Newly developed Ti-Nb-Zr-Ta-Si-Fe biomedical beta titanium alloys with increased strength and enhanced biocompatibility

A Review of Past Research and Some Future Perspectives Regarding Titanium Alloys in Biomedical Applications

This review paper provides a comprehensive synthesis of the current advancements in investigations of different titanium-based alloys, including pure titanium, commercially available Ti6Al4V, and modified alloys, such as Ti-Nb-Zr-Fe alloys, for biomedical applications. Several researchers have explored the effects of alloying elements and processing techniques on enhancing the mechanical, chemical, and biological properties of these materials. Ti-Nb-Zr-Fe alloys are of particular interest due to their potential to address critical requirements in medical applications, including reduced Young's modulus, superior corrosion resistance, biocompatibility, and mechanical strength. Despite substantial progress, the detailed mechanisms for optimizing these properties remain underexplored in the current literature. The main objective of the present review paper is to emphasize the importance of ongoing investigations aimed at overcoming challenges such as biocompatibility concerns, fatigue resistance, and wear under biological conditions. By critically analyzing existing data, this study highlights gaps in knowledge and identifies opportunities for advancing research on these alloys. Specifically, this review paper highlights the need for targeted studies to reduce the Young's modulus and improve other critical characteristics of Ti-Nb-Zr-Fe alloys to better meet the demands of orthopedic implants, dental prosthetics, and cardiovascular devices. Even if the current scientific literature is ample on this topic, we consider that through this review we can positively contribute to the collective effort in this field trying to fill some gaps, including some updates on the topic, time frames, advantages, and limitations, and pave the way for further advancements that could revolutionize biomedical implant technology. The review encompasses studies performed over the last 5 decades, specifically from 1975 to 2025, to ensure the inclusion of the most relevant and up-to-date research. This approach aims to highlight the significant progress made while situating the findings within the broader context of ongoing investigations.

Macrophage-related inflammatory responses to degradation products of biodegradable molybdenum implants

Metallic molybdenum (Mo) has been increasingly recognized as a potential biodegradable metal for biomedical implants. However, the macrophage-mediated inflammatory responses to Mo-based implants remain underexplored. This study examined the in vitro inflammatory reactions of macrophages to the degradation products of biodegradable Mo implants. The short-term and long-term biodegradation behavior and the subsequent impact on cytotoxicity, metabolism, and macrophage polarization were assessed. Both Mo and its degradation products were shown to be non-toxic within macrophage tolerance limits. Nevertheless, morphological changes and pro-inflammatory polarization were observed in cells around Mo-based specimen. Notably, matrix metalloproteinase 9 (Mmp9) was identified as a key gene influencing macrophage polarization in proximity to Mo. Additionally, pre-treating the Mo specimens in culture medium for 24 h significantly mitigated its stimulatory effects on cells. These results demonstrated the significance of optimizing Mo pre-treatment methods to prevent localized inflammation associated with its degradation. Specifically, pre-treatment of Mo can effectively mitigate the adverse impacts of its early degradation on macrophages and the surrounding immune environment. Our research into these early degradation phases introduces new avenues for studying molybdenum's immunomodulatory properties, potentially through precise control of its release and the targeted expression of pivotal genes.

Evolution of temporomandibular joint reconstruction: from autologous tissue transplantation to alloplastic joint replacement

The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery, underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines. This review aims to elucidate the available approaches for TMJ reconstruction, with a particular emphasis on recent groundbreaking advancements. The current spectrum of TMJ reconstruction integrates diverse surgical techniques, such as costochondral grafting, coronoid process grafting, revascularized fibula transfer, transport distraction osteogenesis, and alloplastic TMJ replacement. Despite the available options, a singular, universally accepted 'gold standard' for reconstructive techniques or materials remains elusive in this field. Our review comprehensively summarizes the current available methods of TMJ reconstruction, focusing on both autologous and alloplastic prostheses. It delves into the differences of each surgical technique and outlines the implications of recent technological advances, such as 3D printing, which hold the promise of enhancing surgical precision and patient outcomes. This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ, thereby improving the quality of life for patients with end-stage TMJ disorders.

Understanding crystallization and amorphization in liquid Ti cooled at different rates: A molecular dynamics simulation study

Crystallization and amorphization are important processes and different cooling rates cause these transitions. Obtaining pure metals from their molten state is a challenge unless these two are well understood. Here we study both these transitions in liquid Ti using molecular dynamics simulations wherein Ti is modeled with embedded atom potential. At 1 bar, Ti crystal is melted and then cooled from 2200 to 300 K with cooling rates of 0.1, 1, and 10 K/ps. When cooled at 0.1 and 1 K/ps, molten Ti crystallizes to bcc phase between 1100 and 1000 K, and when cooled at 10 K/ps, it amorphizes between these temperatures. From radial distribution functions and Voronoi tessellation, we observe that liquid to bcc transition takes place through short range distorted hcp/bcc-like structures already present in it. Relaxation dynamics is studied using velocity-autocorrelation functions (VACFs), intermediate scattering function, and dynamic structure factor. For all cooling rates, relaxations in VACFs increase with cooling. However, correlations in them are stronger when the system is cooled at 10 K/ps. Relaxation times decrease and increase between 1100 and 1000 K for crystallization and amorphization, respectively, thereafter they increase again with further cooling. The dynamic structure factor shows stronger damping in thermal diffusive motion when systems are cooled at 0.1 and 1 K/ps and vibration peaks shift to higher frequencies when crystallization take place. Our findings support Binder's [K. Binder, Proc. Natl. Acad. Sci. U. S. A. 111, 9374 (2014)] argument that if we cool the system faster than the minimum time needed for the liquid to relax, it will amorphize. This also prevents the growth of pre-ordered domains in it to establish long-range order.

Recent Advances and Prospects in β-type Titanium Alloys for Dental Implants Applications

Titanium and its alloys, especially Ti-6Al-4V, are widely studied in implantology for their favorable characteristics. However, challenges remain, such as the high modulus of elasticity and concerns about cytotoxicity. To resolve these issues, research focuses on β-type titanium alloys that incorporate elements such as Mo, Nb, Sn, and Ta to improve corrosion resistance and obtain a lower modulus of elasticity compatible with bone. This review comprehensively examines current β titanium alloys, evaluating their mechanical properties, in particular the modulus of elasticity, and corrosion resistance. To this end, a systematic literature search was carried out, where 81 articles were found to evaluate these outcomes. In addition, this review also covers the formation of the alloy, processing methods such as arc melting, and its physical, mechanical, electrochemical, tribological, and biological characteristics. Because β-Ti alloys have a modulus of elasticity closer to that of human bone compared to other metal alloys, they help reduce stress shielding. This is important because the alloy allows for a more even distribution of forces by having a modulus of elasticity more similar to that of bone. In addition, these alloys show good corrosion resistance due to the formation of a noble titanium oxide layer, facilitated by the incorporation of β stabilizers. These alloys also show significant improvements in mechanical strength and hardness. Finally, they also have lower cytotoxicity and bacterial adhesion, depending on the β stabilizer used. However, there are persistent challenges that require detailed research in critical areas, such as optimizing the composition of the alloy to achieve optimal properties in different clinical applications. In addition, it is crucial to study the long-term effects of implants on the human body and to advance the development of cutting-edge manufacturing techniques to guarantee the quality and biocompatibility of implants.

Functional medium entropy alloys for joint replacement: An atomistic perspective of material deformation and a correlation to wear, corrosion, and biocompatibility

The present study adopts a multi-facet approach to design bio inspired concentrated alloys for potential application as articulating surfaces in joint replacements. A series of equiatomic, Nb rich and Ti rich TiMoNbZr based medium entropy alloys (MEAs) were processed via arc melting and their mechanical, in-vitro corrosion, wear, and in vitro and in vivo biocompatibility were investigated. Equiatomic MEA had primarily bcc with minor hcp phases where the single bcc was achieved with the addition of Nb. The single bcc Nb rich alloy resulted in 13 % elongation, much higher than equiatomic or Ti rich alloy. All the MEAs showed comparatively higher yield strength due to the climb of edge dislocations which is the main rate limiting mechanism at 300 K, as evident molecular dynamics (MD) simulation. The locally fluctuating energy landscape promotes kinks on edge dislocation, and at local minima nanoscale segments gets pinned. Upon yielding the entangled kink leaves a trail of vacancies/interstitials and escapes via climb motion to render high yield strength. The higher corrosion and pitting resistance of Nb enriched alloys can be attributed to the stable ZrO2, Nb2O5, TiO2, and MoO3 oxides, high polarization resistance (106-105 Ωcm-2), and low defect densities (1016-1018). In vitro cell-materials interaction using MC3T3-E1 showed bioinert but cytocompatible nature of the MEAs. The wear rate of the MEAs was in the range of 7-9 × 10-5 mm3N-1m-1. The wear debris did not show any tissue necrosis when implanted in rabbit femur rather new bone regeneration can be seen around the particles. STATEMENT OF SIGNIFICANCE: In the present work, a noble Nb enriched MEAs with superior mechanical, in vitro wear, corrosion and cytocompatibility properties was designed for articulating surfaces in joint replacement.

Finite element modeling of stress distribution and safety factors in a Ti-27Nb alloy hip implant under real-world physiological loading scenarios

Total hip arthroplasty (THA) is one of the most successful orthopaedic interventions globally, with over 450,000 procedures annually in the U.S. alone. However, issues like aseptic loosening, dislocation, infection and stress shielding persist, necessitating complex, costly revision surgeries. This highlights the need for continued biomaterials innovation to enhance primary implant integrity and longevity. Implant materials play a pivotal role in determining long-term outcomes, with titanium alloys being the prominent choice. However, emerging evidence indicates scope for optimized materials. The nickel-free β titanium alloy Ti-27Nb shows promise with excellent biocompatibility and mechanical properties. Using finite element analysis (FEA), this study investigated the biomechanical performance and safety factors of a hip bone implant made of nickel-free titanium alloy (Ti-27Nb) under actual loading during routine day life activities for different body weights. The FEA modelled physiological loads during walking, jogging, stair ascent/descent, knee bend, standing up, sitting down and cycling for 75 kg and 100 kg body weights. Comparative analyses were conducted between untreated versus 816-hour simulated body fluid (SBF) treated implant conditions to determine in vivo degradation effects. The FEA predicted elevated von Mises stresses in the implant neck for all activities, especially stair climbing, due to its smaller cross-section. Stresses increased substantially with a higher 100 kg body weight compared to 75 kg, implying risks for heavier patients. Safety factors were reduced by up to 58% between body weights, although remaining above the desired minimum value of 1. Negligible variations were observed between untreated and SBF-treated responses, attributed to Ti-27Nb's excellent biocorrosion resistance. This comprehensive FEA provided clinically relevant insights into the biomechanical behaviour and integrity of the Ti-27Nb hip implant under complex loading scenarios. The results can guide shape and material optimization to improve robustness against repetitive stresses over long-term use. Identifying damage accumulation and failure risks is crucial for hip implants encountering real-world variable conditions. The negligible SBF effects validate Ti-27Nb's resistance to physiological degradation. Overall, the study significantly advances understanding of Ti-27Nb's suitability for reliable, durable hip arthroplasties with low revision rates.

Progress in the Optimization of Compositional Design and Thermomechanical Processing of Metastable β Ti Alloys for Biomedical Applications

Over the past few years, significant research and development in the manufacturing industry related to the medical field has been done. The aim has been to improve existing biomaterials and bioimplants by exploring new methods and strategies. Beta titanium alloys, known for their exceptional strength-to-modulus ratio, corrosion resistance, biocompatibility, and ease of shaping, are expected to play a crucial role in manufacturing the next generation of biomedical equipment. To meet the specific requirements of human bone, researchers have employed key techniques like compositional design and thermomechanical processing routes to advance biomaterial development. These materials find extensive applications in orthopedic, orthodontic, and cardiovascular biomedical implants. Several studies have shown that precise material composition, with appropriate heat treatment and suitable mechanical approaches, can yield the desired mechanical properties for bone implants. In this review article, we explore the evolution of alloys at different stages, with a particular focus on their preparation for use in biomedical implants. The primary focus is on designing low-modulus β Ti alloy compositions and employing processing techniques to achieve high strength while maintaining a low young modulus suitable for biomedical applications.

An Ultra-Low Modulus of Ductile TiZrHfTa Biomedical High-Entropy Alloys through Deformation Induced Martensitic Transformation/Twinning/Amorphization

Biomedical alloys are paramount materials in biomedical applications, particularly in crafting biological artificial replacements. In traditional biomedical alloys, a significant challenge is simultaneously achieving an ultra-low Young's modulus, excellent biocompatibility, and acceptable ductility. A multi-component body-centered cubic (BCC) biomedical high-entropy alloy (Bio-HEA), which is composed of non-toxic elements, is noteworthy for its outstanding biocompatibility and compositional tuning capabilities. Nevertheless, the aforementioned challenges still remain. Here, a method to achieve a single phase with the lowest Young's modulus among the constituent phases by precisely tuning the stability of the BCC phase in the Bio-HEA, is proposed. The subtle tuning of the BCC phase stability also enables the induction of stress-induced martensite transformation with extremely low trigger stress. The transformation-induced plasticity and work hardening capacity are achieved via the stress-induced martensite transformation. Additionally, the hierarchical stress-induced martensite twin structure and crystalline-to-amorphous phase transformation provide robust toughening mechanisms in the Bio-HEA. The cytotoxicity test confirms that this Bio-HEA exhibits excellent biocompatibility without cytotoxicity. In conclusion, this study provides new insights into the development of biomedical alloys with a combination of ultra-low Young's modulus, excellent biocompatibility, and decent ductility.

Effect of Cold-Rolling Deformation on the Microstructural and Mechanical Properties of a Biocompatible Ti-Nb-Zr-Ta-Sn-Fe Alloy

The primary focus of the current paper centers on the microstructures and mechanical properties exhibited by a Ti-30Nb-12Zr-5Ta-2Sn-1.25Fe (wt. %) (TNZTSF) alloy that has been produced through an intricate synthesis process comprising cold-crucible induction in levitation, carried out in an atmosphere controlled by argon, and cold-rolling deformation (CR), applying systematic adjustments in the total deformation degree (total applied thickness reduction), spanning from 10% to 60%. The microstructural characteristics of the processed specimens were investigated by SEM and XRD techniques, and the mechanical properties by tensile and microhardness testing. The collected data indicate that the TNZTSF alloy's microstructure, in the as-received condition, consists of a β-Ti phase, which shows polyhedral equiaxed grains with an average grain size close to 82.5 µm. During the cold-deformation processing, the microstructure accommodates the increased applied deformation degree by increasing crystal defects such as sub-grain boundaries, dislocation cells, dislocation lines, and other crystal defects, powerfully affecting the morphological characteristics. The as-received TNZTSF alloy showed both high strength (i.e., ultimate tensile strength close to σUTS = 705.6 MPa) and high ductility (i.e., elongation to fracture close to εf = 11.1%) properties, and the computed β-Ti phase had the lattice parameter a = 3.304(7) Å and the average lattice microstrain ε = 0.101(3)%, which are drastically influenced by the applied cold deformation, increasing the strength properties and decreasing the ductility properties due to the increased crystal defects density. Applying a deformation degree close to 60% leads to an ultimate tensile strength close to σUTS = 1192.1 MPa, an elongation to fracture close to εf = 7.9%, and an elastic modulus close to 54.9 GPa, while the computed β-Ti phase lattice parameter becomes a = 3.302(1) Å.

The Effect of Solution Treatment Duration on the Microstructural and Mechanical Properties of a Cold-Deformed-by-Rolling Ti-Nb-Zr-Ta-Sn-Fe Alloy

The study presented in this paper is focused on the effect of varying the solution treatment duration on both the microstructural and mechanical properties of a cold-deformed by rolling Ti-30Nb-12Zr-5Ta-2Sn-1.25Fe (wt.%) alloy, referred to as TNZTSF. Cold-crucible induction using the levitation synthesis technique, conducted under an argon-controlled atmosphere, was employed to fabricate the TNZTSF alloy. After synthesis, the alloy underwent cold deformation by rolling, reaching a total deformation degree (total applied thickness reduction) of 60%. Subsequently, a solution treatment was conducted at 850 °C, with varying treatment durations ranging from 2 to 30 min in 2 min increments. X-ray diffraction (XRD) and scanning electron microscopy (SEM) techniques were utilized for the structural analysis, while the mechanical properties were assessed using both tensile and hardness testing. The findings indicate that (i) in both the cold-deformed-by-rolling and solution-treated states, the TNZTSF alloy exhibits a microstructure consisting of a single β-Ti phase; (ii) in the solution-treated state, the microstructure reveals a rise in the average grain size and a decline in the internal average microstrain as the duration of the solution treatment increases; and (iii) owing to the β-phase stability, a favorable mix of elevated strength and considerable ductility properties can be achieved.

Manufacture of titanium alloy materials with bioactive sandblasted surfaces and evaluation of osseointegration properties

Titanium alloys are some of the most important orthopedic implant materials currently available. However, their lack of bioactivity and osteoinductivity limits their osseointegration properties, resulting in suboptimal osseointegration between titanium alloy materials and bone interfaces. In this study, we used a novel sandblasting surface modification process to manufacture titanium alloy materials with bioactive sandblasted surfaces and systematically characterized their surface morphology and physicochemical properties. We also analyzed and evaluated the osseointegration between titanium alloy materials with bioactive sandblasted surfaces and bone interfaces by in vitro experiments with co-culture of osteoblasts and in vivo experiments with a rabbit model. In our in vitro experiments, the proliferation, differentiation, and mineralization of the osteoblasts on the surfaces of the materials with bioactive sandblasted surfaces were better than those in the control group. In addition, our in vivo experiments showed that the titanium alloy materials with bioactive sandblasted surfaces were able to promote the growth of trabecular bone on their surfaces compared to controls. These results indicate that the novel titanium alloy material with bioactive sandblasted surface has satisfactory bioactivity and osteoinductivity and exhibit good osseointegration properties, resulting in improved osseointegration between the material and bone interface. This work lays a foundation for subsequent clinical application research into titanium alloy materials with bioactive sandblasted surfaces.

Microstructural Considerations of a Multi-Pass Rolled Ti-Nb-Ta-Zr Alloy

The microstructural characteristic evolution was investigated during thermomechanical processing of Ti-29Nb-9Ta-10Zr (wt %) alloy, which consisted of, in a first stage, in a Multi-Pass Rolling with increasing thickness reduction of 20%, 40%, 60%, 80%, and 90%; in step two, the multi-pass rolled sample with the highest thickness reduction (90%) was subjected to a series of three variants of static short recrystallization and then to a final similar aging. The objective was to evaluate the microstructural features evolution during thermomechanical processing (phase's nature, morphology, dimensions, and crystallographic characteristics) and to find the optimal heat treatment variant for refinement of the alloy granulation until ultrafine/nanometric level for a promising combination of mechanical properties. The microstructural features were investigated by X-ray diffraction and SEM techniques through which the presence of two phases was recorded: the β-Ti phase and the α″-Ti martensitic phase. The corresponding cell parameters, dimensions of the coherent crystallite and the micro-deformations at the crystalline network level for both recorded phases were determined. The majority β-Ti phase underwent a strong refinement during the Multi-Pass Rolling process until ultrafine/nano grain dimension (about 9.8 nm), with subsequent slow growing during recrystallization and aging treatments, hindered by the presence of sub-micron α″-Ti phase dispersed inside β-Ti grains. An analysis concerning the possible deformation mechanisms was performed.

Modeling of Severe Plastic Deformation by HSHPT of As-Cast Ti-Nb-Zr-Ta-Fe-O Gum Alloy for Orthopedic Implant

The High Speed High Pressure Torsion (HSHPT) is the severe plastic deformation method (SPD) designed for the grain refinement of hard-to-deform alloys, and it is able to produce large, rotationally complex shells. In this paper, the new bulk nanostructured Ti-Nb-Zr-Ta-Fe-O Gum metal was investigated using HSHPT. The biomaterial in the as-cast state was simultaneously compressed up to 1 GPa and torsion was applied with friction at a temperature that rose as a pulse in less than 15 s. The interaction between the compression, the torsion, and the intense friction that generates heat requires accurate 3D finite element simulation. Simufact Forming was employed to simulate severe plastic deformation of a shell blank for orthopedic implants using the advancing Patran Tetra elements and adaptable global meshing. The simulation was conducted by applying to the lower anvil a displacement of 4.2 mm in the z-direction and applying a rotational speed of 900 rpm to the upper anvil. The calculations show that the HSHPT accumulated a large plastic deformation strain in a very short time, leading to the desired shape and grain refinement.

Biomechanical Behavior of Narrow Dental Implants Made with Aluminum- and Vanadium-Free Alloys: A Finite Element Analysis

Titanium (Ti) alloys used for narrow dental implants usually contain aluminum (Al) and vanadium (V) for improved resistance. However, those elements are linked to possible cytotoxic effects. Thus, this study evaluated the biomechanical behavior of narrow dental implants made with Al- and V-free Ti alloys by the finite element method. A virtual model of a partially edentulous maxilla received single implants (diameter: 2.7 and 2.9 mm; length: 10 mm) at the upper lateral incisor area, with respective abutments and porcelain-fused-to-metal crowns. Simulations were performed for each implant diameter and the following eight alloys (and elastic moduli): (1) Ti-6Al-4V (control; 110 GPa), (2) Ti-35Nb-5Sn-6Mo-3Zr (85 GPa), (3) Ti-13Nb-13Zr (77 GPa), (4) Ti-15Zr (113 GPa), (5) Ti-8Fe-5Ta (120 GPa), (6) Ti-26.88Fe-4Ta (175 GPa), (7) TNTZ-2Fe-0.4O (107 GPa), and (8) TNTZ-2Fe-0.7O (109 GPa). The implants received a labially directed total static load of 100 N at a 45° angle relative to their long axis. Parameters for analysis included the maximum and minimum principal stresses for bone, and von Mises equivalent stress for implants and abutments. Ti-26.88Fe-4Ta reaches the lowest maximum (57 MPa) and minimum (125 MPa) principal stress values, whereas Ti-35Nb-5Sn-6Mo-3Zr (183 MPa) and Ti-13Nb-13Zr (191 MPa) models result in the highest principal stresses (the 2.7 mm model surpasses the threshold for bone overload). Implant diameters affect von Mises stresses more than the constituent alloys. It can be concluded that the narrow implants made of the Ti-26.88Fe-4Ta alloy have the most favorable biomechanical behavior, mostly by mitigating stress on peri-implant bone.

Experimental Research on New Developed Titanium Alloys for Biomedical Applications

The mechanical properties and electrochemical behavior of two new titanium alloys, Ti20Mo7Zr and Ti20Mo7Zr0.5Si, are investigated in this paper. The alloys have been manufactured by vacuum arc remelting (VAR) technique and studied to determine their microstructure, corrosion behavior, and mechanical properties. Metallographic observations and quantitative microanalysis by optical microscopy, scanning electron microscopy SEM, and energy dispersive X-rays spectroscopy EDX were performed. Data about the three-point bending test and microhardness are presented. For electrochemical properties, three different environments were used: Ringer solution at 25 °C, Ringer solution at 40 °C simulating fever condition, and 3.5% NaCl solution. Metallographic investigation revealed the biphasic and dendritic structure of both samples when the procedures were performed. Electrochemical testing in body simulation fluid, fever conditions, and saline medium showed that the lower the proportion of silicon in the samples, the higher the corrosion resistance. The formation of a titanium oxide layer on the surface of both samples was noticed using quantitative EDX analysis. The three-point bending test for the two samples revealed that the presence of silicon decreases the modulus of elasticity; the surface of the samples displayed soft and hard phases in the microhardness test. Electrochemical impedance spectroscopy (EIS) measurements were carried out at different potentials, and the obtained spectra exhibit a two-time constant system, attesting double-layer passive film on the samples.

A Review on Biomaterials for Orthopaedic Surgery and Traumatology: From Past to Present

The principal features essential for the success of an orthopaedic implant are its shape, dimensional accuracy, and adequate mechanical properties. Unlike other manufactured products, chemical stability and toxicity are of increased importance due to the need for biocompatibility over an implants life which could span several years. Thus, the combination of mechanical and biological properties determines the clinical usefulness of biomaterials in orthopaedic and musculoskeletal trauma surgery. Materials commonly used for these applications include stainless steel, cobalt-chromium and titanium alloys, ceramics, polyethylene, and poly(methyl methacrylate) (PMMA) bone cement. This study reviews the properties of commonly used materials and the advantages and disadvantages of each, with special emphasis on the sensitivity, toxicity, irritancy, and possible mutagenic and teratogenic capabilities. In addition, the production and final finishing processes of implants are discussed. Finally, potential directions for future implant development are discussed, with an emphasis on developing advanced personalised implants, according to a patient’s stature and physical requirements.

Proliferation of osteoblast precursor cells on the surface of TiO2 nanowires anodically grown on a β-type biomedical titanium alloy

Studies have shown that anodically grown TiO₂ nanotubes (TNTs) exhibit excellent biocompatibility. However, TiO₂ nanowires (TNWs) have received less attention. The objective of this study was to investigate the proliferation of osteoblast precursor cells on the surfaces of TNWs grown by electrochemical anodization of a Ti-35Nb-7Zr-5Ta (TNZT) alloy. TNT and flat TNZT surfaces were used as control samples. MC3T3-E1 cells were cultured on the surfaces of the samples for up to 5 days, and cell viability and proliferation were investigated using fluorescence microscopy, colorimetric assay, and scanning electron microscopy. The results showed lower cell proliferation rates on the TNW surface compared to control samples without significant differences in cell survival among experimental conditions. Contact angles measurements showed a good level of hydrophilicity for the TNWs, however, their relatively thin diameter and their high density may have affected cell proliferation. Although more research is necessary to understand all the parameters affecting biocompatibility, these TiO₂ nanostructures may represent promising tools for the treatment of bone defects and regeneration of bone tissue, among other applications.

Is There a Better Biomaterial for Dental Implants than Titanium?—A Review and Meta-Study Analysis

This article focuses on preclinical studies and reviews the available evidence from the literature on dental implant and abutment materials in the last decade. Specifically, different peri-implantitis materials and how surface modifications may affect the peri-implant soft-tissue seal and subsequently delay or hinder peri-implantitis are examined. This review analyzed more than 30 studies that were Randomized Controlled Trials (RCTs), Controlled Clinical Trials (CCTs), or prospective case series (CS) with at least six months of follow-up. Meta-analyses were performed to make a comparison between different implant materials (titanium vs. zirconia), including impact on bone changes, probing depth, plaque levels, and peri-implant mucosal inflammation, as well as how the properties of the implant material and surface modifications would affect the peri-implant soft-tissue seal and peri-implant health conditions. However, there was no clear evidence regarding whether titanium is better than other implant materials. Clinical evidence suggests no difference between different implant materials in peri-implant bone stability. The metal analysis offered a statistically significant advantage of zirconia implants over titanium regarding developing a favorable response to the alveolar bone.

Coinciding significance of the crystallographic orientation and nanostructuring on the biocompatibility of TZNT-Ag1 .5 alloy deformed by the cold rolling process

In this study, the simultaneous significance of the crystallographic texture and nanostructuring on the cytocompatibility of as-cast (Ti₅₅ Zr₂₅ Nb₁₀ Ta₁₀ )_98.5 -Ag_1.5 alloy (at. %, TZNT-Ag_1.5 ), subjected to cold rolling up to 90% reduction, along with the changes of Young's modulus and hardness under cold rolling were investigated. For this purpose, the as-cast and cold-rolled TZNT-Ag_1.5 alloy test specimens were analyzed by XRD, TEM, HRTEM, SEM, contact angle, nanoindentation, and OM techniques. Moreover, to evaluate the effect of severe cold deformation on the biocompatibility, MG-63 osteoblastic cell was cultured on the surface of 90% cold-rolled and as-cast test specimens of TZNT-Ag_1.5 alloy. The results showed that severe cold deformation was led to fast grain refinement of β grains of the as-cast TZNT-Ag_1.5 alloy in the range of 50-100 nm. In addition to the nanostructuring, upon severe cold deformation, the <gamma>-fiber (<111>// normal direction) texture was formed and after 90% reduction, the (111)<1 1 ¯ 0 > γ_-fiber component was strengthened. The micro-hardness and reduced Young's modulus are 235 ± 5.29, 246 ± 1.73, 271 ± 4.0, and 283 ± 6.25 (HV); and 73.725 ± 1.70, 83.98 ± 5.10, 81.26 ± 6.55, and 88.66 ± 7.16 (GPa) for TZNT-Ag_1.5 (as-cast), TZNT-Ag_1.5 (20%CR), TZNT-Ag_1.5 (50%CR), and TZNT-Ag_1.5 (90%CR) test specimens, respectively. Further, with increasing the cold deformation degree, the dislocation density of TZNT-Ag_1.5 alloy increased as this parameter is 2.79 × 10¹⁵ (m^-2 ) for the 90%CR test specimen. On the other hand, the values of the contact angle for the 90%CR test specimen (46.2 ± 3.5°) exhibit a higher hydrophilic and wettable surface as compared to the other studied test specimens. After 5 days of incubation, osteoblastic cells on the surface of the 90% cold-rolled TZNT-Ag_1.5 test specimens revealed significant differences in cell proliferation and differentiation as compared to the as-cast alloy test specimens and/or CP-Ti. Finally, because the maximum orientation intensities were generally <3, it was deduced that grain refinement rather than the crystallographic texture plays a significant role in improving the surface biocompatibility of the new TZNT-Ag_1.5 alloy.

Properties improvement of titanium alloys scaffolds in bone tissue engineering: a literature review

Owing to their excellent biocompatibility and corrosion-resistant properties, titanium (Ti) (and its alloy) are essential artificial substitute biomaterials for orthopedics. However, flaws, such as weak osteogenic induction ability and higher Young's modulus, have been observed during clinical application. As a result, short- and long-term postoperative follow-up has found that several complications have occurred. For decades, scientists have exerted efforts to compensate for these deficiencies. Different modification methods have been investigated, including changing alloy contents, surface structure transformation, three-dimensional (3D) structure transformation, coating, and surface functionalization technologies. The cell-surface interaction effect and imitation of the natural 3D bone structure are the two main mechanisms of these improved methods. In recent years, significant progress has been made in materials science research methods, including thorough research of titanium alloys of different compositions, precise surface pattern control technology, controllable 3D structure construction technology, improvement of coating technologies, and novel concepts of surface functionalization. These improvements facilitate the possibility for further research in the field of bone tissue engineering. Although the underlying mechanism is still not fully understood, these studies still have some implications for clinical practice. Therefore, for the direction of further research, it is beneficial to summarize these studies according to the basal method used. This literature review aimed to classify these technologies, thereby providing beginners with a preliminary understanding of the field.

Tailoring a Low Young Modulus for a Beta Titanium Alloy by Combining Severe Plastic Deformation with Solution Treatment

The present paper analyzed the microstructural characteristics and the mechanical properties of a Ti-Nb-Zr-Fe-O alloy of β-Ti type obtained by combining severe plastic deformation (SPD), for which the total reduction was of ε_tot = 90%, with two variants of super-transus solution treatment (ST). The objective was to obtain a low Young's modulus with sufficient high strength in purpose to use the alloy as a biomaterial for orthopedic implants. The microstructure analysis was conducted through X-ray diffraction (XRD), scanning electron microscopy (SEM), and high-resolution transmission electron microscopy (HRTEM) investigations. The analyzed mechanical properties reveal promising values for yield strength (YS) and ultimate tensile strength (UTS) of about 770 and 1100 MPa, respectively, with a low value of Young's modulus of about 48-49 GPa. The conclusion is that satisfactory mechanical properties for this type of alloy can be obtained if considering a proper combination of SPD + ST parameters and a suitable content of β-stabilizing alloying elements, especially the Zr/Nb ratio.

Beta-Titanium Alloy Covered by Ferroelectric Coating–Physicochemical Properties and Human Osteoblast-Like Cell Response

Beta-titanium alloys are promising materials for bone implants due to their advantageous mechanical properties. For enhancing the interaction of bone cells with this perspective material, we developed a ferroelectric barium titanate (BaTiO3) coating on a Ti39Nb alloy by hydrothermal synthesis. This coating was analyzed by scanning electron and Raman microscopy, X-ray diffraction, piezoresponse force microscopy, X-ray photoelectron spectroscopy, nanoindentation, and roughness measurement. Leaching experiments in a saline solution revealed that Ba is released from the coating. A progressive decrease of Ba concentration in the material was also found after 1, 3, and 7 days of cultivation of human osteoblast-like Saos-2 cells. On day 1, the Saos-2 cells adhered on the BaTiO3 film in higher initial numbers than on the bare alloy, but they were less spread, and their initial proliferation rate was slower. These cells also contained a lower amount of beta1-integrins and vinculin, i.e., molecules involved in cell adhesion, and produced a lower amount of collagen I. This cell behavior was attributed to a higher surface roughness of BaTiO3 film rather than to its potential cytotoxicity, because the cell viability on this film was very high, reaching almost 99%. The amount of alkaline phosphatase, an enzyme involved in bone matrix mineralization, was similar in cells on the BaTiO3-coated and uncoated alloy, and on day 7, the cells on BaTiO3 film attained a higher final cell population density. These results indicate that after some improvements, particularly in its roughness and stability, the hydrothermal ferroelectric BaTiO3 film could be promising coating for improved osseointegration of bone implants.

Ultrafine-Grained Ti-31Mo-Type Composites with HA and Ag, Ta2O5 or CeO2 Addition for Implant Applications

Ultrafine-grained Ti31Mo alloy and Ti31Mo5HA, Ti31Mo5HA-Ag (or Ta₂O₅, CeO₂) composites with a grain size of approximately 2 μm were produced by the application of mechanical alloying and powder metallurgy. Additionally, the surface of the Ti31Mo alloy was modified. In the first stage, the specimens were immersed in 5M NaOH for 24 h at 60 °C. In the second stage, hydroxyapatite (HA) was deposited on the sample surface. The cathodic deposition at −5 V vs. open circuit potential (OCP) in the electrolyte containing 0.25M CaNa₂-EDTA (di-calcium ethylenediaminetetraacetic acid), 0.25M K₂HPO₄ in 1M NaOH at 120 °C for 2 h was applied. The bulk Ti31Mo alloy is a single β-type phase. In the alkali-modified surface titanium oxide, Ti₃O is formed. After hydrothermal treatment, the surface layer mostly consists of the Ca₁₀(PO₄)₆(OH)₂ (81.23%) with about 19% content of CaHPO₄·2H₂O. Using optical profiler, roughness 2D surface topography parameters were estimated. The in vitro cytocompatibility of synthesized materials was studied. The cell lines of normal human osteoblasts (NHost) and human periodontal ligament fibroblasts (HPdLF) was conducted in the presence of tested biomaterials. Ultrafine-grained Ti-based composites altered with HA and Ag, Ta₂O₅ or CeO₂ have superior biocompatibility than the microcrystalline Ti metal. NHost and HPdLF cells in the contact with the synthesized biomaterial showed stable proliferation activity. Biocompatibility tests carried out indicate that the ultrafine-grained Ti31Mo5HA composites with Ag, Ta₂O_5, or CeO₂ could be a good candidate for implant applications.

Early osteoimmunomodulatory effects of magnesium-calcium-zinc alloys

Today, substantial attention is given to biomaterial strategies for bone regeneration, and among them, there is a growing interest in using immunomodulatory biomaterials. The ability of a biomaterial to induce neo vascularization and macrophage polarization is a major factor in defining its success. Magnesium (Mg)-based degradable alloys have attracted significant attention for bone regeneration owing to their biodegradability and potential for avoiding secondary removal surgeries. However, there is insufficient evidence in the literature regarding the early inflammatory responses to these alloys in vivo. In this study, we investigated the early body responses to Mg-0.45wt%Zn-0.45wt%Ca pin-shaped alloy (known as ZX00 alloy) in rat femora 2, 5, and 10 days after implantation. We used 3D micro computed tomography (µCT), histological, immunohistochemical, histomorphometrical, and small angle X-ray scattering (SAXS) analyses to study new bone formation, early macrophage polarization, neo vascularization, and bone quality at the implant bone interface. The expression of macrophage type 2 biological markers increased significantly after 10 days of Mg alloy implantation, indicating its potential in stimulating macrophage polarization. Our biomineralization results using µCT as well as histological stained sections did not indicate any statistically significant differences between different time points for both groups. The activity of alkaline phosphatase (ALP) and Runt-related transcription factor 2 (Runx 2) biological markers decreased significantly for Mg group, indicating less osteoblast activity. Generally, our results supported the potential of ZX00 alloy to enhance the expression of macrophage polarization in vivo; however, we could not observe any statistically significant changes regarding biomineralization.

A Study of Low Young's Modulus Ti-15Ta-15Nb Alloy Using TEM Analysis

The microstructural characteristics and Young’s modulus of the as-cast Ti–15Ta–15Nb alloy are reported in this study. On the basis of the examined XRD and TEM results, the microstructure of the current alloy is essentially a mixture (α + β+ α′ + α″ + ω + H) phase. The new H phase has not previously been identified as a known phase in the Ti–Ta–Nb alloy system. On the basis of examination of the Kikuchi maps, the new H phase belongs to a tetragonal structural class with lattice parameters of a = b = 0.328 nm and c = 0.343 nm, denoting an optimal presentation of the atomic arrangement. The relationships of orientation between these phases would be {0001}_α//{110}_β//{1¯21¯0}_ω//{101¯}_H and (011¯0)_α//(11¯2)_β//(1¯010)_ω//(121)_H. Moreover, the Young’s modulus of the as-cast Ti–15Ta–15Nb alloy is approximately E = 80.2 ± 10.66 GPa. It is implied that the Young’s modulus can be decreased by the mixing of phases, especially with the presence of the H phase.

Titanium for Orthopedic Applications: An Overview of Surface Modification to Improve Biocompatibility and Prevent Bacterial Biofilm Formation

Titanium and its alloys have emerged as excellent candidates for use as orthopedic biomaterials. Nevertheless, there are often complications arising after implantation of orthopedic devices, most notably prosthetic joint infection and aseptic loosening. To ensure that implanted devices remain functional in situ, innovation in surface modification has attracted much attention in the effort to develop orthopedic materials with optimal characteristics at the biomaterial-tissue interface. This review will draw together metallurgy, surface engineering, biofilm microbiology, and biomaterial science. It will serve to appreciate why titanium and its alloys are frequently used orthopedic biomaterials and address some of the challenges facing these biomaterials currently, including the significant problem of device-associated infection. Finally, the authors shall consolidate and evaluate surface modification techniques employed to overcome some of these issues by offering a unique perspective as to the direction in which research is headed from a broad, interdisciplinary point of view.

Composite and Surface Functionalization of Ultrafine-Grained Ti23Zr25Nb Alloy for Medical Applications

In this study, the ultrafine-grained Ti23Zr25Nb-based composites with 45S5 Bioglass and Ag, Cu, or Zn additions were produced by application of the mechanical alloying technique. Additionally, the base Ti23Zr25Nb alloy was electrochemically modified in the two stages of processing: electrochemical etching in the solution of H₃PO₄ and HF followed by electrochemical deposition in Ca(NO₃)₂, (NH₄)₂HPO₄, and HCl. The in vitro cytocompatibility studies were also done with comparison to the commercially pure titanium. The established cell lines of Normal Human Osteoblasts (NHost, CC-2538) and Human Periodontal Ligament Fibroblasts (HPdLF, CC-7049) were used. The culture was conducted among the tested materials. Ultrafine-grained titanium-based composites modified with 45S5 Bioglass and Ag, Cu, or Zn metals have higher biocompatibility than the reference material in the form of a microcrystalline Ti. Proliferation activity was at a stable level with contact with studied materials. In vitro evaluation research showed that the ultrafine-grained Ti23Zr25Nb-based composites with 45S5 Bioglass and Ag, Cu, or Zn additions, with a Young modulus below 50 GPa, can be further used in the biomedical field.

Biomedical Implants for Regenerative Therapies

Regenerative therapies aim to develop novel treatments to restore tissue function. Several strategies have been investigated including the use of biomedical implants as three-dimensional artificial matrices to fill the defect side, to replace damaged tissues or for drug delivery. Bioactive implants are used to provide growth environments for tissue formation for a variety of applications including nerve, lung, skin and orthopaedic tissues. Implants can either be biodegradable or non-degradable, should be nontoxic and biocompatible, and should not trigger an immunological response. Implants can be designed to provide suitable surface area-to-volume ratios, ranges of porosities, pore interconnectivities and adequate mechanical strengths. Due to their broad range of properties, numerous biomaterials have been used for implant manufacture. To enhance an implant’s bioactivity, materials can be functionalised in several ways, including surface modification using proteins, incorporation of bioactive drugs, growth factors and/or cells. These strategies have been employed to create local bioactive microenvironments to direct cellular responses and to promote tissue regeneration and controlled drug release. This chapter provides an overview of current bioactive biomedical implants, their fabrication and applications, as well as implant materials used in drug delivery and tissue regeneration. Additionally, cell- and drug-based bioactivity, manufacturing considerations and future trends will be discussed.

Improving the Mechanical Properties of a β-type Ti-Nb-Zr-Fe-O Alloy

The influence of complex thermo-mechanical processing (TMP) on the mechanical properties of a Ti-Nb-Zr-Fe-O bio-alloy was investigated in this study. The proposed TMP program involves a schema featuring a series of severe plastic deformation (SPD) and solution treatment (STs). The purpose of this study was to find the proper parameter combination for the applied TMP and thus enhance the mechanical strength and diminish the Young’s modulus. The proposed chemical composition of the studied β-type Ti-alloy was conceived from already-appreciated Ti-Nb-Ta-Zr alloys with high β-stability by replacing the expensive Ta with more accessible Fe and O. These chemical additions are expected to better enhance β-stability and thus avoid the generation of ω, α’, and α” during complex TMP, as well as allow for the processing of a single bcc β-phase with significant grain diminution, increased mechanical strength, and a low elasticity value/Young’s modulus. The proposed TMP program considers two research directions of TMP experiments. For comparisons using structural and mechanical perspectives, the two categories of the experimental samples were analyzed using SEM microscopy and a series of tensile tests. The comparison also included some already published results for similar alloys. The analysis revealed the advantages and disadvantages for all compared categories, with the conclusions highlighting that the studied alloys are suitable for expanding the database of possible β-Ti bio-alloys that could be used depending on the specific requirements of different biomedical implant applications.

The Influence of Severe Plastic Deformation on Microstructure and In Vitro Biocompatibility of the New Ti-Nb-Zr-Ta-Fe-O Alloy Composition

In this work, severe plastic deformation (SPD) of the newly designed Ti-Nb-Zr-Ta-Fe-O GUM metal was successfully conducted at room temperature using high speed high pressure torsion (HSHPT) followed by cold rolling (CR) to exploit the suitability of the processed alloy for bone staples. The Ti-31.5Nb-3.1Zr-3.1Ta-0.9Fe-0.16O GUM alloy was fabricated in a levitation melting furnace using a cold crucible and argon protective atmosphere. The as-cast specimens were subjected to SPD, specifically HSHPT, and then processed by the CR method to take the advantages of both grain refinement and larger dimensions. This approach creates the opportunity to obtain temporary orthopedic implants nanostructured by SPD. The changes induced by HSHPT technology from the coarse dendrite directly into the ultrafine grained structure were examined by optical microscopy, scanning electron microscopy and X-ray diffraction. The structural investigations showed that by increasing the deformation, a high density of grain boundaries is accumulated, leading gradually to fine grain size. In addition, the in vitro biocompatibility studies were conducted in parallel on the GUM alloy specimens in the as-cast state, and after HSHPT- and HSHPT+CR- processing. For comparative purposes, in vitro behavior of the bone-derived MC3T3-E1 cells on the commercially pure titanium has also been investigated regarding the viability and proliferation, morphology and osteogenic differentiation. The results obtained support the appropriateness of the HSHPT technology for developing compression staples able to ensure a better fixation of bone fragments.

In vitro evaluation of a novel nanostructured Ti-36Nb-6Ta alloy for orthopedic applications

Aim: To evaluate the impact of a nanostructured surface created on β-titanium alloy, Ti-36Nb-6Ta, on the growth and differentiation of human mesenchymal stem cells. Materials & methods: The nanotubes, with average diameters 18, 36 and 46 nm, were prepared by anodic oxidation. Morphology, hydrophilicity and mechanical properties of the nanotube layers were characterized. The biocompatibility and osteogenic potential of the nanostructured surfaces were established using various in vitro assays, scanning electron microscopy and confocal microscopy. Results: The nanotubes lowered elastic modulus close to that of bone, positively influenced cell adhesion, improved ALP activity, synthesis of type I collagen and osteocalcin expression, but diminished early cell proliferation. Conclusion: Nanostructured Ti-36Nb-6Ta with nanotube diameters 36 nm was the most promising material for bone implantation.

High pressure torsion induced lowering of Young's modulus in high strength TNZT alloy for bio-implant applications

An exceptional combination of low Young's modulus (E ~68 GPa) and high flow strength (σ_f ~1 GPa) was achieved for a consolidated β-Ti-based metastable Ti-35Nb-7Zr-5Ta (TNZT) alloy subjected to room temperature high-pressure torsion (HPT). The mechanical properties of the alloy were studied by quasistatic nanoindentation tests at different strain rates, where a reduction in Young's modulus E ~73 GPa (N_HPT¹⁰) and E ~68 GPa (N_HPT⁴⁰) is observed together with an increase in plastic deformability (or HPT rotations). The microstructure evolution with increasing shear strain has been investigated. The stabilized bcc β-Ti phase with homogeneous nanostructure distribution was observed leading to a low Young's modulus. Severe straining causes a uniform hardness distribution without any noticeable change in the strength of the material. This study may be useful for developing excellent removable implant materials.

A study on the mechanical properties and corrosion behavior of the new as-cast TZNT alloys for biomedical applications

In this study, four different TZNT based alloys, (Ti₅₅Zr₂₅Nb₁₀Ta₁₀, (Ti₅₅Zr₂₅Nb₁₀Ta₁₀)_99.5Fe_0.5, (Ti₅₅Zr₂₅Nb₁₀Ta₁₀)₉₈Sn₂, and (Ti₅₅Zr₂₅Nb₁₀Ta₁₀)_98.5Ag_1.5, (at. %), designated TZNT, TZNT-Fe, TZNT-Sn, TZNT-Ag, respectively) are produced by non-consumable vacuum arc melting and suction casting. These alloys using the d-electron alloy design method and considering the criteria of [Mo]eq and (e/a) _ratio for β-phase Ti alloys are designed. The microstructure, mechanical properties, and corrosion behavior of the alloys are investigated via optical microscopy, scanning electron microscopy, X-ray diffraction, nanoindentation, and electrochemical tests. The designed alloys exhibit dendritic morphology, however, the TZNT-Ag alloy indicates a more homogenous microstructure after suction casting. X-ray diffraction analyses reveal not only the beta phase in the TZNT, TZNT-Fe, and TZNT-Ag alloys, but also beta lean/beta rich separation in the TZNT-Sn alloy. In addition to the microstructural features, the new TZNT alloys show very high ductility upon cold compressive deformation, as well as the lowest Young's modulus (65.54±1.7 GPa, P<0.05) is achieved in TZNT-Ag alloy. Furthermore, the compressive yield stress to Young's modulus (Y_cys/E) ratio of the designed alloys is in the range of 0.92-1.08%. In terms of corrosion behavior, Ag increases the corrosion resistance of the TZNT alloy in Ringer's solution. As a result, owing to the effect of Ag on the optimization of the mechanical properties and corrosion resistance of the TZNT alloy, the as-cast Ag-containing TZNT alloy can be developed to be a promising candidate for biomedical applications.

Fabrication of a Promising Hierarchical Porous Surface on Titanium for Promoting Biocompatibility

The effects of the nano-titanium hydrides (nano-γ-TiH) phase on the formation of nanoporous Ti oxide layer by the potential approach (hydrogen fluoride (HF) pretreatment and sodium hydroxide (NaOH) anodization) were investigated using scanning electron microscopy, X-ray photoelectron spectroscopy, X-ray diffractometry, and transmission electron microscopy. The nano-γ-TiH phase was formed by the HF pretreatment with various current densities. After the NaOH anodization, the nano-γ-TiH phase was dissolved and transformed into nanoporous rutile-Ti dioxide (R-TiO2). As the Ti underwent HF pretreatment and NaOH anodization, the microstructure on the surface layer was transformed from α-Ti → (α-Ti + nano-γ-TiH) → (α-Ti + R-TiO2). In-vitro biocompatibility also indicated that the Ti with a hierarchical porous (micro and nanoporous) TiO2 surface possessed great potential to enhance cell adhesion ability. Thus, the potential approach can be utilized to fabricate a promising hierarchical porous surface on the Ti implant for promoting biocompatibility.

The Effect of Hot Working on the Mechanical Properties of High Strength Biomedical Ti-Nb-Ta-Zr-O Alloy

Beta titanium alloy Ti-35Nb-6Ta-7Zr-0.7O (wt%) was developed as a material intended for the manufacturing of a stem of a hip joint replacement. This alloy contains only biocompatible elements and possesses a very high yield strength already in the cast condition (900 MPa). However, the porosity, large grain size and chemical inhomogeneity reduce the fatigue performance below the limits required for utilization in the desired application. Two methods of hot working, die forging and hot rolling, were used for processing of this alloy. Microstructural evolution, tensile properties and fatigue performance of the hot worked material were investigated and compared to the cast material. Microstructural observations revealed that porosity is removed in all hot-worked conditions and the grain size is significantly reduced when the area reduction exceeds 70%. Static tensile properties were improved by both processing methods and ultimate tensile strength (UTS) of 1200 MPa was achieved. Fatigue results were more reproducible in the hot rolled material due to better microstructural homogeneity, but forging leads to an improved fatigue performance. Fatigue limit of 400 MPa was achieved in the die-forged condition after 70% of area reduction and in the hot rolled condition after 86% of area reduction.

Mechanical aspects of dental implants and osseointegration: A narrative review

With the need of rapid healing and long-term stability of dental implants, the existing Ti-based implant materials do not meet completely the current expectation of patients. Low elastic modulus Ti-alloys have shown superior biocompatibility and can achieve comparable or even faster bone formation in vivo at the interface of bone and the implant. Porous structured Ti alloys have shown to allow rapid bone ingrowth through their open structure and to achieve anchorage with bone tissue by increasing the bone-implant interface area. In addition to the mechanical properties of implant materials, the design of the implant body can be used to optimize load transfer and affect the ultimate results of osseointegration. The aim of this narrative review is to define the mechanical properties of dental implants, summarize the relationship between implant stability and osseointegration, discuss the effect of metallic implant mechanical properties (e.g. stiffness and porosity) on the bone response based on existing in vitro and in vivo information, and analyze load transfer through mechanical properties of the implant body. This narrative review concluded that although several studies have presented the advantages of low elastic modulus or high porosity alloys and their effect on osseointegration, further in vivo studies, especially long-term observational studies are needed to justify these novel materials as a replacement for current Ti-based implant materials.

Mechanical Properties of Ti-15Mo Alloy Prepared by Cryogenic Milling and Spark Plasma Sintering

Metastable β-Ti alloy Ti-15Mo was prepared by cryogenic ball milling in a slurry of liquid argon. Material remained ductile even at low temperatures, which suppressed particle refinement, but promoted intensive plastic deformation of individual powder particles. Repetitive deformation of powder particles is similar to the multidirectional rolling and resembles bulk severe plastic deformation (SPD) methods. Initial and milled powders were compacted by spark plasma sintering. Sintered milled powder exhibited a refined microstructure with small β-grains and submicrometer sized α-phase precipitates. The microhardness and the yield tensile strength of the milled powder after sintering at 850 °C attained 350 HV and 1200 MPa, respectively. Low ductility of the material can be attributed to high oxygen content originating from the cryogenic milling. This pioneering work shows that cryogenic milling followed by spark plasma sintering is able to produce two-phase β-Ti alloys with refined microstructure and very high strength levels.

Titanium alloys: in vitro biological analyzes on biofilm formation, biocompatibility, cell differentiation to induce bone formation, and immunological response

Biological effects of titanium (Ti) alloys were analyzed on biofilms of Candida albicans, Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus mutans, and Streptococcus sanguinis, as well as on osteoblast-like cells (MG63) and murine macrophages (RAW 264.7). Standard samples composed of aluminum and vanadium (Ti-6Al-4V), and sample containing niobium (Ti-35Nb) and zirconium (Ti-13Nb-13Zr) were analyzed. Monomicrobial biofilms were formed on the Ti alloys. MG63 cells were grown with the alloys and the biocompatibility (MTT), total protein (TP) level, alkaline phosphatase (ALP) activity, and mineralization nodules (MN) formation were verified. Levels of interleukins (IL-1β and IL-17), tumor necrosis factor alpha (TNF-α), and oxide nitric (NO) were checked, from RAW 264.7 cells supernatants. Data were statically analyzed by one-way analysis of variance (ANOVA) and Tukey's test, or T-test (P ≤ 0.05). Concerning the biofilm formation, Ti-13Nb-13Zr alloy showed the best inhibitory effect on E. faecalis, P. aeruginosa, and S. aureus. And, it also acted similarly to the Ti-6Al-4V alloy on C. albicans and Streptococcus spp. Both alloys were biocompatible and similar to the Ti-6Al-4V alloy. Additionally, Ti-13Nb-13Zr alloy was more effective for cell differentiation, as observed in the assays of ALP and MN. Regarding the stimulation for release of IL-1β and TNF-α, Ti-35Nb and Ti-13Nb-13Zr alloys inhibited similarly the synthesis of these molecules. However, both alloys stimulated the production of IL-17. Additionally, all Ti alloys showed the same effect for NO generation. Thus, Ti-13Nb-13Zr alloy was the most effective for inhibition of biofilm formation, cell differentiation, and stimulation for release of immune mediators.

Review on titanium and titanium based alloys as biomaterials for orthopaedic applications

Variety of implant materials have been employed in various disciplines of medical science depending on the requirement of a particular application. Metals, alloys, ceramics, and polymers are the commonly used biomaterials. The main focus of this study is to review the various structural and microstructural properties of titanium and titanium based alloys used as orthopaedic implants. Orthopaedic implants need to possess certain important qualities to ensure their safe and effective use. These properties like the biocompatibility, relevant mechanical properties, high corrosion and wear resistance and osseointegration are summarized in this review. Various attempts to improve upon these properties like different processing routes, surface modifications have also been inculcated in the paper to provide an insight into the extent of research and effort that has been put into developing a highly superior titanium orthopaedic implant.

Intrasurgical Protein Layer on Titanium Arthroplasty Explants: From the Big Twelve to the Implant Proteome

PURPOSE

Aseptic loosening in total joint replacement due to insufficient osteointegration is an unsolved problem in orthopaedics. The purpose of the study is to obtain a picture of the initial protein adsorption layer on femoral endoprosthetic surfaces as the key to the initiation of osseointegration.

EXPERIMENTAL DESIGN

The paper describes the first study of femoral stem explants from patients for proteome analysis of the primary protein layer. After 2 min in situ, the stems are explanted and frozen in liquid nitrogen. Proteins are eluted under reducing conditions and analyzed by LC-MS/MS.

RESULTS

After exclusion of proteins identified by a single peptide, the implant proteome is found to consist of 2802 unique proteins. Of these, 77% are of intracellular origin, 9% are derived from the plasma proteome, 8% from the bone proteome, and four proteins with highest specificity score could be assigned to the bone marrow proteome (transcriptome). The most abundant protein in the adsorbed total protein layer is hemoglobin (8-11%) followed by serum albumin (3.6-6%).

CONCLUSIONS

A detailed knowledge of the initial protein film deposited onto the implants, as demonstrated here for the first time, may help to understand and predict the response of the osseous microenvironment to implant surfaces.

Mechanical and in vitro degradation behavior of magnesium-bioactive glass composites prepared by SPS for biomedical applications

In order to make magnesium (Mg) a successful candidate for fracture fixation devices, it is imperative to control the corrosion rate and enhance its elastic modulus. In the present work, we have prepared bioactive glass (BG) reinforced magnesium composite using spark plasma sintering (SPS). Simultaneous application of heat and pressure during SPS decreased the softening point of BG (600°C), allowing it to coat the Mg particles partially. As a result, BG was found along the Mg particle boundaries, which was confirmed by elemental mapping. Addition of BG improved microhardness and elastic modulus of Mg-BG composites. Corrosion behavior was studied by hydrogen evolution and immersion corrosion in phosphate buffered saline (PBS). After 64 h of immersion, Mg-10 wt % BG composite showed highest corrosion resistance. Quantitative micro-computed tomography (micro-CT) results indicated porosity increase in Mg-BG composites during immersion. The maximum increase in porosity (1.66%) was noticed for pure Mg while the minimum for Mg-10 wt % BG composite. MG63 cell-material interactions, using extract method, showed good cytocompatibility for Mg-10 wt % BG composite. The concentration of Mg ion in cell culture media was measured using atomic absorption spectroscopy after 24 h immersion of Mg/BG composites. The results indicated that using BG as reinforcement and SPS as sintering method; we can prepare corrosion resistant and high modulus Mg-BG composites that can be used for fabricating bone fracture fixation plates. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 352-365, 2019.

Fabrication of Titanium-Niobium-Zirconium-Tantalium Alloy (TNZT) Bioimplant Components with Controllable Porosity by Spark Plasma Sintering

Spark Plasma Sintering (SPS) is used to fabricate Titanium-Niobium-Zirconium-Tantalum alloy (TNZT) powder-based bioimplant components with controllable porosity. The developed densification maps show the effects of final SPS temperature, pressure, holding time, and initial particle size on final sample relative density. Correlations between the final sample density and mechanical properties of the fabricated TNZT components are also investigated and microstructural analysis of the processed material is conducted. A densification model is proposed and used to calculate the TNZT alloy creep activation energy. The obtained experimental data can be utilized for the optimized fabrication of TNZT components with specific microstructural and mechanical properties suitable for biomedical applications.

Biodegradable Materials and Metallic Implants-A Review

Recent progress made in biomaterials and their clinical applications is well known. In the last five decades, great advances have been made in the field of biomaterials, including ceramics, glasses, polymers, composites, glass-ceramics and metal alloys. A variety of bioimplants are currently used in either one of the aforesaid forms. Some of these materials are designed to degrade or to be resorbed inside the body rather than removing the implant after its function is served. Many properties such as mechanical properties, non-toxicity, surface modification, degradation rate, biocompatibility, and corrosion rate and scaffold design are taken into consideration. The current review focuses on state-of-the-art biodegradable bioceramics, polymers, metal alloys and a few implants that employ bioresorbable/biodegradable materials. The essential functions, properties and their critical factors are discussed in detail, in addition to their challenges to be overcome.

Development of binary and ternary titanium alloys for dental implants

OBJECTIVE

The aim of this study was to develop binary and ternary titanium (Ti) alloys containing zirconium (Zr) and niobium (Nb) and to characterize them in terms of microstructural, mechanical, chemical, electrochemical, and biological properties.

METHODS

The experimental alloys - (in wt%) Ti-5Zr, Ti-10Zr, Ti-35Nb-5Zr, and Ti-35Nb-10Zr - were fabricated from pure metals. Commercially pure titanium (cpTi) and Ti-6Al-4V were used as controls. Microstructural analysis was performed by means of X-ray diffraction and scanning electron microscopy. Vickers microhardness, elastic modulus, dispersive energy spectroscopy, X-ray excited photoelectron spectroscopy, atomic force microscopy, surface roughness, and surface free energy were evaluated. The electrochemical behavior analysis was conducted in a body fluid solution (pH 7.4). The albumin adsorption was measured by the bicinchoninic acid method. Data were evaluated through one-way ANOVA and the Tukey test (α=0.05).

RESULTS

The alloying elements proved to modify the alloy microstructure and to enhance the mechanical properties, improving the hardness and decreasing the elastic modulus of the binary and ternary alloys, respectively. Ti-Zr alloys displayed greater electrochemical stability relative to that of controls, presenting higher polarization resistance and lower capacitance. The experimental alloys were not detrimental to albumin adsorption.

SIGNIFICANCE

The experimental alloys are suitable options for dental implant manufacturing, particularly the binary system, which showed a better combination of mechanical and electrochemical properties without the presence of toxic elements.