size (UCS) variations showed promising results. In detail, the smallest unit cells achieved fatigue strength at 10⁶ cycles at 45% of their compressive offset stress, which is comparatively good for additively manufactured porous biomaterials. In summary, it is demonstrated that the mechanical properties can be significantly modified by varying the unit cell size, thus enabling the scaffolds to be specifically tailored to avoid stress shielding and ensure implant safety. Together with the morphological properties of the gyroid unit cells, the fabricated scaffolds represent a promising approach for use as a bone substitute material.

Influence of relative density on quasi-static and fatigue failure of lattice structures in Ti6Al4V produced by laser powder bed fusion

Lattice structures produced by additive manufacturing have been increasingly studied in recent years due to their potential to tailor prescribed mechanical properties. Their mechanical performances are influenced by several factors such as unit cell topology, parent material and relative density. In this study, static and dynamic behaviors of Ti6Al4V lattice structures were analyzed focusing on the criteria used to define the failure of lattices. A modified face-centered cubic (FCCm) lattice structure was designed to avoid the manufacturing problems that arise in the production of horizontal struts by laser powder bed fusion. The Gibson-Ashby curves of the FCCm lattice were obtained and it was found that relative density not only affects stiffness and strength of the structures, but also has important implications on the assumption of macroscopic yield criterion. Regarding fatigue properties, a stiffness based criterion was analyzed to improve the assessment of lattice structure failure in load bearing applications, and the influence of relative density on the stiffness evolution was studied. Apart from common normalization of S-N curves, a more accurate fatigue failure surface was developed, which is also compatible with stiffness based failure criteria. Finally, the effect of hot isostatic pressing in FCCm structures was also studied.

Numerical and Experimental Investigation of Cumulative Fatigue Damage under Random Dynamic Cyclic Loads of Lattice Structures Manufactured by Laser Powder Bed Fusion

Lattice structures are lightweight engineering components suitable for a great variety of applications, including those in which the structural integrity under vibration fatigue is of paramount importance. In this work, we experimentally and numerically investigate the dynamic response of two distinct lattice configurations, in terms of fatigue damage and life. Specifically, Face-Centered-Cubic (FCC) and Diamond lattice-based structures are numerically studied and experimentally tested under resonant conditions and random vibrations, until their failure. To this end, Finite Element (FE) models are employed to match the dynamic behavior of the system in the neighborhood of the first natural frequency. The FE models are employed to estimate the structural integrity by way of frequency and tip acceleration drops, which allow for the identification of the failure time and a corresponding number of cycles to failure. Fatigue life under resonant conditions is well predicted by the application of conventional multiaxial high cycle fatigue criteria to the local state of stress. The same approach, combined with the Rainflow algorithm and Miner’s rule, provides good results in predicting fatigue damage under random vibrations.

Cubic Lattice Structures of Ti6Al4V under Compressive Loading: Towards Assessing the Performance for Hard Tissue Implants Alternative

Porous Lattice Structure (PLS) scaffolds have shown potential applications in the biomedical domain. These implants’ structural designs can attain compatibility mechanobiologically, thereby avoiding challenges related to the stress shielding effect. Different unit cell structures have been explored with limited work on the fabrication and characterization of titanium-based PLS with cubic unit cell structures. Hence, in the present paper, Ti6Al4V (Ti64) cubic PLS scaffolds were analysed by finite element (FE) analysis and fabricated using selective laser melting (SLM) technique. PLS of the rectangular shape of width 10 mm and height 15 mm (ISO: 13314) with an average pore size of 600–1000 μm and structure porosity percentage of 40–70 were obtained. It has been found that the maximum ultimate compressive strength was found to be 119 MPa of PLS with a pore size of 600 μm and an overall relative density (RD) of 57%. Additionally, the structure’s failure begins from the micro-porosity formed during the fabrication process due to the improper melting along a plane inclined at 45 degree.

Characterization of Ultralow Density Cellular Solids: Lessons from 30 years of Bone Biomechanics Research

Advances in additive manufacturing techniques have enabled the development of micro-architectured materials displaying a combination of low-density and lightweight structures with high specific strength and toughness. The mechanical performance of micro-architectured materials can be assessed using standard techniques; however, when studying low- and ultralow density micro-architectured materials, standard characterization techniques can be subject to experimental artifacts. Additionally, quantitative assessment and comparisons of microarchitectures with distinct lattice patterns is not always straightforward. Cancellous bone is a natural, ultralow density (porosity often exceeding 90%), irregular, cellular solid that has been thoroughly characterized in terms of micro-architecture and mechanical performance over the past 30 years. However, most the literature on cancellous bone mechanical properties and micro-structure-function relationships is in the medical literature and is not immediately accessible to materials designers. Here we provide a brief review of state-of-the-art approaches for characterizing the micro-architecture and mechanical performance of ultralow density cancellous bone, including methods of addressing experimental artifacts during mechanical characterization of ultralow density cellular solids, methods of quantifying microarchitecture, and currently understood structure-function relationships.

Microlattice Metamaterials with Simultaneous Superior Acoustic and Mechanical Energy Absorption

The advent of 3D printing brought about the possibilities of microlattice metamaterials as advanced materials with the potentials to surpass the functionalities of traditional materials. Sound absorbing materials which are also tough and lightweight are of particular importance as practical engineering materials. There are however a lack of attempts on the study of metamaterials multifunctional for both purposes. Herein, we present four types of face-centered cubic based plate and truss microlattices as novel metamaterials with simultaneous excellent sound and mechanical energy absorption performance. High sound absorption coefficients nearing 1 and high specific energy absorption of 50.3 J g^-1 have been measured. Sound absorption mechanisms of microlattices are proposed to be based on a "cascading resonant cells theory", an extension of the Helmholtz resonance principle that we have conceptualized herein. Characteristics of absorption coefficients are found to be essentially geometry limited by the pore and cavity morphologies. The excellent mechanical properties in turn derive from both the approximate membrane stress state of the plate architecture and the excellent ductility and strength of the base material. Overall, this work presents a new concept on the specific structural design and materials selection for architectured metamaterials with dual sound and mechanical energy absorption capabilities.

Fatigue performance of auxetic meta-biomaterials

Meta-biomaterials offer a promising route towards the development of life-lasting implants. The concept aims to achieve solutions that are ordinarily impossible, by offering a unique combination of mechanical, mass transport, and biological properties through the optimization of their small-scale geometrical and topological designs. In this study, we primarily focus on auxetic meta-biomaterials that have the extraordinary ability to expand in response to axial tension. This could potentially improve the longstanding problem of implant loosening, if their performance can be guaranteed in cyclically loaded conditions. The high-cycle fatigue performance of additively manufactured (AM) auxetic meta-biomaterials made from commercially pure titanium (CP-Ti) was therefore studied. Small variations in the geometry of the re-entrant hexagonal honeycomb unit cell and its relative density resulted in twelve different designs (relative density: ~5-45%, re-entrant angle = 10-25°, Poisson's ratio = -0.076 to -0.504). Micro-computed tomography, scanning electron microscopy and mechanical testing were used to respectively measure the morphological and quasi-static properties of the specimens before proceeding with compression-compression fatigue testing. These auxetic meta-biomaterials exhibited morphological and mechanical properties that are deemed appropriate for bone implant applications (elastic modulus = 66.3-5648 MPa, yield strength = 1.4-46.7 MPa, pore size = 1.3-2.7 mm). With an average maximum stress level of 0.47 σ_y at 10⁶ cycles (range: 0.35 σ_yσ_y- 0.82 σ_yσ_y), the auxetic structures characterized here are superior to many other non-auxetic meta-biomaterials made from the same material. The optimization of the printing process and the potential application of post-processing treatments could improve their performance in cyclically loaded settings even further. STATEMENT OF SIGNIFICANCE: Auxetic meta-biomaterials have a negative Poisson's ratio and, therefore, expand laterally in response to axial tension. Recently, they have been found to restore bone-implant contact along the lateral side of a hip stem. As a result, the bone will be compressed along both of the implant's contact lines, thereby actively reducing the risk of implant failure. In this case the material will be subjected to cyclic loading, for which no experimental data has been reported yet. Here, we present the first ever study of the fatigue performance of additively manufactured auxetic meta-biomaterials based on the re-entrant hexagonal honeycomb. These results will advance the adoption of auxetic meta-biomaterials in load-bearing applications, such as the hip stem, to potentially improve implant longevity.

Additively manufactured space-filling meta-implants

The unprecedented properties of meta-biomaterials could pave the way for the development of life-lasting orthopedic implants. Here, we used non-auxetic meta-biomaterials to address the shortcomings of the current treatment options in acetabular revision surgery. Due to the severe bone deficiencies and poor bone quality, it can be very challenging to acquire adequate initial implant stability and long-term fixation. More advanced treatments, such as patient-specific implants, do guarantee the initial stability, but are formidably expensive and may eventually fail due to stress shielding. We, therefore, developed meta-implants furnished with a deformable porous outer layer. Upon implantation, this layer plastically deforms into the defects, thereby improving the initial stability and homogeneously stimulating the surrounding bone. We first studied the space-filling behavior of additively manufactured pure titanium lattices, based on six different unit cells, in a compression test complemented with full-field strain measurements. The diamond, body-centered cubic, and rhombic dodecahedron unit cells were eventually selected for the design of the deformable porous outer layer. Each design came in three different relative density profiles, namely maximum (MAX), functionally graded (FG), and minimum (MIN). After their compression in bone-mimicking molds with simulated acetabular defects, the space-filling behavior of the implants was evaluated using load-displacement curves, micro-CT images, and 3D reconstructions. The meta-implants with an FG diamond infill exhibited the most promising space-filling behavior. However, the required push-in forces exceed the impact forces currently applied in surgery. Future research should, therefore, focus on design optimization, to improve the space-filling behavior and to facilitate the implantation process for orthopedic surgeons. STATEMENT OF SIGNIFICANCE: Ideally, orthopedic implants would last for the entire lifetime of the patient. Unfortunately, they rarely do. Critically sized defects are a common sight in the revision of acetabular cups, and rather difficult to treat. The permanent deformation of lattice structures can be used to create shape-morphing implants that would fill up the defect site, and thereby restore the physiological loading conditions. Bending-dominated structures were incorporated in the porous outer layer of the space-filling meta-implants for their considerable lateral expansion in response to axial compression. A functionally graded density offered structural integrity at the joint while enhancing the deformability at the bone-implant interface. With the use of a more ductile metal, CP-Ti, these meta-implants could be deformed without strut failure.

Computational analysis of the effects of geometric irregularities and post-processing steps on the mechanical behavior of additively manufactured 316L stainless steel stents

Advances in additive manufacturing enable the production of tailored lattice structures and thus, in principle, coronary stents. This study investigates the effects of process-related irregularities, heat and surface treatment on the morphology, mechanical response, and expansion behavior of 316L stainless steel stents produced by laser powder bed fusion and provides a methodological approach for their numerical evaluation. A combined experimental and computational framework is used, based on both actual and computationally reconstructed laser powder bed fused stents. Process-related morphological deviations between the as-designed and actual laser powder bed fused stents were observed, resulting in a diameter increase by a factor of 2-2.6 for the stents without surface treatment and 1.3-2 for the electropolished stent compared to the as-designed stent. Thus, due to the increased geometrically induced stiffness, the laser powder bed fused stents in the as-built (7.11 ± 0.63 N) or the heat treated condition (5.87 ± 0.49 N) showed increased radial forces when compressed between two plates. After electropolishing, the heat treated stents exhibited radial forces (2.38 ± 0.23 N) comparable to conventional metallic stents. The laser powder bed fused stents were further affected by the size effect, resulting in a reduced yield strength by 41% in the as-built and by 59% in the heat treated condition compared to the bulk material obtained from tensile tests. The presented numerical approach was successful in predicting the macroscopic mechanical response of the stents under compression. During deformation, increased stiffness and local stress concentration were observed within the laser powder bed fused stents. Subsequent numerical expansion analysis of the derived stent models within a previously verified numerical model of stent expansion showed that electropolished and heat treated laser powder bed fused stents can exhibit comparable expansion behavior to conventional stents. The findings from this work motivate future experimental/numerical studies to quantify threshold values of critical geometric irregularities, which could be used to establish design guidelines for laser powder bed fused stents/lattice structures.

The Role of Epigenetic Functionalization of Implants and Biomaterials in Osseointegration and Bone Regeneration-A Review

The contribution of epigenetic mechanisms as a potential treatment model has been observed in cancer and autoimmune/inflammatory diseases. This review aims to put forward the epigenetic mechanisms as a promising strategy in implant surface functionalization and modification of biomaterials, to promote better osseointegration and bone regeneration, and could be applicable for alveolar bone regeneration and osseointegration in the future. Materials and Methods: Electronic and manual searches of the literature in PubMed, MEDLINE, and EMBASE were conducted, using a specific search strategy limited to publications in the last 5 years to identify preclinical studies in order to address the following focused questions: (i) Which, if any, are the epigenetic mechanisms used to functionalize implant surfaces to achieve better osseointegration? (ii) Which, if any, are the epigenetic mechanisms used to functionalize biomaterials to achieve better tissue regeneration? Findings from several studies have emphasized the role of miRNAs in functionalizing implants surfaces and biomaterials to promote osseointegration and bone regeneration, respectively. However, there are scarce data on the role of DNA methylation and histone modifications for these specific applications, despite being commonly applied in cancer research. Studies over the past few years have demonstrated that biomaterials are immunomodulatory rather than inert materials. In this context, epigenetics can act as next generation of advanced treatment tools for future regenerative techniques. Yet, there is a need to evaluate the efficacy/cost effectiveness of these techniques in comparison to current standards of care.

Effect of Pore Size on the Physicochemical Properties and Osteogenesis of Ti6Al4V Porous Scaffolds with Bionic Structure

Ti6Al4V is widely used in implants in the fields of orthopedics and dentistry due to its high compressive strength and good biocompatibility. Nevertheless, Ti6Al4V has a certain degree of biological inertness and the elastic modulus of Ti6Al4V is much higher than the cortex and trabecular bone. In this study, we designed and printed a new type of pore size Ti6Al4V with like-trabecular structure scaffold (the pore size is 800/900/1000 μm, named P8/P9/P10, respectively) with electron beam melting (EBM). Its elastic modulus, compressive strength, and other physical and chemical properties, as well as cell adhesion, proliferation, and differentiation ability and in vitro biological properties were studied. The physical and chemical performance test results showed that as the pore size increased, the surface wettability increased and the elastic modulus decreased. As the pore size increased, F-actin and alkaline phosphatase (ALP) increased significantly, and osteogenesis-related genes including BMP2, OCN, RUNX2, and ALP were upregulated significantly. The reason may be that the components on the Ti6Al4V pore size may have an influence on intracellular signal conversion and then change the mode of cell proliferation and diffusion. In summary, the like-trabecular porous structure can effectively reduce the elastic modulus of metal materials, thereby avoiding stress concentration and promoting the adhesion and proliferation of osteoblasts. Porous materials with larger pores are more conducive to the proliferation and differentiation of osteoblasts. The irregular porous Ti6Al4V scaffold prepared by the EBM technology has good mechanical properties and the potential to promote adhesion, proliferation, and differentiation of osteoblasts, and has the possibility of application in the field of implantation.

Exploring Macroporosity of Additively Manufactured Titanium Metamaterials for Bone Regeneration with Quality by Design: A Systematic Literature Review

Additive manufacturing facilitates the design of porous metal implants with detailed internal architecture. A rationally designed porous structure can provide to biocompatible titanium alloys biomimetic mechanical and biological properties for bone regeneration. However, increased porosity results in decreased material strength. The porosity and pore sizes that are ideal for porous implants are still controversial in the literature, complicating the justification of a design decision. Recently, metallic porous biomaterials have been proposed for load-bearing applications beyond surface coatings. This recent science lacks standards, but the Quality by Design (QbD) system can assist the design process in a systematic way. This study used the QbD system to explore the Quality Target Product Profile and Ideal Quality Attributes of additively manufactured titanium porous scaffolds for bone regeneration with a biomimetic approach. For this purpose, a total of 807 experimental results extracted from 50 different studies were benchmarked against proposed target values based on bone properties, governmental regulations, and scientific research relevant to bone implants. The scaffold properties such as unit cell geometry, pore size, porosity, compressive strength, and fatigue strength were studied. The results of this study may help future research to effectively direct the design process under the QbD system.

A multifunctional silk coating on additively manufactured porous titanium to prevent implant-associated infection and stimulate bone regeneration

Despite tremendous progress in the design and manufacturing of metallic implants, they do not outlive the patient. To illustrate, more than half of hip replacements will fail, mainly due to implant infection and loosening. Surface engineering approaches and, in particular, coatings can facilitate implant bio-functionality via the recruitment of more host cells for new bone formation and inhibition of bacterial colonization. Here, we used electrophoretic deposition to apply a silk fibroin solution consisting of tricalcium phosphate (TCP) and vancomycin as a coating on the surface of additively-manufactured porous titanium. Furthermore, the surface properties of the coatings developed and the release kinetics of the vancomycin were studied to evaluate the applied coating. The in vitro antibacterial behavior of the multifunctional coating, as well as the cell viability and osteogenic differentiation of the MC3T3-E1 cell line were extensively studied. The biomaterials developed exhibited an antibacterial behavior with a reduction of up to four orders of magnitude in both planktonic and adherent bacteria for 6 h and 1 d. A live-dead assay, the Alamar Blue activity, the DNA content, and cytoskeleton staining demonstrated a significant increase in the cell density of the coated groups versus the as-manufactured ones. The significantly enhanced calcium deposition and the increase in mineralization for the groups with TCP after 21 and 28 d, respectively, demonstrate upregulation of the MC3T3 cells' osteogenic differentiation. Our results collectively show that the multifunctional coating studied here can be potentially used to develop a new generation of orthopedic implants.

Additively manufactured biomedical Ti-Nb-Ta-Zr lattices with tunable Young's modulus: Mechanical property, biocompatibility, and proteomics analysis

Some β-Ti alloys, such as Ti-Nb-Ta-Zr (TNTZ) alloys, exhibit a low Young's modulus and excellent biocompatibility. These alloys are promising new generation biomedical implant materials. Selective laser melting (SLM) can further enable customer-specific manufacturing of β-Ti alloys to satisfy the ever-increasing need for enhanced biomedical products. In this study, we quantitatively determined the relationships between porosity, yield strength, and Young's modulus of SLM-prepared TNTZ lattices. The study constitutes a critical step toward understanding the behavior of the lattice and eventually enables tuning the Young's modulus to match that of human bones. Fatigue properties were also investigated on as-printed lattices in terms of the stress limit. The biocompatibility study included a routine evaluation of the relative cell growth rate and a proteomics analysis using a common mouse fibroblast cell line, L929. The results indicated that the as-printed TNTZ samples exhibited evidence of protein proliferation of the L929 cells, particularly P06733, and that those proteins are responsible for biological processes and molecular functions. They in turn may have promoted cell regeneration, cell motility, and protein binding, which at least partially explains the good biocompatibility of the as-printed TNTZ at the protein level. The study highlights the promising applications of additively manufactured TNTZ as a bone-replacing material from mechanical and biocompatibility perspectives.

3D Printing metamaterials towards tissue engineering

The rapid growth and disruptive potentials of three-dimensional (3D) printing demand further research for addressing fundamental fabrication concepts and enabling engineers to realize the capabilities of 3D printing technologies. There is a trend to use these capabilities to develop materials that derive some of their properties via their structural organization rather than their intrinsic constituents, sometimes referred to as mechanical metamaterials. Such materials show qualitatively different mechanical behaviors despite using the same material composition, such as ultra-lightweight, super-elastic, and auxetic structures. In this work, we review current advancements in the design and fabrication of multi-scale advanced structures with properties heretofore unseen in well-established materials. We classify the fabrication methods as conventional methods, additive manufacturing techniques, and 4D printing. Following a comprehensive comparison of different fabrication methods, we suggest some guidelines on the selection of fabrication parameters to construct meta-biomaterials for tissue engineering. The parameters include multi-material capacity, fabrication resolution, prototyping speed, and biological compatibility.

A multifaceted biomimetic interface to improve the longevity of orthopedic implants

The rise of additive manufacturing has provided a paradigm shift in the fabrication of precise, patient-specific implants that replicate the physical properties of native bone. However, eliciting an optimal biological response from such materials for rapid bone integration remains a challenge. Here we propose for the first time a one-step ion-assisted plasma polymerization process to create bio-functional 3D printed titanium (Ti) implants that offer rapid bone integration. Using selective laser melting, porous Ti implants with enhanced bone-mimicking mechanical properties were fabricated. The implants were functionalized uniformly with a highly reactive, radical-rich polymeric coating generated using a unique combination of plasma polymerization and plasma immersion ion implantation. We demonstrated the performance of such activated Ti implants with a focus on the coating's homogeneity, stability, and biological functionality. It was shown that the optimized coating was highly robust and possessed superb physico-chemical stability in a corrosive physiological solution. The plasma activated coating was cytocompatible and non-immunogenic; and through its high reactivity, it allowed for easy, one-step covalent immobilization of functional biomolecules in the absence of solvents or chemicals. The activated Ti implants bio-functionalized with bone morphogenetic protein 2 (BMP-2) showed a reduced protein desorption and a more sustained osteoblast response both in vitro and in vivo compared to implants modified through conventional physisorption of BMP-2. The versatile new approach presented here will enable the development of bio-functionalized additively manufactured implants that are patient-specific and offer improved integration with host tissue. STATEMENT OF SIGNIFICANCE: Additive manufacturing has revolutionized the fabrication of patient-specific orthopedic implants. Although such 3D printed implants can show desirable mechanical and mass transport properties, they often require surface bio-functionalities to enable control over the biological response. Surface covalent immobilization of bioactive molecules is a viable approach to achieve this. Here we report the development of additively manufactured titanium implants that precisely replicate the physical properties of native bone and are bio-functionalized in a simple, reagent-free step. Our results show that covalent attachment of bone-related growth factors through ion-assisted plasma polymerized interlayers circumvents their desorption in physiological solution and significantly improves the bone induction by the implants both in vitro and in vivo.

Porous Scaffold Design for Additive Manufacturing in Orthopedics: A Review

With the increasing application of orthopedic scaffolds, a dramatically increasing number of requirements for scaffolds are precise. The porous structure has been a fundamental design in the bone tissue engineering or orthopedic clinics because of its low Young's modulus, high compressive strength, and abundant cell accommodation space. The porous structure manufactured by additive manufacturing (AM) technology has controllable pore size, pore shape, and porosity. The single unit can be designed and arrayed with AM, which brings controllable pore characteristics and mechanical properties. This paper presents the current status of porous designs in AM technology. The porous structures are stated from the cellular structure and the whole structure. In the aspect of the cellular structure, non-parametric design and parametric design are discussed here according to whether the algorithm generates the structure or not. The non-parametric design comprises the diamond, the body-centered cubic, and the polyhedral structure, etc. The Voronoi, the Triply Periodic Minimal Surface, and other parametric designs are mainly discussed in parametric design. In the discussion of cellular structures, we emphasize the design, and the resulting biomechanical and biological effects caused by designs. In the aspect of the whole structure, the recent experimental researches are reviewed on uniform design, layered gradient design, and layered gradient design based on topological optimization, etc. These parts are summarized because of the development of technology and the demand for mechanics or bone growth. Finally, the challenges faced by the porous designs and prospects of porous structure in orthopedics are proposed in this paper.

On the design and properties of porous femoral stems with adjustable stiffness gradient

There is a large gap between the elastic modulus of the existing femoral stem and the host bone. This gap can lead to long-term complications, such as aseptic loosening and, eventually, a need for revision surgery. The porous metallic biomimetic femoral stem can effectively reduce stress shielding and provide firm implant fixation through bone ingrowth. The purpose of this research is to investigate the application of different porous femoral stems in relieving bone resorption and promoting osseointegration by finite element analysis. We present an intuitive visualization method based on a diamond lattice structure to understand the relationship between pore size, porosity, bone ingrowth criteria and additive manufacturing constraints. We further obtain an admissible design space of diamond lattice structure for porosity selection. We evaluate the relative micromotion of bone-implant interface and bone volume with density loss for three femoral stems with diamond lattice-based homogenous porous structures in admissible design space. We also evaluate porous femoral stems with four different grading orientations along the axial and radial directions of the femoral stem. These include an axial graded femoral stem with a porosity increased distally (DAGS), an axial graded femoral stem with a porosity increased proximally (PAGS), a radial graded femoral stem with a porosity increased inwardly (IRGS), and a radial graded femoral stem with a porosity increased externally (ERGS). The results indicate that: (i) homogenous porous femoral stems with 40% porosity, (ii) DAGS and (iii) IRGS can maintain the relative micromotion of the bone-implant interface in the safety range for bone ingrowth. The calculated volumes of bone with density loss in the cases of DAGS and IRGS are 3.6% and 3.3%, respectively, which are nearly 74% lower than that of fully dense stems. Therefore, DAGS and IRGS have an evident advantage in promoting osseointegration and relieving bone resorption. Thus, the graded femoral stem is more promising than the homogeneous porous stem.