Surface modification techniques of titanium and titanium alloys for biomedical dental applications: A review

Immobilization of KR-12 on a Titanium Alloy Surface Using Linking Arms Improves Antimicrobial Activity and Supports Osteoblast Cytocompatibility

Implant-associated infections pose significant challenges due to bacterial resistance to antibiotics. Recent research highlights the potential of immobilizing antimicrobial peptides (AMPs) onto implants as an alternative to conventional antibiotics for the prevention of bacterial infection. While various AMP immobilization methodologies have been investigated, they lack responsiveness to biological cues. This study proposes an enzyme-responsive antimicrobial coating for orthopedic devices using KR-12, an AMP derived from Cathelicidin LL-37, coupled with the Human Elastin-Like Polypeptide (HELP) as a biomimetic and stimuli-responsive linker, while mimicking the extracellular matrix (ECM). During implantation, these customized interfaces encounter the innate immune response triggering elastase release, which degrades HELP biopolymers, enabling the controlled release of KR-12. After coupling KR-12 with HELP to titanium surfaces, the antimicrobial activity against four pathogenic bacterial strains (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa) was assessed, revealing an inhibition ratio of bacterial adhesion and colonization exceeding 92% for all tested strains, compared with surfaces functionalized with KR-12 only. It is thought that the enhanced antimicrobial activity was due to the improved mobility of KR-12 when coupled with HELP. Furthermore, the prepared coatings boosted the adhesion and proliferation of human osteoblasts, confirming the cytocompatibility. These findings suggest the potential for smart coatings that combine the antimicrobial functions of AMPs with HELP's biological properties for use in a variety of settings, including medical devices.

Sustained release of Sr and Ca from a micronanotopographic titanium surface improves osteoblast function

The surface chemistry and topographical features of dental implants play a crucial role in influencing the osseointegration process. Alkaline earth elements such as strontium (Sr) and calcium (Ca) exert beneficial effects in promoting bone formation. This study aimed to evaluate micronanotopographic cpTi substrates that doped these elements, Sr and Ca. The composition and morphology were analyzed by X-ray photoelectron spectroscopy, scanning electron microscopy (SEM), and atomic force microscopy (AFM). Wettability assays, Sr and Ca release tests, and electrochemical behavior were also conducted. Proliferation, adhesion, and differentiation of MC3T3-E1 cells on this surface were evaluated in vitro. Direct fluorescence assays and SEM, cell viability, alkaline phosphatase (ALP) activity, and mineralization nodule formation were performed. The biological results showed the absence of cytotoxicity after the treatments, increased cell spreading on the micronanotopographic substrates, and greater mineralization nodule formation on surfaces doped with Sr and Sr/Ca. Gene and protein expression of osteoblastic markers were assessed through PCR and ELISA, and some genes were regulated on the doped surfaces at three and seven days of cell culture, like Bglap, Ibsp, Spp, Col1a1, and Runx2. The micronanotopographic substrates modified the physicochemical properties and morphology of the pre-osteoblasts. The results indicate that the biological effect of implants treated with Sr and Sr/Ca was significantly superior to that of polished surfaces and undoped micronanotopographic implants. Furthermore, the addition of Sr alone was sufficient to improve events related to osseointegration.

Citrus-Fruit-Based Hydroxyapatite Anodization Coatings on Titanium Implants

The increasing demand for titanium implants necessitates improved longevity. Plasma-sprayed hydroxyapatite coatings enhance implant osseointegration but are susceptible to delamination. Alternatively, anodized hydroxyapatite coatings have shown greater adhesion strengths. The present study aimed to develop anodized hydroxyapatite coatings on titanium using commercial calcium-fortified fruit juice as a calcium source. Varying the electrolyte compositions enabled the formation of four oxide groups with different predominate calcium compounds. Each oxide's morphology, crystallinity, chemistry, molecular structure, and adhesion quality were compared and contrasted. Nanoscale SEM images revealed a progression from porous surface oxide to white surface deposits to petal-like hydroxyapatite structures with the changing anodization electrolytes. Oxide thickness evaluations showed progression from a single-layered oxide with low Ca-, P-, and Mg-dopant incorporations to bi-layered oxide structures with increased Ca-, P-, and Mg-dopant incorporation with changing electrolytes. The bi-layered oxide structures exhibited a titanium-dioxide-rich inner layer and calcium-compound-rich outer layers. Furthermore, indentation analyses confirmed good adhesion quality for three oxides. For the predominate hydroxyapatite oxides, FTIR analyses showed carbonate substitutions indicating the presence of bone-like apatite formation, and ICP-OES analyses revealed prolonged Ca and Mg release over 30 days. These Mg-enhanced carbonated apatite coatings show much promise to improve osseointegration and future implant lifetimes.

Antibacterial Properties of PMMA/ZnO(NanoAg) Coatings for Dental Implant Abutments

Infections continue to pose significant challenges in dentistry, necessitating the development of innovative solutions that can effectively address these issues. This study focuses on creating coatings made from polymethyl methacrylate (PMMA) enriched with zinc oxide-silver composite nanoparticles, layered to Ti6Al4V-titanium alloy substrates. The application of these materials aims to create a solution for the abutments utilized in complete dental implant systems, representing the area most susceptible to bacterial infections. The nanoparticles were synthesized using a hydrothermal method, optimized through specific temperature and pressure parameters to achieve effective morphologies and sizes that enhance antibacterial efficacy. The layers were applied to the titanium substrate using the spin coating technique, chosen for its advantages and compatibility with the materials involved. Comprehensive analyses were conducted on the antimicrobial powders, including X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Furthermore, the PMMA-based coatings incorporating antimicrobial nanoparticles were evaluated to ensure uniformity and homogeneity across the titanium alloy surface by IR mapping and SBF immersion-SEM analysis. The antimicrobial activity of the samples was demonstrated with impressive results against Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans, as assessed through biofilm modulation studies. The biocompatibility of the samples was validated through in vitro cell-based assays, which demonstrated excellent compatibility between PMMA-based coatings and human preosteoblasts, confirming their potential suitability for future use in dental implants.

Amorphous Magnesium Coating for Achieving Functional Changes from Antibacterial to Osteogenic Activities

Medical devices composed of titanium (Ti) should exhibit antibacterial and osteogenic activities to achieve both infection prevention and rapid bone reconstruction. Here, a Ti surface was modified by performing magnetron sputtering (MS) using pure Mg or Mg-30Ca alloy targets for surface functionalization. MC0, prepared with a pure Mg target, had a crystalline metallic-Mg coating layer, whereas MC30, prepared with an Mg-30Ca alloy target, had an amorphous coating composed of Mg and Ca. Both samples rapidly dissolved when immersed in a cell culture medium and exhibited antibacterial activities against methicillin-resistant Staphylococcus aureus and cytotoxicity against MC3T3-E1 cells. Furthermore, MC30 promoted the proliferation and calcification of MC3T3-E1 cells because of the subsequent deposition of calcite on the surface after rapid dissolution. Our findings are the first to reveal that MS performed by using an Mg-30Ca alloy target endowed Ti surfaces with functional changes from antibacterial to osteogenic activities over time. Our results provide fundamental insights into the surface design of Ti-based medical devices for enhanced bone reconstruction and infection prevention and offer possibilities for biomedical applications of Mg-based coatings.

Enhancing orthopaedic implant efficacy: the development of cerium-doped bioactive glass and polyvinylpyrrolidone composite coatings via MAPLE technique

This study investigates the potential of combining Cerium-doped bioactive glass (BBGi) with Polyvinylpyrrolidone (PVP) to enhance the properties of titanium (Ti) implant surfaces using the Matrix-Assisted Pulsed Laser Evaporation (MAPLE) technique. The primary focus is on improving osseointegration, corrosion resistance, and evaluating the cytotoxicity of the developed thin films towards host cells. The innovative approach involves synthesizing a composite thin film comprising BBGi and PVP, leveraging the distinct benefits of both materials: BBGi's biocompatibility and osteoinductive capabilities, and PVP's film-forming and biocompatible properties. Results demonstrate that the BBGi + PVP coatings significantly enhance hydrophilicity, indicating improved cell-material interaction potential. The electrochemical analysis reveals superior corrosion resistance of the BBGi + PVP films compared to BBGi alone, which is critical for long-term implant stability. The mechanical adherence tests confirm the robust attachment of the coatings to Ti substrates, surpassing the ISO standards for implant materials. Biocompatibility tests show promising cell viability and negligible cytotoxic effects, with a controlled inflammatory response, underscoring the potential of BBGi + PVP coatings for orthopedic applications. The study concludes that the synergistic combination of BBGi and PVP, applied through the MAPLE technique, offers a promising route to fabricate bioactive and corrosion-resistant coatings for Ti implants, potentially enhancing osseointegration and longevity in clinical settings.

Osseointegration of Implants Through Ti Biofunctionalization with Biomass from Chlorella sorokiniana UTEX 1230 and Synechococcus sp. PCC 7002

The inadequate osseointegration of titanium implants remains a significant challenge in orthopedics, limiting the long-term efficacy of prostheses and medical devices. It has been determined that biological aging of the titanium surface compromises the implant-bone tissue interaction due to increased hydrophobicity and accumulation of organic molecules. To address this issue, an innovative strategy has been proposed: the biofunctionalization of Ti6Al4V surfaces utilizing biomass derived from Chlorella sorokiniana UTEX 1230 and Synechococcus sp. PCC 7002. This research was structured to encompass microalgal culture optimization through biocompatibility evaluation of biofunctionalized surfaces. Biofunctionalization stages were analyzed using contact angle measurements, EDS, SEM, and cellular assays. It was observed that piranha solution activation generated a hydrophilic surface, while silanization was more efficient in samples treated for 14 h. It was found that Synechococcus sp. PCC 7002 presented a higher biomass concentration on the surface compared to C. sorokiniana UTEX 1230. Cytotoxicity assays revealed that the coating with Synechococcus sp. PCC 7002 was potentially non-cytotoxic, with a cell viability of 86.8%. SEM images showed a significant number of cells adhered to the treated sample. In conclusion, the potential of using microalgal biomass to biofunctionalize titanium surfaces has been demonstrated, offering an innovative alternative to improve implant-tissue interaction and, consequently, the osseointegration process in orthopedic applications.

Evaluation of the In Vitro Behavior of Electrochemically Deposited Plate-like Crystal Hydroxyapatite Coatings

The purpose of coatings is to protect or enhance the functionality of the substrate material, irrespective of the field in which the material was designed. The use of coatings in medicine is rapidly expanding with the objective of enhancing the osseointegration ability of metallic materials such as titanium. The aim of this study was to obtain biomimetic hydroxyapatite (HAp)-based coatings on titanium by using the pulsed galvanostatic method. The morphology of the HAp-based coatings revealed the presence of very thin and wide plate-like crystals, grown perpendicular to the Ti substrate, while the chemical composition highlighted a Ca/P ratio of 1.66, which is close to that of stoichiometric HAp (1.67). The main phases and chemical bonds identified confirmed the presence of the HAp phase in the developed coatings. A roughness of 228 nm and a contact angle of approx. 17° were obtained for the HAp coatings, highlighting a hydrophilic character. In terms of biomineralization and electrochemical behavior, it was shown that the HAp coatings have significantly enhanced the titanium properties. Finally, the in vitro cell tests carried out with human mesenchymal stem cells showed that the Ti samples coated with HAp have increased cell viability, extracellular matrix, and Ca intracellular deposition when compared with the uncoated Ti, indicating the beneficial effect.

Osteoblast Response to Widely Ranged Texturing Conditions Obtained through High Power Laser Beams on Ti Surfaces

Titanium and titanium alloys are the prevailing dental implant materials owing to their favorable mechanical properties and biocompatibility, but how roughness dictates the biological response is still a matter of debate. In this study, laser texturing was used to generate eight paradigmatic roughened surfaces, with the aim of studying the early biological response elicited on MC3T3-E1 pre-osteoblasts. Prior to cell tests, the samples underwent SEM analysis, optical profilometry, protein adsorption assay, and optical contact angle measurement with water and diiodomethane to determine surface free energy. While all the specimens proved to be biocompatible, supporting similar cell viability at 1, 2, and 3 days, surface roughness could impact significantly on cell adhesion. Factorial analysis and linear regression showed, in a robust and unprecedented way, that an isotropic distribution of deep and closely spaced valleys provides the best condition for cell adhesion, to which both protein adsorption and surface free energy were highly correlated. Overall, here the authors provide, for the first time, a thorough investigation of the relationship between roughness parameters and osteoblast adhesion that may be applied to design and produce new tailored interfaces for implant materials.

Comparative Analysis of Osteoblastic Responses to Titanium and Alumina-Toughened Zirconia Implants: An In Vitro Study

INTRODUCTION

Osteoblastic responses play a crucial role in the success of oral implants. Enhanced proliferation of osteoblast cells is associated with reduced cell mortality and an increase in bone regeneration. This study aims to evaluate the osteoblastic responses following oral implantation.

MATERIALS AND METHODS

Osteoblast stem cells were harvested and subsequently cultivated using cell culture techniques. The osteoblastic phenotype of the extracted cells was confirmed by examining the extracellular matrix. Cell morphogenesis on functionalized biomaterial surfaces was assessed through indirect immunofluorescence staining. The cellular response was investigated in the presence of two types of implant materials: titanium (Ti) and alumina-toughened zirconia (ATZ). Cell viability and apoptosis were quantitatively assessed using MTT assays and flow cytometry, respectively.

RESULTS

The survival of osteoblastic lineage cells was moderately reduced post-implantation. Viability in the Ti implant group remained at approximately 86%, while in the ATZ group, it was observed at 75%, which is considered acceptable. Moreover, there was a significant disparity in cell survival between the two implant groups (p < 0.05). Analysis of apoptosis levels at various concentrations revealed that the rate of apoptosis was 3.6% in the control group and 18.5% in the ATZ group, indicating that apoptosis or programmed cell death in the ATZ-treated group had increased nearly four-fold (p < 0.05).

CONCLUSIONS

The findings of this study indicate a reduction in osteoblastic cell line survival following implant treatment, with titanium implants exhibiting superior performance in terms of cell survival. However, it was also noted that the incidence of apoptosis in osteoblast cells was significantly higher in the presence of zirconium-based implants.

Biomaterials science and surface engineering strategies for dental peri-implantitis management

Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption, ultimately resulting in implant failure. Dental implants for clinical use barely have antibacterial properties, and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis. Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque. However, it is particularly important to prevent the occurrence of peri-implantitis rather than treatment. Therefore, the current research spot has focused on improving the antibacterial properties of dental implants, such as the construction of specific micro-nano surface texture, the introduction of diverse functional coatings, or the application of materials with intrinsic antibacterial properties. The aforementioned antibacterial surfaces can be incorporated with bioactive molecules, metallic nanoparticles, or other functional components to further enhance the osteogenic properties and accelerate the healing process. In this review, we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration. Furthermore, we summarized the obstacles existing in the process of laboratory research to reach the clinic products, and propose corresponding directions for future developments and research perspectives, so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy, biological safety, and osteogenic property.

Hierarchically porous surface of HA-sandblasted Ti implant screw using the plasma electrolytic oxidation: Physical characterization and biological responses

The surface topological features of bioimplants are among the key indicators for bone tissue replacement because they directly affect cell morphology, adhesion, proliferation, and differentiation. In this study, we investigated the physical, electrochemical, and biological responses of sandblasted titanium (SB-Ti) surfaces with pore geometries fabricated using a plasma electrolytic oxidation (PEO) process. The PEO treatment was conducted at an applied voltage of 280 V in a solution bath consisting of 0.15 mol L-1 calcium acetate monohydrate and 0.02 mol L-1 calcium glycerophosphate for 3 min. The surface chemistry, wettability, mechanical properties and corrosion behavior of PEO-treated sandblasted Ti implants using hydroxyapatite particles (PEO-SB-Ti) were improved with the distribution of calcium phosphorous porous oxide layers, and showed a homogeneous and hierarchically porous surface with clusters of nanopores in a bath containing calcium acetate monohydrate and calcium glycerophosphate. To demonstrate the efficacy of PEO-SB-Ti, we investigated whether the implant affects biological responses. The proposed PEO-SB-Ti were evaluated with the aim of obtaining a multifunctional bone replacement model that could efficiently induce osteogenic differentiation as well as antibacterial activities. These physical and biological responses suggest that the PEO-SB-Ti may have a great potential for use an artificial bone replacement compared to that of the controls.

In Vitro Characterization of Hydroxyapatite-Based Coatings Doped with Mg or Zn Electrochemically Deposited on Nanostructured Titanium

Biomaterials are an important and integrated part of modern medicine, and their development and improvement are essential. The fundamental requirement of a biomaterial is found to be in its interaction with the surrounding environment, with which it must coexist. The aim of this study was to assess the biological characteristics of hydroxyapatite (HAp)-based coatings doped with Mg and Zn ions obtained by the pulsed galvanostatic electrochemical method on the surface of pure titanium (cp-Ti) functionalized with titanium dioxide nanotubes (NTs TiO2) obtained by anodic oxidation. The obtained results highlighted that the addition of Zn or Mg into the HAp structure enhances the in vitro response of the cp-Ti surface functionalized with NT TiO2. The contact angle and surface free energy showed that all the developed surfaces have a hydrophilic character in comparison with the cp-Ti surface. The HAp-based coatings doped with Zn registered superior values than the ones with Mg, in terms of biomineralization, electrochemical behavior, and cell interaction. Overall, it can be said that the addition of Mg or Zn can enhance the in vitro behavior of the HAp-based coatings in accordance with clinical requirements. Antibacterial tests showed that the proposed HAp-Mg coatings had no efficiency against Escherichia coli, while the HAp-Zn coatings registered the highest antibacterial efficiency.

Microstructure and tribological behaviour of CoCrCuFeTi high entropy alloy reinforced SS304 through friction stir processing

Surface modification by suitable technique aids in improving the characteristics of material to resist severe wear in demanding environments and challenging applications. The present study aims to analyse the tribological performance of Stainless Steel (SS304) reinforced with CoCrCuFeTi High Entropy Alloy (HEA) through friction stir processing and compares the results with annealed specimens. The CoCrCuFeTi HEA was ball milled and revealed irregular fragment particles with Body Centred Cubic (BCC) phase. The processed samples exhibited excellent refinement in grains with uniform HEA reinforcement distribution. The grains were observed to be in nano level post-annealing promoting exceptional microhardness. The pin-on-disc wear test was conducted by varying load (10-40N), sliding velocity (0.5-3.5 m/s) and sliding distance (500-2000 m) and the respective worn surface was analysed. The processed sample with HEA after annealing offered 29.8%, 57.4% and 58.49% improved wear resistance at the minimum level of load, sliding velocity and sliding distance than the processed base samples. The worn morphology revealed delamination, abrasion, adhesion and oxide layer formation to be the predominant wear mechanisms.

Nanoscale Topography of Anodic TiO2 Nanostructures Is Crucial for Cell-Surface Interactions

Anodic titanium dioxide (TiO2) nanostructures, i.e., obtained by electrochemical anodization, have excellent control over the nanoscale morphology and have been extensively investigated in biomedical applications owing to their sub-100 nm nanoscale topography range and beneficial effects on biocompatibility and cell interactions. Herein, we obtain TiO2 nanopores (NPs) and nanotubes (NTs) with similar morphologies, namely, 15 nm diameter and 500 nm length, and investigate their characteristics and impact on stem cell adhesion. We show that the transition of TiO2 NPs to NTs occurs via a pore/wall splitting mechanism and the removal of the fluoride-rich layer. Furthermore, in contrast to the case of NPs, we observe increased cell adhesion and proliferation on nanotubes. The enhanced mesenchymal stem cell adhesion/proliferation seems to be related to a 3-fold increase in activated integrin clustering, as confirmed by immunogold labeling with β1 integrin antibody on the nanostructured layers. Moreover, computations of the electric field and surface charge density show increased values at the inner and outer sharp edges of the top surfaces of the NTs, which in turn can influence cell adhesion by increasing the bridging interactions mediated by proteins and molecules in the environment. Collectively, our results indicate that the nanoscale surface architecture of the lateral spacing topography can greatly influence stem cell adhesion on substrates for biomedical applications.

Microstructure and Wear Resistance of Ti6Al4V Titanium Alloy Laser-Clad Ni60/WC Composite Coating

In this paper, Ni60/WC wear-resistant coatings have been created on the Ti6Al4V substrate surface using a pre-layered powder laser cladding method by deploying various scanning speeds of 8, 10, 12, and 14 mm/s. The coatings are characterized through X-ray diffraction (XRD), scanning electron microscopy (SEM), and a high-speed reciprocating fatigue wear tester. It is found that the phase composition of the coating comprises the synthesized, hard phase TiC and TiB2, the silicides WSi2 and W5Si3, and NiTi and γ-Ni solid solutions. At different scanning speeds, there is a metallurgical fusion line in the bonding area of the fused cladding layer, indicating a good metallurgical bonding between the substrate and the powder. At a low scanning speed, the coating develops into coarse dendrites, which shows significant improvement with scanning speed. The microhardness first increases and then decreases with the scanning speed, and the coating's average microhardness was 2.75-3.13 times higher than that of the substrate. The amount of mass wear has been reduced by 60.1-79.7% compared to the substrate. The wear behavior of the coatings was studied through detailed analysis of wear surfaces' microstructures and the amount of wear to identify the optimum scanning speed.

Bioabsorbable Composites Based on Polymeric Matrix (PLA and PCL) Reinforced with Magnesium (Mg) for Use in Bone Regeneration Therapy: Physicochemical Properties and Biological Evaluation

Improvements in Tissue Engineering and Regenerative Medicine (TERM)-type technologies have allowed the development of specific materials that, together with a better understanding of bone tissue structure, have provided new pathways to obtain biomaterials for bone tissue regeneration. In this manuscript, bioabsorbable materials are presented as emerging materials in tissue engineering therapies related to bone lesions because of their ability to degrade in physiological environments while the regeneration process is completed. This comprehensive review aims to explore the studies, published since its inception (2010s) to the present, on bioabsorbable composite materials based on PLA and PCL polymeric matrix reinforced with Mg, which is also bioabsorbable and has recognized osteoinductive capacity. The research collected in the literature reveals studies based on different manufacturing and dispersion processes of the reinforcement as well as the physicochemical analysis and corresponding biological evaluation to know the osteoinductive capacity of the proposed PLA/Mg and PCL/Mg composites. In short, this review shows the potential of these composite materials and serves as a guide for those interested in bioabsorbable materials applied in bone tissue engineering.

Nanotechnology development in surgical applications: recent trends and developments

This paper gives a detailed analysis of nanotechnology's rising involvement in numerous surgical fields. We investigate the use of nanotechnology in orthopedic surgery, neurosurgery, plastic surgery, surgical oncology, heart surgery, vascular surgery, ophthalmic surgery, thoracic surgery, and minimally invasive surgery. The paper details how nanotechnology helps with arthroplasty, chondrogenesis, tissue regeneration, wound healing, and more. It also discusses the employment of nanomaterials in implant surfaces, bone grafting, and breast implants, among other things. The article also explores various nanotechnology uses, including stem cell-incorporated nano scaffolds, nano-surgery, hemostasis, nerve healing, nanorobots, and diagnostic applications. The ethical and safety implications of using nanotechnology in surgery are also addressed. The future possibilities of nanotechnology are investigated, pointing to a possible route for improved patient outcomes. The essay finishes with a comment on nanotechnology's transformational influence in surgical applications and its promise for future breakthroughs.

Biomaterials and Clinical Application of Dental Implants in Relation to Bone Density-A Narrative Review

Titanium has been the material of choice for dental implant fixtures due to its exceptional qualities, such as its excellent balance of rigidity and stiffness. Since zirconia is a soft-tissue-friendly material and caters to esthetic demands, it is an alternative to titanium for use in implants. Nevertheless, bone density plays a vital role in determining the material and design of implants. Compromised bone density leads to both early and late implant failures due to a lack of implant stability. Therefore, this narrative review aims to investigate the influence of implant material/design and surgical technique on bone density from both biomechanical and biological standpoints. Relevant articles were included for analysis. Dental implant materials can be fabricated from titanium, zirconia, and PEEK. In terms of mechanical and biological aspects, titanium is still the gold standard for dental implant materials. Additionally, the macro- and microgeometry of dental implants play a role in determining and planning the appropriate treatment because it can enhance the mechanical stress transmitted to the bone tissue. Under low-density conditions, a conical titanium implant design, longer length, large diameter, reverse buttress with self-tapping, small thread pitch, and deep thread depth are recommended. Implant material, implant design, surgical techniques, and bone density are pivotal factors affecting the success rates of dental implant placement in low-density bone. Further study is required to find the optimal implant material for a clinical setting's bone state.

Surface antibacterial properties enhanced through engineered textures and surface roughness: A review

The spread of bacteria through contaminated surfaces is a major issue in healthcare, food industry, and other economic sectors. The widespread use of antibiotics is not a sustainable solution in the long term due to the development of antibiotic resistance. Therefore, surfaces with antibacterial properties have the potential to be a disruptive approach to combat microbial contamination. Different methods and approaches have been studied to impart or enhance antibacterial properties on surfaces. The surface roughness and texture are inherent parameters that significantly impact the antibacterial properties of a surface. They are also directly related to the previously employed machining and treatment methods. This review article discusses the correlation between surface roughness and antibacterial properties is presented and discussed. It begins with an introduction to the concepts of surface roughness and texture, followed by a description of the most commonly utilized machining methods and surface. A thorough analysis of bacterial adhesion and growth is then presented. Finally, the most recent studies in this research area are comprehensively reviewed. The studies are sorted and classified based on the utilized machining and treatment methods, which are divided into mechanical processes, surface treatments and coatings. Through the systematic review and record of the recent advances, the authors aim to assist and promote further research in this very promising and extremely important direction, by providing a systematic review of recent advances.

Bioglass and Vitamin D3 Coatings for Titanium Implants: Osseointegration and Corrosion Protection

The use of MAPLE synthesized thin films based on BG and VD3 for improving the osseointegration and corrosion protection of Ti-like implant surfaces is reported. The distribution of chemical elements and functional groups was shown by FTIR spectrometry; the stoichiometry and chemical functional integrity of thin films after MAPLE deposition was preserved, optimal results being revealed especially for the BG+VD3_025 samples. The morphology and topography were examined by SEM and AFM, and revealed surfaces with many irregularities, favoring a good adhesion of cells. The thin films' cytotoxicity and biocompatibility were evaluated in vitro at the morphological, biochemical, and molecular level. Following incubation with HDF cells, BG57+VD3_ 025 thin films showed the best degree of biocompatibility, as illustrated by the viability assay values. According to the LDH investigation, all tested samples had higher values compared to the unstimulated cells. The evaluation of cell morphology was performed by fluorescence microscopy following cultivation of HDF cells on the obtained thin films. The cultivation of HDF's on the thin films did not induce major cellular changes. Cells cultured on the BG57+VD3_025 sample had similar morphology to that of unstimulated control cells. The inflammatory profile of human cells cultured on thin films obtained by MAPLE was analyzed by the ELISA technique. It was observed that the thin films did not change the pro- and anti-inflammatory profile of the HDF cells, the IL-6 and IL-10 levels being similar to those of the control sample. The wettability of the MAPLE thin films was investigated by the sessile drop method. A contact angle of 54.65° was measured for the sample coated with BG57+VD3_025. Electrochemical impedance spectroscopy gave a valuable insight into the electrochemical reactions occurring on the surface.

Osteogenic properties of bioactive titanium in inflammatory environment

OBJECTIVES

It is very important that the effects of surface modified titanium on osteogenic differentiation of bone marrow mesenchymal stem cells in the process of bone regeneration. The bio-function of modified titanium could be affected by the inflammatory micro-environment. The aim of this study was to investigate the effects of modified titanium on osteogenic differentiation in the inflammatory conditions and the osteogenic properties of the modified titanium dental implant in vivo.

METHODS

The medical pure titanium metals (PT-Ti) subjected to Anodic Oxidation (AO-Ti), Sand Blasting/acid etching (SLA-Ti) and Plasma-sprayed HA coating (HA coating-Ti) were used for regulating the osteogenic properties of MSCs in the normal and inflammatory conditions.

RESULTS

The amount of the MSCs in the inflammatory environment were more similar to that in the non-inflammatory environment after cultured on AO-Ti samples for 7D. However, the proliferation of the MSCs was obviously inhibited on the other groups in the inflammatory condition. The morphology of MSC cells on the modified titanium surface was affected in the inflammatory conditions and the AO-Ti was more conducive to maintain the skeletal morphology of MSCs. The results of osteogenic related proteins expression showed that the amount of BMP-2 on AO-Ti group was the highest in the inflammatory conditions, and followed the order of AO-Ti > HA coating-Ti > SLA-Ti > PT-Ti. What's more, the AO-Ti samples were more beneficial to promote the expression of osteogenic genes ALP, OCN, COL-I and Runx2 in the inflammatory conditions. The results of osteogenic properties in vivo showed that the gingival depth of the AO-Ti group was smaller than that on the other groups. Some new bone could be observed around the AO-Ti implant at two weeks. The bone binding rates on AO-Ti group was the highest of 81.3% after implanted for one year.

SIGNIFICANCE

The AO-Ti was beneficial to osteogenic differentiation than other modified titanium metals in inflammatory condition. The anodic oxidation is an effective surface modification method on titanium to promote bone regeneration.

Impact of Beam Deflection Geometry on the Surface Architecture and Mechanical Properties of Electron-Beam-Modified TC4 Titanium Alloy

This paper aims to investigate the impact of beam deflection geometry on the structure, surface architecture, and friction coefficient of electron-beam-modified TC4 titanium alloys. During the experiments, the electron beam was deflected in the form of different scanning geometries, namely linear, circular, and matrix. The structure of the treated specimens was investigated in terms of their phase composition by employing X-ray diffraction experiments. The microstructure was studied by scanning electron microscopy (SEM). The surface architecture was examined by atomic force microscopy (AFM). The friction coefficient was studied by a mechanical wear test. It was found that the linear and circular deflection geometries lead to a transformation of the phase composition, from double-phase α + β to α' martensitic structure. The application of a linear manner of scanning leads to a residual amount of beta phase. The use of a matrix does not tend to structural changes on the surface of the TC4 alloy. In the case of linear geometry, the thickness of the modified zone is more than 800 μm while, in the case of EBSM using circular scanning, the thickness is about 160 μm. The electron-beam surface modification leads to a decrease in the surface roughness to about 27 nm in EBSM with linear deflection geometry and 31 nm in circular deflection geometry, compared to that of the pure TC4 substrate (about 160 nm). The electron-beam surface modification of the TC4 alloy leads to a decrease in the coefficient of friction (COF), with the lowest COF values obtained in the case of linear deflection geometry (0.32). The results obtained in this study show that beam deflection geometry has a significant effect on the surface roughness and friction coefficient of the treated surfaces. It was found that the application of a linear manner of scanning leads to the formation of a surface with the lowest roughness and friction coefficient.

Advances of plant and biomass extracted zirconium nanoparticles in dental implant application

Nanoparticles are minimal materials with unique physicochemical features that set them apart from bulk materials of the same composition. These properties make nanoparticles highly desirable for use in commercial and medical research. The primary intention for the development of nanotechnology is to achieve overarching social objectives like bettering our understanding of nature, boosting productivity, improving healthcare, and extending the bounds of sustainable development and human potential. Keeping this as a motivation, Zirconia nanoparticles are becoming the preferred nanostructure for modern biomedical applications. This nanotechnology is exceptionally versatile and has several potential uses in dental research. This review paper concentrated on the various benefits of zirconium nanoparticles in dentistry and how they provide superior strength and flexibility compared to their counterparts. Moreover, the popularity of zirconium nanoparticles is also growing as it has strong biocompatibility potency. Zirconium nanoparticles can be used to develop or address the major difficulty in dentistry. Therefore, this review paper aims to provide a summary of the fundamental research and applications of zirconium nanoparticles in dental implants.

M. N. Mydin RB, Widera D, Noordin SS, Harun NH, Wan Eddis Effendy WN, Hazan R, Sreekantan S. Double-edged sword of biofouling potentials associated with haemocompatibility behaviour: titania nanotube arrays for medical implant surface technology

Background

Medical implant failures are frequently associated with limitations of the surface technology that lead to biofouling and haemocompatibility issues. Titania nanotube array technology could provide a solution for this existing limitation. The present study describes the biofouling potential using the simulated body fluid model according to ISO 23317-2007 and haemocompatibility profiles according to ISO 10993-4 guidelines. Further haemocompatibility profiles were also assessed by evaluating full blood count, coagulation assays, haemolytic rate, whole blood clotting factor, platelet profiles, and FESEM characterization.

Result

Titania nanotube array nanosurface was found to present with better apatite biofouling and hydrophilic potential compared to bare titanium foil. Furthermore, good compatibility behaviour was observed based on the haemocompatibility profiles where no signs of thrombogenesis and haemolysis risks were observed. Titania nanotube array reduced fibrinogen adsorption, red blood cell and platelet adhesion and activation, which could be associated with detrimental biofouling properties.

Conclusion

Titania nanotube array could possess a double-edged sword of biofouling potentials that resist detrimental biofouling properties associated with thrombogenesis and haemolysis risk. It also provides better apatite biofouling potential for improved tissue and osseointegration activities. Knowledge from this study provides a better understanding of medical implant surface technology.

Graphical Abstract

Influence of surface coatings on the stress distribution by varying friction contact at implant-bone interface using finite element analysis

The present work aims to evaluate the effect of various surface coatings of titanium dental implants by varying the friction coefficient (µ) at the interface between the dental implant and jawbone using finite element analysis (FEA) methods and to provide a comparative analysis between the various surface coatings and implant designs. An accurate model of the dental implant prosthetics consisting of the hard (cortical) and the soft (cancellous) bone, with the various titanium dental implant designs was modelled using a 3D CAD software, and the FE mesh model was generated using HyperMesh 13.0. Three coatings having different coefficient of friction values were selected: Titanium Nitride (TiN) with a friction coefficient of 0.19, Titanium Oxide (TiO₂) with a friction coefficient of 0.30 and Zirconium Nitride (ZrN) with a coefficient of friction of 0.49. The non-linear static stress analysis was conducted under three different loading conditions (vertical, lateral and oblique loading) using a CAE solver. The present study showed that surface coatings with high friction coefficients generated lower stresses in the cancellous bone while generating higher stresses in the cortical bone. However, for dental implants having microthreads in their neck region, surface coatings with a high coefficient of friction generated lower stresses at the interface between the cortical bone and the implant. The FEA results indicate that selecting suitable surface coatings would significantly decrease the stresses developed at the bone-implant interface, and future studies should conduct in vivo trials to validate the FEA results obtained.

Strain based in vitro analysis of dental implant using artificial bone model and validation by numerical technique

BACKGROUND/PURPOSE

Dental implant fails due to mechanical failure of the implant contribute to about 10-15 % of implant failures. It is necessary to prevent the design failure of the implant since it leads to bone loss which further leads to complications in reimplantation. This makes it important to test the design of a dental implant using FEM and in vitro testing before its application. The purpose of this article is to test the design of a dental implant using in vitro testing by using an artificial bone model and validation of the data using Finite Element Method (FEM).

METHODS

A dental implant was selected for in vitro testing and 3D FE analysis was conducted to observe the stress values. The in vitro study was done on a custom designed testing rig where the implant was drilled into a ABS and sawbone (polyurethane) bone model. Vertical and lateral loads of 100 N and 40 N respectively, were applied to evaluate the micro-strains using strain gauge technique. 3D FEA technique was used to evaluate stress concentrations and micro-strains in the bone-implant interface.

RESULTS

The strain values were found to be higher in the case of lateral loading than vertical loading with in vitro testing. The von-mises stresses on the cortical bone were greater at the bone-implant interface near the neck region of the implant.

CONCLUSIONS

The results obtained from the in vitro analysis and FEA were found to have a good agreement with an error percentage of 2-5 %.

Evaluation of the Biocompatibility and Osteogenic Properties of Metal Oxide Coatings Applied by Magnetron Sputtering as Potential Biofunctional Surface Modifications for Orthopedic Implants

Biomaterials with adequate properties to direct a biological response are essential for orthopedic and dental implants. The surface properties are responsible for the biological response; thus, coatings with biologically relevant properties such as osteoinduction are exciting options to tailor the surface of different bulk materials. Metal oxide coatings such as TiO₂, ZrO₂, Nb₂O₅ and Ta₂O₅ have been suggested as promising for orthopedic and dental implants. However, a comparative study among them is still missing to select the most promising for bone-growth-related applications. In this work, using magnetron sputtering, TiO₂, ZrO₂, Ta₂O₅, and Nb₂O₅ thin films were deposited on Si (100) substrates. The coatings were characterized by Optical Profilometry, Scanning Electron Microscopy, Energy-Dispersive X-ray Spectroscopy, X-ray Photoelectron Spectroscopy, X-ray Diffraction, Water Contact Angle measurements, and Surface Free Energy calculations. The cell adhesion, viability, proliferation, and differentiation toward the osteoblastic phenotype of mesenchymal stem cells plated on the coatings were measured to define the biological response. Results confirmed that all coatings were biocompatible. However, a more significant number of cells and proliferative cells were observed on Nb₂O₅ and Ta₂O₅ compared to TiO₂ and ZrO_2. Nevertheless, Nb₂O₅ and Ta₂O₅ seemed to induce cell differentiation toward the osteoblastic phenotype in a longer cell culture time than TiO₂ and ZrO₂.

Antibacterial properties of laser-encapsulated titanium oxide nanotubes decorated with nanosilver and covered with chitosan/Eudragit polymers

To provide antibacterial properties, the titanium samples were subjected to electrochemical oxidation in the fluoride-containing diethylene glycol-based electrolyte to create a titanium oxide nanotubular surface. Afterward, the surface was covered by sputtering with silver 5 nm film, and the tops of the nanotubes were capped using laser treatment, resulting in an appearance of silver nanoparticles (AgNPs) of around 30 nm in diameter on such a modified surface. To ensure a controlled release of the bactericidal substance, the samples were additionally coated with a pH-sensitive chitosan/Eudragit 100 coating, also exhibiting bactericidal properties. The modified titanium samples were characterized using SEM, EDS, AFM, Raman, and XPS techniques. The wettability, corrosion properties, adhesion of the coating to the substrate, the release of AgNPs into solutions simulating body fluids at different pH, and antibacterial properties were further investigated. The obtained composite coatings were hydrophilic, adjacent to the surface, and corrosion-resistant. An increase in the amount of silver released as ions or metallic particles into a simulated body fluid solution at acidic pH was observed for modified samples with the biopolymer coating after three days of exposure avoiding burst effect. The proposed modification was effective against both Gram-positive and Gram-negative bacteria.

Titanium Dental Implants: An Overview of Applied Nanobiotechnology to Improve Biocompatibility and Prevent Infections

This review addresses the different aspects of the use of titanium and its alloys in the production of dental implants, the most common causes of implant failures and the development of improved surfaces capable of stimulating osseointegration and guaranteeing the long-term success of dental implants. Titanium is the main material for the development of dental implants; despite this, different surface modifications are studied aiming to improve the osseointegration process. Nanoscale modifications and the bioactivation of surfaces with biological molecules can promote faster healing when compared to smooth surfaces. Recent studies have also pointed out that gradual changes in the implant, based on the microenvironment of insertion, are factors that may improve the integration of the implant with soft and bone tissues, preventing infections and osseointegration failures. In this context, the understanding that nanobiotechnological surface modifications in titanium dental implants improve the osseointegration process arouses interest in the development of new strategies, which is a highly relevant factor in the production of improved dental materials.

Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications

An increase in the world population and its life expectancy, as well as the ongoing concern about our physical appearance, have elevated the relevance of dental implantology in recent decades. Engineering strategies to improve the survival rate of dental implants have been widely investigated, focusing on implant material composition, geometry (usually guided to reduce stiffness), and interface surrounding tissues. Although efforts to develop different implant surface modifications are being applied in commercial dental prostheses today, the inclusion of surface coatings has gained special interest, as they can be tailored to efficiently enhance osseointegration, as well as to reduce bacterial-related infection, minimizing peri-implantitis appearance and its associated risks. The use of biomaterials to replace teeth has highlighted the need for the development of reliable analytical methods to assess the therapeutic benefits of implants. This literature review considers the state-of-the-art strategies for surface modification or coating and analytical methodologies for increasing the survival rate for teeth restoration.

Electrochemical Surface Biofunctionalization of Titanium through Growth of TiO2 Nanotubes and Deposition of Zn Doped Hydroxyapatite

The current research aim is to biofunctionalize pure titanium (Ti, grade IV) substrate with titania nanotubes and Zn doped hydroxyapatite-based coatings by applying a duplex electrochemical treatment, and to evaluate the influence of Zn content on the physico-chemical properties of hydroxyapatite (HAp). The obtained nanostructured surfaces were covered with HAp-based coatings doped with Zn in different concentrations by electrochemical deposition in pulsed galvanostatic mode. The obtained surfaces were characterized in terms of morphology, elemental and phasic composition, chemical bonds, roughness, and adhesion. The nanostructured surface consisted of titania nanotubes (NT), aligned, vertically oriented, and hollow, with an inner diameter of ~70 nm. X-ray Diffraction (XRD) analysis showed that the nanostructured surface consists of an anatase phase and some rutile peaks as a secondary phase. The morphology of all coatings consisted of ribbon like-crystals, and by increasing the Zn content the coating became denser due to the decrement of the crystals’ dimensions. The elemental and phase compositions evidenced that HAp was successfully doped with Zn through the pulsed galvanostatic method on the Ti nanostructured surfaces. Fourier Transform Infrared spectroscopy (FTIR) and XRD analysis confirmed the presence of HAp in all coatings, while the adhesion test showed that the addition of a high quantity leads to some delamination. Based on the obtained results, it can be said that the addition of Zn enhances the properties of HAp, and through proper experimental design, the concentration of Zn can be modulated to achieve coatings with tunable features.

Bioactive Coatings on Titanium: A Review on Hydroxylation, Self-Assembled Monolayers (SAMs) and Surface Modification Strategies

Titanium (Ti) and its alloys have been demonstrated over the last decades to play an important role as inert materials in the field of orthopedic and dental implants. Nevertheless, with the widespread use of Ti, implant-associated rejection issues have arisen. To overcome these problems, antibacterial properties, fast and adequate osseointegration and long-term stability are essential features. Indeed, surface modification is currently presented as a versatile strategy for developing Ti coatings with all these challenging requirements and achieve a successful performance of the implant. Numerous approaches have been investigated to obtain stable and well-organized Ti coatings that promote the tailoring of surface chemical functionalization regardless of the geometry and shape of the implant. However, among all the approaches available in the literature to functionalize the Ti surface, a promising strategy is the combination of surface pre-activation treatments typically followed by the development of intermediate anchoring layers (self-assembled monolayers, SAMs) that serve as the supporting linkage of a final active layer. Therefore, this paper aims to review the latest approaches in the biomedical area to obtain bioactive coatings onto Ti surfaces with a special focus on (i) the most employed methods for Ti surface hydroxylation, (ii) SAMs-mediated active coatings development, and (iii) the latest advances in active agent immobilization and polymeric coatings for controlled release on Ti surfaces.

Influence of Sandblasting and Chemical Etching on Titanium 99.2-Dental Porcelain Bond Strength

The metal-ceramic interface requires proper surface preparation of both metal and ceramic substrates. This process is complicated by the differences in chemical bonds and physicochemical properties that characterise the two materials. However, adequate bond strength at the interface and phase composition of the titanium-bioceramics system is essential for the durability of dental implants and improving the substrates' functional properties. In this paper, the authors present the results of a study determining the effect of mechanical and chemical surface treatment (sandblasting and etching) on the strength and quality of the titanium-low-fusing dental porcelain bond. To evaluate the strength of the metal-ceramic interface, the authors performed mechanical tests (three-point bending) according to EN ISO 9693 standard, microscopic observations (SEM-EDS), and Raman spectroscopy studies. The results showed that depending on the chemical etching medium used, different bond strength values and failure mechanisms of the metal-ceramic system were observed. The analyzed samples met the requirements of EN ISO 9693 for metal-ceramic systems and received strength values above 25 MPa. Higher joint strength was obtained for the samples after sandblasting and chemical etching compared to the samples subjected only to sandblasting.

Fabrication and evaluation of antimicrobial biomimetic nanofibre coating for improved dental implant bio-seal: An in vitro study

BACKGROUND

A weak implant-soft tissue interface may lead to bacterial ingression, breakdown of underlying tissues, and eventually implant failure. This study proposes a surface modification technique of titanium alloy (Ti), using a nano-biopolymer scaffold to enhance soft tissue attachment in dental implants.

METHODS

Gelatin (20% w/v) embedded with 10±2 nm silver nanoparticles (AgNPs) was electrospun to form a Gelatin Electrospun Mat (GEM) scaffold, bonded to Ti alloy surface using chemical surface functionalization. Antimicrobial activity of AgNPs was tested against representative Gram-positive (S. aureus) and Gram-negative bacteria (E. coli) at 4, 24, and 48 hours (h) and after embedding in scaffold at 48 h. Cytotoxicity analysis (MTT assay) was carried out using the 3T3 mouse fibroblast cell line at 24 and 72 h for two groups: Control (unmodified Ti disc) and Experimental (GEM embedded with AgNPs); and further validated by scanning electron microscopy (SEM).

RESULTS

The AgNPs-embedded GEM showed good antimicrobial activity at 48 h, with the AgNPs showing complete (99.99%) inhibition of bacterial colony counts at 24 h and 48 h. Cell viability and proliferation over the GEM modified Ti discs were seen to be significantly increased (p < 0.05) at 72 h as compared to control. SEM images revealed intimate spreading of fibroblasts, with differentiated cell morphology and pseudopodial processes, indicative of enhanced fibroblastic adhesion, growth, and differentiation over the scaffold.

CONCLUSION

Results show good antifouling properties and biocompatibility of the fabricated coating, making it a promising strategy to reduce post-operative infections and peri-implant diseases in Ti dental implants. This article is protected by copyright. All rights reserved.

β-Ti Alloys for Orthopedic and Dental Applications: A Review of Progress on Improvement of Properties through Surface Modification

Ti and Ti alloys have charming comprehensive properties (high specific strength, strong corrosion resistance, and excellent biocompatibility) that make them the ideal choice in orthopedic and dental applications, especially in the particular fabrication of orthopedic and dental implants. However, these alloys present some shortcomings, specifically elastic modulus, wear, corrosion, and biological performance. Beta-titanium (β-Ti) alloys have been studied as low elastic modulus and low toxic or non-toxic elements. The present work summarizes the improvements of the properties systematically (elastic modulus, hardness, wear resistance, corrosion resistance, antibacterial property, and bone regeneration) for β-Ti alloys via surface modification to address these shortcomings. Additionally, the shortcomings and prospects of the present research are put forward. β-Ti alloys have potential regarding implants in biomedical fields.

Single-Point Incremental Forming of Titanium and Titanium Alloy Sheets

Incremental sheet forming of titanium and its alloys has a significant role in modern manufacturing techniques because it allows for the production of high-quality products with complex shapes at low production costs. Stamping processes are a major contributor to plastic working techniques in industries such as automotive, aerospace and medicine. This article reviews the development of the single-point incremental forming (SPIF) technique in titanium and its alloys. Problems of a tribological and microstructural nature that make it difficult to obtain components with the desired geometric and shape accuracy are discussed. Great emphasis is placed on current trends in SPIF of difficult-to-form α-, α + β- and β-type titanium alloys. Potential uses of SPIF for forming products in various industries are also indicated, with a particular focus on medical applications. The conclusions of the review provide a structured guideline for scientists and practitioners working on incremental forming of titanium and titanium alloy sheets. One of the ways to increase the formability and minimize the springback of titanium alloys is to treat them at elevated temperatures. The main approaches developed for introducing temperature into a workpiece are friction heating, electrical heating and laser heating. The selection of an appropriate lubricant is a key aspect of the forming process of titanium and its alloys, which exhibit unfavorable tribological properties such as high adhesion and a tendency to adhesive wear. A review of the literature showed that there are insufficient investigations into the synergistic effect of rotational speed and tool rotation direction on the surface roughness of workpieces.

Mechanical Properties and Residual Stress Measurements of Grade IV Titanium and Ti-6Al-4V and Ti-13Nb-13Zr Titanium Alloys after Laser Treatment

Nowadays, surface engineering focuses on research into materials for medical applications. Titanium and its alloys are prominent, especially Ti-6Al-4V and Ti-13Nb-13Zr. Samples made of pure grade IV titanium and the titanium alloys Ti-6Al-4V and Ti-13Nb-13Zr were modified via laser treatment with laser beam frequency f = 25 Hz and laser beam power P = 1000 W during a laser pulse with duration t = 1 ms. Subsequently, to analyze the properties of the obtained surface layers, the following tests were performed: scanning electron microscopy, chemical and phase composition analysis, wetting angle tests and roughness tests. The assessment of the impact of the laser modification on the internal stresses of the investigated materials was carried out by comparing the values of the stresses of the laser-modified samples to those of the reference samples. The obtained results showed increased values of tensile stresses after laser modification: the highest value was found for the Ti-6Al-4V alloy at 6.7434 GPa and the lowest for pure grade IV titanium at 3.742 GPa. After laser and heat treatment, a reduction in the stress was observed, together with a significant increase in the hardness of the tested materials, with the highest value for Ti-6Al-4V alloy at 27.723 GPa. This can provide better abrasion resistance and lower long-term toxicity, both of which are desirable when using Ti-6Al-4V and Ti-13Nb-13Zr alloys for implant materials.

Comparison of Rat Connective Tissue Response to BioMTA, Angelus MTA, and Root MTA

Due to the widespread use of MTA in dentistry and various brands of this product, we decided to compare the three brands available in the country market by their biocompatibility. We divided 20 male Wistar rats into four groups. After local anesthesia and washing, we made two incisions on both sides (4 incisions in total). The experimental groups were Angelus MTA (Angelus, Brazil), BioMTA (CERKAMED, Poland), Root MTA (Dr. Lotfi, Tabriz, Iran), and the control group. The resulting paste was placed in a tube and implanted subcutaneously into male Wistar rats. Wistar rats were sacrificed 7, 15, 30, and 60 days later, with high anesthetic doses. The sample implanted in 10% formalin was stabilized after tissue processing and H&E staining under a microscope. The inflammatory reaction in the tissues received different scores at the beginning of the tube opening. BioMTA had the highest inflammatory response among the groups, but the difference was not statistically significant (p > 0.05). Also, there was no significant difference between the groups' granulation and calcification (p < 0.05). There was a significant difference between BioMTA, Angelus MTA, Root MTA, and control groups in fibrous capsule formation (p < 0.05). Angelus MTA showed the lowest mean fibrous capsule formation in all periods. The effects of Angelus MTA, Root MTA, and BioMTA on connective tissue were investigated and compared. According to this study, these materials have good biocompatibility. According to the findings and statistical analysis, Angelus MTA has the most biocompatibility.

Anodic TiO2 Nanotubes: Tailoring Osteoinduction via Drug Delivery

TiO₂ nanostructures and more specifically nanotubes have gained significant attention in biomedical applications, due to their controlled nanoscale topography in the sub-100 nm range, high surface area, chemical resistance, and biocompatibility. Here we review the crucial aspects related to morphology and properties of TiO₂ nanotubes obtained by electrochemical anodization of titanium for the biomedical field. Following the discussion of TiO₂ nanotopographical characterization, the advantages of anodic TiO₂ nanotubes will be introduced, such as their high surface area controlled by the morphological parameters (diameter and length), which provides better adsorption/linkage of bioactive molecules. We further discuss the key interactions with bone-related cells including osteoblast and stem cells in in vitro cell culture conditions, thus evaluating the cell response on various nanotubular structures. In addition, the synergistic effects of electrical stimulation on cells for enhancing bone formation combining with the nanoscale environmental cues from nanotopography will be further discussed. The present review also overviews the current state of drug delivery applications using TiO₂ nanotubes for increased osseointegration and discusses the advantages, drawbacks, and prospects of drug delivery applications via these anodic TiO₂ nanotubes.

Innovative Surface Modification Procedures to Achieve Micro/Nano-Graded Ti-Based Biomedical Alloys and Implants

Due to the growing aging population of the world, and as a result of the increasing need for dental implants and prostheses, the use of titanium and its alloys as implant materials has spread rapidly. Although titanium and its alloys are considered the best metallic materials for biomedical applications, the need for innovative technologies is necessary due to the sensitivity of medical applications and to eliminate any potentially harmful reactions, enhancing the implant-to-bone integration and preventing infection. In this regard, the implant’s surface as the substrate for any reaction is of crucial importance, and it is accurately addressed in this review paper. For constructing this review paper, an internet search was performed on the web of science with these keywords: surface modification techniques, titanium implant, biomedical applications, surface functionalization, etc. Numerous recent papers about titanium and its alloys were selected and reviewed, except for the section on forthcoming modern implants, in which extended research was performed. This review paper aimed to briefly introduce the necessary surface characteristics for biomedical applications and the numerous surface treatment techniques. Specific emphasis was given to micro/nano-structured topographies, biocompatibility, osteogenesis, and bactericidal effects. Additionally, gradient, multi-scale, and hierarchical surfaces with multifunctional properties were discussed. Finally, special attention was paid to modern implants and forthcoming surface modification strategies such as four-dimensional printing, metamaterials, and metasurfaces. This review paper, including traditional and novel surface modification strategies, will pave the way toward designing the next generation of more efficient implants.

Passive Layers and Corrosion Resistance of Biomedical Ti-6Al-4V and β-Ti Alloys

The high specific strength, good corrosion resistance, and great biocompatibility make titanium and its alloys the ideal materials for biomedical metallic implants. Ti-6Al-4V alloy is the most employed in practical biomedical applications because of the excellent combination of strength, fracture toughness, and corrosion resistance. However, recent studies have demonstrated some limits in biocompatibility due to the presence of toxic Al and V. Consequently, scientific literature has reported novel biomedical β-Ti alloys containing biocompatible β-stabilizers (such as Mo, Ta, and Zr) studying the possibility to obtain similar performances to the Ti-6Al-4V alloys. The aim of this review is to highlight the corrosion resistance of the passive layers on biomedical Ti-6Al-4V and β-type Ti alloys in the human body environment by reviewing relevant literature research contributions. The discussion is focused on all those factors that influence the performance of the passive layer at the surface of the alloy subjected to electrochemical corrosion, among which the alloy composition, the method selected to grow the oxide coating, and the physicochemical conditions of the body fluid are the most significant.