A review on alloy design, biological response, and strengthening of β-titanium alloys as biomaterials

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.

In situ production of low-modulus Ti-Nb alloys by selective laser melting and their functional assessment toward orthopedic applications

This work aimed to manufacture Ti-28.5Nb and Ti-40.0Nb (wt%) alloys in situ via selective laser melting (SLM) from Ti and Nb elemental powders. X-ray diffraction analysis revealed complete β-phase (cubic) in Ti-40.0Nb and a mixture of (α'' orthorhombic + β cubic) phases in Ti-28.5Nb were formed, whereas few of the Nb particles remained only partially fused during manufacturing. The fraction of partially melted Nb particles was determined as ∼2 and ∼18% in Ti-28.5Nb and Ti-40Nb, respectively. Mechanical characterization revealed higher hardness and more strength in Ti-28.5Nb than in Ti-40.0Nb due to the presence of the α'' phase in the former. Tribocorrosion tests reveal a significantly better wear-corrosion resistance for Ti-40.0Nb, as determined from a lower total volume loss in Ti-40.0Nb (∼2 × 10-4 mm-3) than in Ti-28.5Nb (∼13 × 10-2 mm-3). The lower volume loss and better corrosion resistance behavior are attributed to the β phase, which was dominant in Ti-40.0Nb. Cell studies reveal no toxicity for up to 7 days. Both the alloys were better at supporting cell proliferation than wrought Ti6Al4V. This study presents a route to preparing Ti-Nb alloys in situ by SLM that are promising candidates for biomedical applications.

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.

Data-Driven Design of Nickel-Free Superelastic Titanium Alloys

In this paper, a CatBoost model for predicting superelastic strains of alloys was established by utilizing features construction and selection as well as model filtering and evaluation based on 125 existing data points of superelastic titanium alloys. The alloy compositions of a TiNbMoZrSnTa system were optimized and three nickel-free titanium alloys with potentially excellent superelastic properties were designed using the Bayesian optimization algorithm using a superelastic strain as the optimization target. The experimental results indicated that only Ti-12Nb-18Zr-2Sn and Ti-12Nb-16Zr-3Sn exhibited clear superelasticity due to the absence of relevant information about the alloys' β stability in the machine learning model. Through experimental optimization of the heat treatment regimens, Ti-12Nb-18Zr-2Sn and Ti-12Nb-16Zr-3Sn ultimately achieved recovery strains of 4.65% after being heat treated at 853 K for 10 min and 3.01% after being heat treated at 1073 K for 30 min, respectively. The CatBoost model in this paper possessed a certain ability to design nickel-free superelastic titanium alloys but it was still necessary to combine it with existing knowledge of material theory for effective utilization.

Experimental Investigation of the Impact of Niobium Additions on the Structural Characteristics and Properties of Ti-5Cr-xNb Alloys for Biomedical Applications

In this study, a series of Ti-5Cr-xNb alloys with varying Nb content (ranging from 1 to 40 wt.%) were investigated to assess their suitability as implant materials. Comprehensive analyses were conducted, including phase analysis, microscopy examination, mechanical testing, and corrosion resistance evaluation. The results revealed significant structural alterations attributed to Nb addition, notably suppressing the formation of the ω phase and transitioning from α' + β + ω to single β phase structures. Moreover, the incorporation of Nb markedly improved the alloys' plastic deformation ability and reduced their elastic modulus. In particular, the Ti-5Cr-25Nb alloy demonstrated high values in corrosion potential and polarization resistance, signifying exceptional corrosion resistance. This alloy also displayed high bending strength (approximately 1500 MPa), a low elastic modulus (approximately 80 GPa), and outstanding elastic recovery and plastic deformation capabilities. These aggregate outcomes indicate the promising potential of the β-phase Ti-5Cr-25Nb alloy for applications in orthopedic and dental implants.

Tribological behavior and in vitro biocompatibility of powder metallurgical Ti-15Mo/HA composite for bone repair

Ti-15Mo/HA composite was prepared by powder metallurgy, and the influence of Hydroxyapatite (HA) on the microstructure, tribological behavior and in vitro biocompatibility was studied by comparison with TC4. The results show that the Ti-15Mo/HA composite consists of increased α-Ti, decreased β-Ti and a variety of ceramic phases (CaTiO3, Ca3(PO4)2, CaO, etc.) with the increase of HA content. The friction coefficient and wear rate of Ti-15Mo/HA composite is apparently lower than those of TC4 due to solid solution strengthening of Mo in Ti and dispersion strengthening of ceramic phases. Ti-15Mo/5HA displays more excellent wear resistance than the other composite. TC4 alloy is dominated by adhesive wear, however, Ti-15Mo alloy is a combination of adhesive wear and abrasive wear. Ti-15Mo/HA composite is mainly subjected to abrasive wear, together with adhesive wear. The viability and the number of mouse osteoblasts in Ti-15Mo/5HA extract are higher than that of Ti-15Mo. The morphology of the osteoblasts is clear and full, and the growth and proliferation are satisfactory with the increased cell pseudopodia with the culture time. The Ti-15Mo/HA composite displays good wear resistance and biocompatibility, and accordingly has a potential application in bone repair materials.

Modeling of a New Percutaneous Orthopedic Implant System to Control the Post-surgery Osseointegration Process

This study presents a mechanical model of a novel medical device designed to optimize the osseointegration process in upper and lower limb amputees, leading to the promotion of optimal rehabilitation. The medical device is developed to reduce the risk of implant failure, leading to re-amputation above the implant. The proposed model serves several purposes: 1) to guide the osseointegration process by providing electrical endo-stimulation directly to the bone-implant contact site, using an invasive electrical stimulation system, which is implanted in the bone permanently, 2) to locally transmit stem cells after implantation, without the need for opening the skin or perforating the bone, which is particularly useful for regenerative medicine after partial healing of the implant, 3) to transmit necessary nutrients from the bone, also without opening the skin or puncturing the bone, and 4) to combat infections by locally administering drugs after implantation.

The {332}<113> Twinning Behavior of a Ti-15Mo Medical Alloy during Cyclic Deformation and Its Effect on Microstructure and Performance

In this study, the microstructural evolution of a Ti-15Mo medical alloy was investigated, when the in situ cyclic tensile strain had 2% amplitude and the tension-compression cyclic deformation had 1%, 2%, and 3% amplitude. The Vickers hardness and wear resistance of the alloy were also optimized due to the grain-refining effect after cyclic deformation and annealing. The twinning-induced plasticity (TWIP) was considered the main deformation mechanism of the Ti-15Mo alloy during the tensile-compressive cycle deformation with suitable strain amplitude. The {332}<113> twins and boundaries were the main contributors to the grain refinement. The optimal microstructure, hardness, and wear resistance were obtained in the alloy deformed by tension-compression cyclic strain with a 3% strain amplitude. The wear resistance of the annealed alloy in Hank's solution was excellent in contrast to the original Ti-15Mo alloy due to its reasonable microstructure and hardness. It is clear that abundant twins were formed and retained in the coarse grains of the original alloy after cyclic deformation and annealing, which provided the expected refined grains and performance.

Selective laser melting of low-alloyed titanium based alloy with a large solidification range

In this work, thermodynamic calculations for α + β Type Ti-Fe-Cu-Sn alloy were carried out by the Thermo-Calc software. Powders from this alloy were obtained by plasma sputtering and used for subsequent 3D printing of experimental samples. The effect of various selective laser melting (SLM) parameters on porosity and hot cracking susceptibility as well as the electrochemical characteristics of the alloy have been studied. The optimal technological regime for the manufacture of samples by the SLM method was determined. It has been established that to obtain relatively dense samples without cracks, regimes with volumetric energy density Ev = 250-300 J/mm3 are required. It has been established that a change in the electrochemical behavior of the Ti94Fe1Cu1Sn4 alloy is related to the formation of a nonequilibrium Ti2Cu phase. Based on the findings we recomended directions for further research.

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.

Investigation of the Chemical Composition, Microstructure, Density, Microhardness, and Elastic Modulus of the New β Ti-50Nb-xMo Alloys for Biomedical Applications

β-type titanium alloys with a body-centered cubic structure are highly useful in orthopedics due to their low elastic modulus, lower than other commonly used alloys such as stainless steel and Co-Cr alloys. The formation of the β phase in titanium alloys is achieved through β-stabilizing elements such as Nb, Mo, and Ta. To produce new β alloys with a low modulus of elasticity, this work aimed to produce our alloy system for biomedical applications (Ti-50Nb-Mo). The alloys were produced by arc-melting and have the following compositions Ti-50Nb-xMo (x = 0, 3, 5, 7, and 12 wt% Mo). The alloys were characterized by density, X-ray diffraction, scanning electron microscopy, microhardness, and elastic modulus. It is worth highlighting that this new set of alloys of the Ti-50Nb-Mo system produced in this study is unprecedented; due to this, there needs to be a report in the literature on the production and structural characterization, hardness, and elastic modulus analyses. The microstructure of the alloys has an exclusively β phase (with bcc crystalline structure). The results show that adding molybdenum considerably increased the microhardness and decreased the elastic modulus, with values around 80 GPa, below the metallic materials used commercially for this type of application. From the produced alloys, Ti-50Nb-12Mo is highlighted due to its lower elastic modulus.

Development of Ti-10Nb alloy by powder metallurgy processing route for dental application

Titanium and its alloys are used to make dental implants because of its low density, high strength, and corrosion resistance. This paper describes the development of a potential biomaterial Ti-10Nb by powder metallurgy utilizing four different compaction pressures and analyses its microstructural, physical, mechanical, electrochemical, biological, and tribological behavior under various situations. The alloys were fabricated using four different compaction pressures, that is, 600, 650, 700, and 750 MPa, and sintered in a vacuum atmosphere at 1000°C for 1.5 h. The density of the samples was measured using Archimedes principle. X-ray diffraction and scanning electron microscopy equipped with energy dispersive spectroscopy were used to investigate the phase composition and microstructure, and a profilometer was used to examine the surface roughness of various samples. Vickers hardness tester was used to evaluate hardness, and a universal testing machine was used for compression testing. Corrosion and wear behavior were examined using a potentiostat and a Bio-Tribometer, respectively. This Ti-10Nb alloys consist of α + β phase, and have 16% highest porosity in sample compacted at 600 MPa. The samples compacted at 750 MPa achieved highest hardness, yield strength, compressive strength, and elastic modulus of 450 ± 29.72 HV, 718.22 ± 16.37 MPa, 1543.59 ± 24.37 MPa, and 41.27 ± 3.29 GPa, respectively. In addition, it also possesses highest corrosion and wear resistance with lowest icorr of 0.3954 ± 0.008 μA/cm2 and wear volume of (31.25 ± 0.206) × 10-3  mm3 . These results indicate that the developed alloys have a variety of desirable properties, including high hardness, adequate compressive strength, good corrosion and wear resistance, apatite-forming capability, and a low elastic modulus, which is advantageous for avoiding stress shielding. Therefore, it may be recommended to use it as a dental implant material.

Biomedical Applications of Titanium Alloys: A Comprehensive Review

Titanium alloys have emerged as the most successful metallic material to ever be applied in the field of biomedical engineering. This comprehensive review covers the history of titanium in medicine, the properties of titanium and its alloys, the production technologies used to produce biomedical implants, and the most common uses for titanium and its alloys, ranging from orthopedic implants to dental prosthetics and cardiovascular devices. At the core of this success lies the combination of machinability, mechanical strength, biocompatibility, and corrosion resistance. This unique combination of useful traits has positioned titanium alloys as an indispensable material for biomedical engineering applications, enabling safer, more durable, and more efficient treatments for patients affected by various kinds of pathologies. This review takes an in-depth journey into the inherent properties that define titanium alloys and which of them are advantageous for biomedical use. It explores their production techniques and the fabrication methodologies that are utilized to machine them into their final shape. The biomedical applications of titanium alloys are then categorized and described in detail, focusing on which specific advantages titanium alloys are present when compared to other materials. This review not only captures the current state of the art, but also explores the future possibilities and limitations of titanium alloys applied in the biomedical field.

Effects of Zr Addition on the Microstructural Evolution, Mechanical Properties, and Corrosion Behavior of Novel Biomedical Ti-Zr-Mo-Mn Alloys

β-Type Ti alloys have been widely investigated as implant materials owing to their excellent mechanical properties, corrosion resistance, and biocompatibility. In the present work, the effects of Zr on the microstructure, mechanical properties, and corrosion behaviors of Ti-Zr-Mo-Mn alloys were systematically studied. With the increase of Zr content, the phase composition gradually changed from intragranular-α + β of (TZ)5:1MM alloy to grain-boundary-α + β of (TZ)2:1MM alloy and finally transferred to a single β phase structure of (TZ)1:1MM alloy. The (TZ)1:1MM alloy exhibited a good mechanical combination with a yield strength of 750.8 MPa, an elastic modulus of 61.3 GPa, and a tensile ductility of 14.6%. Moreover, the addition of Zr can effectively stabilize the passivation film and reduce the sensitivity of microgalvanic corrosion in simulated body fluid, leading to enhanced corrosion resistance in the TZMM alloys. X-ray photoelectron spectroscopy analysis together with the ion-sputtering technique revealed that the passivation films formed on TZMM alloys possessed a bilayered structure (outer Ti+Zr mixed-oxide layer and inner Zr-oxide-rich layer), in which the inner Zr oxide layer plays an important role in the corrosion resistance of the TZMM alloys. In vitro biocompatibility evaluations demonstrated that the TZMM alloys can support cell adhesion and proliferation with high biocompatibility comparable to that of CP-Ti, while in vivo biocompatibility evaluations validated the bone osteointegration ability of TZMM alloys after long-term implantation. The above results indicate that novel TZMM alloys are promising candidates for implant material.

Micro finite element analysis of continuously loaded mini-implants - A micro-CT study in the rat tail model

Implant migration has been described as a minor displacement of orthodontic mini-implants (OMIs) when subjected to constant forces. Aim of this study was to evaluate the impact of local stresses on implant migration and bone remodelling around constantly loaded OMIs. Two mini-implants were placed in one caudal vertebra of 61 rats, connected by a nickel‑titanium contraction spring, and loaded with different forces (0.0, 0.5, 1.0, 1.5 N). In vivo micro-CT scans were taken immediately and 1, 2 (n = 61), 4, 6 and 8 (n = 31) weeks post-op. Nine volumes of interest (VOIs) around each implant were defined. To analyse stress values, micro-finite element models were created. Bone remodelling was analysed by calculating the bone volume change between scans performed at consecutive time points. Statistical analysis was performed using a linear mixed model and likelihood-ratio-tests, followed by Tuckey post hoc tests when indicated. The highest stresses were observed in the proximal top VOI. In all VOIs, stress values tended to reach their maximum after two weeks and decreased thereafter. Bone remodelling analysis revealed initial bone loss within the first two weeks and bone gain up to week eight, which was noted especially in the highest loading group. The magnitude of local stresses influenced bone remodelling and it can be speculated that the stress related bone resorption favoured implant migration. After a first healing phase with a high degree of bone resorption, net bone gain representing consolidation was observed.

Predicting Low-Modulus Biocompatible Titanium Alloys Using Machine Learning

Titanium alloys have been present for decades as the main components for the production of various orthopedic and dental elements. However, modern times require titanium alloys with a low Young's modulus, and without the presence of cytotoxic alloying elements. Machine learning was used with aim to analyze biocompatible titanium alloys and predict the composition of Ti alloys with a low Young's modulus. A database was created using experimental data for alloy composition, Young's modulus, and mechanical and thermal properties of biocompatible titanium alloys. The Extra Tree Regression model was built to predict the Young's modulus of titanium alloys. By processing data of 246 alloys, the specific heat was discovered to be the most influential parameter that contributes to the lowering of the Young's modulus of titanium alloys. Further, the Monte Carlo method was used to predict the composition of future alloys with the desired properties. Simulation results of ten million samples, with predefined conditions for obtaining titanium alloys with a Young's modulus lower than 70 GPa, show that it is possible to obtain several multicomponent alloys, consisting of five main elements: titanium, zirconium, tin, manganese and niobium.

Octacalcium Phosphate-Laden Hydrogels on 3D-Printed Titanium Biomaterials Improve Corrosion Resistance in Simulated Biological Media

The inflammatory-associated corrosion of metallic dental and orthopedic implants causes significant complications, which may result in the implant's failure. The corrosion resistance can be improved with coatings and surface treatments, but at the same time, it might affect the ability of metallic implants to undergo proper osteointegration. In this work, alginate hydrogels with and without octacalcium phosphate (OCP) were made on 3D-printed (patterned) titanium alloys (Ti Group 2 and Ti-Al-V Group 23) to enhance their anticorrosion properties in simulated normal, inflammatory, and severe inflammatory conditions in vitro. Alginate (Alg) and OCP-laden alginate (Alg/OCP) hydrogels were manufactured on the surface of 3D-printed Ti substrates and were characterized with wettability analysis, XRD, and FTIR. The electrochemical characterization of the samples was carried out with open circuit potential, potentiodynamic polarization, and electrochemical impedance spectroscopy (EIS). It was observed that the hydrophilicity of Alg/OCP coatings was higher than that of pure Alg and that OCP phase crystallinity was increased when samples were subjected to simulated biological media. The corrosion resistance of uncoated and coated samples was lower in inflammatory and severe inflammatory environments vs. normal media, but the hydrogel coatings on 3D-printed Ti layers moved the corrosion potential towards more nobler values, reducing the corrosion current density in all simulated solutions. These measurements revealed that OCP particles in the Alg hydrogel matrix noticeably increased the electrical charge transfer resistance at the substrate and coating interface more than with Alg hydrogel alone.

Fabrication of CO-releasing surface to enhance the blood compatibility and endothelialization of TiO2 nanotubes on titanium surface

Although the construction of nanotube arrays with the micro-nano structures on the titanium surfaces has demonstrated a great promise in the field of blood-contacting materials and devices, the limited surface hemocompatibility and delayed endothelial healing should be further improved. Carbon monoxide (CO) gas signaling molecule within the physiological concentrations has excellent anticoagulation and the ability to promote endothelial growth, exhibiting the great potential for the blood-contact biomaterials, especially the cardiovascular devices. In this study, the regular titanium dioxide nanotube arrays were firstly prepared in situ on the titanium surface by anodic oxidation, followed by the immobilization of the complex of sodium alginate/carboxymethyl chitosan (SA/CS) on the self-assembled modified nanotube surface, the CO-releasing molecule (CORM-401) was finally grafted onto the surface to create a CO-releasing bioactive surface to enhance the biocompatibility. The results of scanning electron microscopy (SEM), X-ray energy dispersion spectroscopy (EDS), and X-ray photoelectron spectroscopy (XPS) revealed that the CO-releasing molecules were successfully immobilized on the surface. The modified nanotube arrays not only exhibited excellent hydrophilicity but also could slowly release CO gas molecules, and the amount of CO release increased when cysteine was added. Furthermore, the nanotube array can promote albumin adsorption while inhibit fibrinogen adsorption to some extent, demonstrating its selective albumin adsorption; although this effect was somewhat reduced by the introduction of CORM-401, it can be significantly enhanced by the catalytic release of CO. The results of hemocompatibility and endothelial cell growth behaviors showed that, as compared with the CORM-401 modified sample, although the SA/CS-modified sample had better biocompatibility, in the case of cysteine-catalyzed CO release, the released CO could not only reduce the platelet adhesion and activation as well as hemolysis rate, but also promote endothelial cell adhesion and proliferation as well as vascular endothelial growth factor (VEGF) and nitric oxide (NO) expression. As a result, the research of the present study demonstrated that the releasing CO from TiO₂ nanotubes can simultaneously enhance the surface hemocompatibility and endothelialization, which could open a new route to enhance the biocompatibility of the blood-contacting materials and devices, such as the artificial heart valve and cardiovascular stents.

Application of Biomaterials in Treating Early Osteonecrosis of the Femoral Head: Research Progress and Future Perspectives

Osteonecrosis of the femoral head (ONFH), a progressive pathological process of femoral head ischemia and osteocyte necrosis, is a refractory orthopedic disease caused by multiple etiologies and there is no complete cure at present. With the extension of ONFH duration, osteocyte apoptosis and trabecular bone loss can decrease the load-bearing capacity of the femoral head, which leads to the collapse of the articular cartilage and subchondral bone. Therefore, an urgent clinical need exists to develop effective treatment strategies of early-stage ONFH for maintaining the hip joint function and preventing femoral head collapse. In recent years, extensive attention has been paid to the application of diverse biomaterials in treating early ONFH for sustaining the normal morphology and function of the autologous femoral head, and slowing disease progression. Herein, we review the research progress of bone grafts, metallic materials, bioceramics, bioglasses and polymer materials for early ONFH treatment, and discuss the biological mechanisms of bone repair and regeneration in the femoral-head necrotic area. We propose suggestions for future research directions, from a special perspective of improving the local microenvironment in femoral head by facilitating vessel-associated osteoclasts (VAOs) generation and coupling of bone-specific angiogenesis and osteogenesis, as well as inhibiting bone-associated osteoclasts (BAOs) and BAO-mediated bone resorption. This review can provide ideas for the research, development, and clinical application of biomaterials for treating early ONFH. STATEMENT OF SIGNIFICANCE: We believe that at least three aspects of this manuscript make it interesting to readers of the Acta Biomaterialia. First, we briefly summarize the incidence, pathogenesis, risk factors, classification criteria and treatment of early osteonecrosis of the femoral head (ONFH). Second, we review the research progress in biomaterials for early ONFH treatment and the biological mechanisms of bone repair and regeneration in femoral-head necrotic area. Third, we propose future research progress on improving the local microenvironment in femoral head by facilitating vessel-associated osteoclasts generation and coupling of bone-specific angiogenesis and osteogenesis, as well as inhibiting bone-associated osteoclasts and bone resorption. We hope this review can provide ideas for the research, development, and clinical application of biomaterials for treating early ONFH.

Effect of oxidation at an elevated temperature on the evolution of phases, microstructure, and properties of the oxide films formed on the surface of TiZr

This study examined the evolution of the microstructure, microhardness, corrosion resistance, and selective leaching properties of oxide films formed on the surface of a Ti-50Zr (%) alloy during heat treatment at 600 °C for various time intervals. According to our experimental results, the growth and evolution of oxide films can be divided into three stages. In stage I (heat treatment for less than 2 min), ZrO₂ was first formed on the surface of the TiZr alloy, which slightly improved its corrosion resistance. In stage II (heat treatment for 2-10 min), the initially generated ZrO₂ is gradually transformed into ZrTiO₄ from the top to the bottom of the surface layer. The formation of ZrTiO₄ significantly improves the microhardness and corrosion resistance of the alloy. In stage III (heat treatment for more than 10 min), microcracks appeared and propagated on the surface of the ZrTiO₄ film, deteriorating the surface properties of the alloy. The ZrTiO₄ began to peel off after heat treatment for more than 60 min. The untreated and heat-treated TiZr alloys exhibited excellent selective leaching properties in Ringer's solution, whereas a trace amount of suspended ZrTiO₄ oxide particles formed in the solution after soaking the 60 min heat-treated TiZr alloy for 120 days. Surface modification of the TiZr alloy by generating an intact ZrTiO₄ oxide film effectively improved its microhardness and corrosion resistance; however, oxidation should be performed appropriately to obtain materials with optimal properties for biomedical applications.

Development of Ti-Al-V alloys for usage as single-axis knee prostheses: evaluation of mechanical, corrosion, and tribocorrosion behaviors

Single-axis knee prosthesis is an artificial biomechanical device that provides motion to amputees without the need for assistance appliances. Besides it is mainly composed of metallic materials, the current commercial materials did not group adequate properties for long-term usage or accessible cost. This study produced and characterized Ti-(10 -x)Al-xV (x = 0, 2, and 4 wt.%) alloys for potential use as single-axis knee prostheses. The samples exhibited a gradual decrease in the density values, with proper chemical mixing of the alloying elements on the micro-scale. The phase composition exhibited a primary α phase with a minor α' + β phase for the Ti-8Al-2V and Ti-6Al-4V samples. Due to their different atomic radius compared to Ti, the addition of alloying elements changed the cell parameters. Their selected mechanical properties (Young's modulus, Vickers microhardness, and damping factor) performed better values than the CP-Ti grade 4. The samples also exhibited good corrosion properties against the simulated marine solution. The tribocorrosion resistance of the samples was better than the reference material, with the wear tracks composed of some tribolayers and grooves resulting from adhesive and abrasive wear. The Ti-10Al alloy displayed the best properties and estimated low cost to be used as single-axis knee prostheses.

Biocompatibility and osseointegration properties of a novel high strength and low modulus β- Ti10Mo6Zr4Sn3Nb alloy

Introduction: Ti6Al4V titanium alloy is widely used in producing orthopedic and maxillofacial implants, but drawbacks include high elastic modulus, poor osseointegration performance, and toxic elements. A new medical titanium alloy material with better comprehensive performance is urgently needed in the clinic. Methods: Ti10Mo6Zr4Sn3Nb titanium alloy (referred to as Ti-B12) is a unique medical ß titanium alloy material developed by us. The mechanical properties of Ti-B12 depict that it has advantages, such as high strength, low elastic modulus, and fatigue resistance. In our study, the biocompatibility and osseointegration properties of Ti-B12 titanium alloy are further studied to provide theoretical guidance for its clinical transformation. Results and Discussion: The titanium alloy Ti-B12 displays no significant effect on MC3T3-E1 cell morphology, proliferation, or apoptosis in vitro. Neither Ti-B12 titanium alloy nor Ti6Al4V titanium alloy depicts a significant difference (p > 0.05); Ti-B12 material extract injected into the abdominal cavity of mice does not cause acute systemic toxicity. The skin irritation test and intradermal irritation test reveal that Ti-B12 does not cause skin allergic reactions in rabbits. Compared to Ti6Al4V, Ti-B12 titanium alloy material has more advantages in promoting osteoblast adhesion and ALP secretion (p < 0.05). Although there is no significant difference in OCN and Runx2 gene expression between the three groups on the 7th and 14th days of differentiation induction (p > 0.05), the expression of Ti-B12 group is higher than that of Ti6Al4V group and blank control group. Furthermore, the rabbit in vivo test present that 3 months after the material is implanted in the lateral epicondyle of the rabbit femur, the Ti-B12 material fuses with the surrounding bone without connective tissue wrapping. This study confirms that the new β-titanium alloy Ti-B12 not only has low toxicity and does not cause rejection reaction but also has better osseointegration performance than the traditional titanium alloy Ti6Al4V. Therefore, Ti-B12 material is expected to be further promoted in clinical practice.

Structure, Properties, and Corrosion Behavior of Ti-Rich TiZrNbTa Medium-Entropy Alloys with β+α″+α' for Biomedical Application

Five Ti-rich β+α″+α′ Ti−Zr−Nb−Ta biomedical medium-entropy alloys with excellent mechanical properties and corrosion resistance were developed by considering thermodynamic parameters and using the valence electron concentration formula. The results of this study demonstrated that the traditional valence electron concentration formula for predicting phases is not entirely applicable to medium-entropy alloys. All solution-treated samples with homogeneous compositions were obtained at a low temperature (900 °C) and within a short period (20 min). All solution-treated samples exhibited low elastic moduli ranging from 49 to 57 GPa, which were significantly lower than those of high-entropy alloys with β phase. Solution-treated Ti65−Zr29−Nb3−Ta3 exhibited an ultra-high bending strength (1102 MPa), an elastic recovery angle (>30°), and an ultra-low elastic modulus (49 GPa), which are attributed to its α″ volume fraction as high as more than 60%. The pitting potentials of all samples were higher than 1.8 V, and their corrosion current densities were lower than 10−5 A/cm3 in artificially simulated body fluid at 37 °C. The surface oxide layers on Ti65−Zr29−Nb3−Ta3 comprised TiO2, ZrO2, Nb2O5, and Ta2O5 (as discovered through X-ray photoelectron spectroscopy) and provided the alloy with excellent corrosion and pitting resistance.

{332}<113> and {112}<111> Twin Variant Activation during Cold-Rolling of a Ti-Nb-Zr-Ta-Sn-Fe Alloy

Deformation twinning is a phenomenon that causes local shear strain concentrations, with the material either experiencing elongation (and thus a tensile stress) or contraction (compressive stress) along the stress directions. Thus, in order to gauge the performance of the alloy better, it is imperative to predict the activation of twinning systems successfully. The present study investigates the effects of deformation by cold-rolling on the {332}<113> and {112}<111> twin variant activation in a Ti-30Nb-12Zr-5Ta-2Sn-1.25Fe (wt.%) (TNZTSF) alloy. The Ti-30Nb-12Zr-5Ta-2Sn-1.25Fe (wt.%) alloy was synthesized in a cold crucible induction levitation furnace, under an argon-controlled atmosphere, using high-purity elemental components. The TNZTSF alloy was cold-deformed by rolling, in one single step, with a total deformation degree (thickness reduction) of ε ≈ 1% (CR 1), ε ≈ 3% (CR 3), and ε ≈ 15% (CR 15). The microstructural investigations were carried out with the SEM-EBSD technique in order to determine the grain morphology, grain-size distribution, crystallographic orientation, accumulated strain-stress fields and Schmid Factor (SF) analysis, all necessary to identify the active twin variants. The EBSD data were processed using an MTEX Toolbox ver. 5.7.0 software package. The results indicated that the TNZTSF alloy’s initial microstructure consists of a homogeneous β-Ti single phase that exhibits equiaxed polyhedral grains and an average grain-size close to 71 μm. It was shown that even starting with a 1% total deformation degree, the microstructure shows the presence of the {332}<113> twinning ((233)[3¯11] active twin variant; Schmit factor SF = −0.487); at a 3% total deformation degree, one can notice the presence of primary and secondary twin variants within the same grain belonging to the same {332}<113> twinning system ((323¯)[13¯1¯] primary twin variant—SF = −0.460; (233¯)[3¯11¯] secondary twin variant—SF = −0.451), while, at a 15% total deformation degree, besides the {332}<113> twinning system, one can notice the activation of the {112}<111> twinning system ((11¯2)[1¯11] active twin variant—SF = −0.440). This study shows the {332}<113> and {112}<111> twinning variant activation during cold-deformation by rolling in the case of a Ti-30Nb-12Zr-5Ta-2Sn-1.25Fe (wt.%) (TNZTSF) alloy.

Advances in surface modification of tantalum and porous tantalum for rapid osseointegration: A thematic review

After bone defects reach a certain size, the body can no longer repair them. Tantalum, including its porous form, has attracted increasing attention due to good bioactivity, biocompatibility, and biomechanical properties. After a metal material is implanted into the body as a medical intervention, a series of interactions occurs between the material’s surface and the microenvironment. The interaction between cells and the surface of the implant mainly depends on the surface morphology and chemical composition of the implant’s surface. In this context, appropriate modification of the surface of tantalum can guide the biological behavior of cells, promote the potential of materials, and facilitate bone integration. Substantial progress has been made in tantalum surface modification technologies, especially nano-modification technology. This paper systematically reviews the progress in research on tantalum surface modification for the first time, including physicochemical properties, biological performance, and surface modification technologies of tantalum and porous tantalum.

Effect of Alloying Elements on the Compressive Mechanical Properties of Biomedical Titanium Alloys: A Systematic Review

Due to problems such as the stress-shielding effect, strength-ductility trade-off dilemma, and use of rare-earth, expensive elements with high melting points in Ti alloys, the need for the design of new Ti alloys for biomedical applications has emerged. This article reports the effect of various alloying elements on the compressive mechanical performance of Ti alloys for biomedical applications for the first time as a systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on this subject. The search strategy in this systematic review used Scopus, Web of Science, and PubMed databases and searched the articles using (Beta-type OR β) AND Titanium AND (Mechanical property OR Microstructure) AND Alloying element keywords. Original articles from 2016 to 2022 published in English have been selected for this study as per the inclusion criteria. The results have shown that Nb can be used as the primary alloying element with Ti as it is a strong β-stabilizer element which also reduces the elastic modulus of Ti alloys. The β-eutectic elements (Fe, Cr, and Mn) have also emerged as cost-effective alloying elements that could improve the mechanical performance of Ti alloys. Ti-Nb-Zr-Ta alloyed with Si has shown potential to withstand the strength-ductility trade-off dilemma. The combination of a Ti-Nb binary alloy has emerged as an attractive material for designing low elastic modulus Ti alloys. The mechanical performance of the Ti-Nb alloy can be further improved using the β-eutectic (Fe, Cr, and Mn) and neutral (Zr, Sn) elements to be alloyed with a Ti-Nb binary alloy. The strength-ductility trade-off issue can be overcome using Si as an alloying element in Ti-Nb-Zr-Ta alloys.

Improved Tribocorrosion Behavior Obtained by In-Situ Precipitation of Ti2C in Ti-Nb Alloy

Novel in-situ Ti-based matrix composites (TMCs) were developed through the reactive hot pressing of Ti + NbC powder blends. Due to the chemical reaction that occurred in the solid-state during processing, the produced samples were composed of an Nb-rich β-Ti phase that formed a metallic matrix along with Ti2C as a reinforcing phase. By employing different proportions of Ti:NbC, the phase composition of the alloys was designed to contain different ratios of α-Ti and β-Ti. The present work investigated the corrosion and tribocorrosion behavior of the composites, compared to unreinforced Ti, in a phosphate-buffered solution (PBS) at body temperature. Corrosion tests included potentiodynamic polarization and electrochemical impedance spectroscopy (EIS). Tribocorrosion tests were carried out using a ball-on-plate tribometer with sliding performed at open circuit potential (OCP) and under anodic potentiostatic conditions. Results showed that the stabilization of the β phase in the matrix led to a decrease in the hardness. However, the formation of the in-situ reinforcing phase significantly improved the tribocorrosion behavior of the composites due to a load-carrying effect, lowering the corrosion tendency and kinetics under sliding. Furthermore, localized corrosion was not observed at the interface between the reinforcing phase and the matrix.

Machine Learning Assisted Prediction of Microstructures and Young’s Modulus of Biomedical Multi-Component β-Ti Alloys

Recently, the development of β-titanium (Ti) alloys with a low Young’s modulus as human implants has been the trend of research in biomedical materials. However, designing β-titanium alloys by conventional experimental methods is too costly and inefficient. Therefore, it is necessary to propose a method that can efficiently and reliably predict the microstructures and the mechanical properties of biomedical titanium alloys. In this study, a machine learning prediction method is proposed to accelerate the design of biomedical multi-component β-Ti alloys with low moduli. Prediction models of microstructures and Young’s moduli were built at first. The performances of the models were improved by introducing new experimental data. With the help of the models, a Ti–13Nb–12Ta–10Zr–4Sn (wt.%) alloy with a single β-phase microstructure and Young’s modulus of 69.91 GPa is successfully developed. This approach could also be used to design other advanced materials.

Effect of Thermomechanical Treatments on Microstructure, Phase Composition, Vickers Microhardness, and Young’s Modulus of Ti-xNb-5Mo Alloys for Biomedical Applications

The development of new β-Ti alloys has been extensively studied in the medical field in recent times due to their more suitable mechanical properties, such as a relatively low Young’s modulus. This paper analyzes the influence of heat treatments (homogenization and annealing) and hot rolling on the microstructure, phase composition, and some mechanical properties of ternary alloys of the Ti-xNb-5Mo system, with an amount of Nb varying between 0 and 30 wt%. The samples are produced by argon arc melting. After melting, the samples are homogenized at 1000 °C for 24 h and are hot rolled and annealed at 1000 °C for 6 h with slow cooling. Structural and microstructural analyses are made using X-ray diffraction and optical and scanning electron microscopy. Mechanical properties are evaluated by Vickers microhardness and Young’s modulus. The amount of β phase increases after heat treatment and reduces after hot rolling. The microhardness and Young’s modulus of all heat-treated samples decrease when compared with the hot rolled ones. Some samples exhibit atypical Young’s modulus and microhardness values, such as 515 HV for the as-cast Ti-10Nb-5Mo sample, indicating the possible presence of ω phase in the microstructure. The Ti-30Nb-5Mo sample suffers less variation in its phase composition with thermomechanical treatments due to the β-stabilizing effect of the alloying elements. The studied mechanical properties indicate that the annealed Ti-30Nb-5Mo sample has potential for biomedical applications, exhibiting a Young’s modulus value of 69 GPa and a microhardness of 236 HV.

Influence of Femtosecond Laser Modification on Biomechanical and Biofunctional Behavior of Porous Titanium Substrates

Bone resorption and inadequate osseointegration are considered the main problems of titanium implants. In this investigation, the texture and surface roughness of porous titanium samples obtained by the space holder technique were modified with a femtosecond Yb-doped fiber laser. Different percentages of porosity (30, 40, 50, and 60 vol.%) and particle range size (100–200 and 355–500 μm) were compared with fully-dense samples obtained by conventional powder metallurgy. After femtosecond laser treatment the formation of a rough surface with micro-columns and micro-holes occurred for all the studied substrates. The surface was covered by ripples over the micro-metric structures. This work evaluates both the influence of the macro-pores inherent to the spacer particles, as well as the micro-columns and the texture generated with the laser, on the wettability of the surface, the cell behavior (adhesion and proliferation of osteoblasts), micro-hardness (instrumented micro-indentation test, P–h curves) and scratch resistance. The titanium sample with 30 vol.% and a pore range size of 100–200 μm was the best candidate for the replacement of small damaged cortical bone tissues, based on its better biomechanical (stiffness and yield strength) and biofunctional balance (bone in-growth and in vitro osseointegration).

Construction of Mussel-Inspired Dopamine-Zn2+ Coating on Titanium Oxide Nanotubes to Improve Hemocompatibility, Cytocompatibility, and Antibacterial Activity

Zinc ions (Zn2+) are a highly potent bioactive factor with a broad spectrum of physiological functions. In situ continuous and controllable release of Zn2+ from the biomaterials can effectively improve the biocompatibility and antibacterial activity. In the present study, inspired by the adhesion and protein cross-linking in the mussel byssus, with the aim of improving the biocompatibility of titanium, a cost-effective one-step metal-catecholamine assembly strategy was developed to prepare a biomimetic dopamine-Zn2+ (DA-Zn2+) coating by immersing the titanium oxide nanotube (TNT) arrays on the titanium surface prepared by anodic oxidation into an aqueous solution containing dopamine (DA) and zinc ions (Zn2+). The DA-Zn2+ coatings with the different zinc contents exhibited excellent hydrophilicity. Due to the continuous release of zinc ions from the DA-Zn2+ coating, the coated titanium oxide nanotubes displayed excellent hemocompatibility characterized by platelet adhesion and activation and hemolysis assay. Moreover, the DA-Zn2+-coated samples exhibited an excellent ability to enhance endothelial cell (EC) adhesion and proliferation. In addition, the DA-Zn2+ coating can also enhance the antibacterial activity of the nanotubes. Therefore, long-term in situ Zn2+-releasing coating of the present study could serve as the bio-surfaces for long-term prevention of thrombosis, improvement of cytocompatibility to endothelial cells, and antibacterial activity. Due to the easy operation and strong binding ability of the polydopamine on various complicated shapes, the method of the present study can be further applied to other blood contact biomaterials or implantable medical devices to improve the biocompatibility.

Additive manufacturing of titanium-based alloys- A review of methods, properties, challenges, and prospects

The development of materials for biomedical, aerospace, and automobile industries has been a significant area of research in recent years. Various metallic materials, including steels, cast iron, nickel-based alloys, and other metals with exceptional mechanical properties, have been reportedly utilized for fabrication in these industries. However, titanium and its alloys have proven to be outstanding due to their enhanced properties. The β-titanium alloys with reduced modulus compared with the human bone have found more usage in the biomedical industry. In contrast, the α and α+β titanium alloys are more utilized to fabricate parts in the automobile and aerospace industries due to their relatively lightweight. Amongst the numerous additive manufacturing (AM) techniques, selective laser and electron beam melting techniques are frequently used for the fabrication of metallic components due to the full densification and high dimensional accuracy they offer. This paper reviews and discusses the different types of AM techniques, attention is also drawn to the properties and challenges associated with additively manufactured titanium -based alloys. The outcome from this study shows that 3D printed titanium and titanium-alloys exhibit huge prospects for various applications in the medical and aerospace industries. Also, laser-assisted 3D technologies were found to be the most effective AM method for achieving enhanced or near-full densification.

Mechanical Characterization and In Vitro Assay of Biocompatible Titanium Alloys

Metals that come into contact with the body can cause reactions in the body, so biomaterials must be tested to avoid side effects. Mo, Zr, and Ta are non-toxic elements; alloyed with titanium, they have very good biocompatibility properties and mechanical properties. The paper aims to study an original Ti20Mo7ZrxTa system (5, 10, 15 wt %) from a mechanical and in vitro biocompatibility point of view. Alloys were examined by optical microstructure, tensile strength, fractographic analysis, and in vitro assay. The obtained results indicate very good mechanical and biological properties, recommending them for future orthopedic medical applications.

Magnetic Properties and Biocompatibility of Different Thickness (Pd/Fe)n Coatings Deposited on Pure Ti Surface via Multi Arc Ion Plating

The different thickness (Fe/Pd)_n coatings were prepared by vacuum ion plating technology on a pure Ti substrate. The (Fe/Pd)_n coatings were magnetized using an MC-4000 high-pressure magnetizing machine. Then, the effect of the (Fe/Pd)_n coating thickness on the magnetic properties was studied. The surface and section morphology, composition, phase structure, magnetic properties, and biocompatibility of the (Fe/Pd)_n coatings were studied by scanning electron microscopy, X-ray diffraction, energy-dispersive X-ray spectroscopy, and CCTC-1 digital flux field measurement. The results showed that the (Fe/Pd)_n coatings were granular, smooth, and compact, without cracks. In addition the (Fe/Pd)_n coatings formed an L₁₀ phase with a magnetic face-centered tetragonal-ordered structure after heat treatment. With the increase in the thickness of (FePd)_n coatings, the content of L₁₀ FePd phase increased and the remanence increased. The remanence values of the Fe/Pd, (Fe/Pd)₅, (Fe/Pd)₁₀, and (Fe/Pd)₁₅ magnetic coatings were 0.83 Gs, 5.52 Gs, 7.14 Gs, and 7.94 Gs, respectively. Additionally, the (Fe/Pd)_n magnetic coatings showed good blood compatibility and histocompatibility.

Nanoarchitectonics of Electrically Activable Phosphonium Self-Assembled Monolayers to Efficiently Kill and Tackle Bacterial Infections on Demand

Prosthetic implants are widely used in dentistry and orthopedics and, as a result, infections can occur which cause their removal. Therefore, it is essential to propose methods of eradicating the bacteria that remain on the prosthesis during treatment. For this purpose, it is necessary to develop surfaces whose antibacterial activity can be controlled. Herein, we designed innovative and smart phosphonium self-assembled monolayer (SAM) interfaces that can be electrically activated on demand for controlling bacterial contaminations on solid surfaces. Upon electroactivation with a low potential (0.2 V for 60 min., conditions determined through a DOE), a successful stamping out of Gram-positive and Gram-negative bacterial strains was obtained with SAM-modified titanium surfaces, effectively killing 95% of Staphylococcus aureus and 90% Klebsiellapneumoniae. More importantly, no toxicity towards eukaryotic cells was observed which further enhances the biocompatible character of these novel surfaces for further implementation.

Using a two-step method of surface mechanical attrition treatment and calcium ion implantation to promote the osteogenic activity of mesenchymal stem cells as well as biomineralization on a β-titanium surface

Combination of the SMAT technique and Ca-ion implantation produced a β-titanium alloy with a bioactive surface layer, which was proved to effectively promote the osteogenic activity of MSCs and Ca–P mineral deposition in vitro.

Femoral Stems With Porous Lattice Structures: A Review

Cementless femoral stems are prone to stress shielding of the femoral bone, which is caused by a mismatch in stiffness between the femoral stem and femur. This can cause bone resorption and resultant loosening of the implant. It is possible to reduce the stress shielding by using a femoral stem with porous structures and lower stiffness. A porous structure also provides a secondary function of allowing bone ingrowth, thus improving the long-term stability of the prosthesis. Furthermore, due to the advent of additive manufacturing (AM) technology, it is possible to fabricate femoral stems with internal porous lattices. Several review articles have discussed porous structures, mainly focusing on the geometric design, mechanical properties and influence on bone ingrowth. However, the safety and effectiveness of porous femoral stems depend not only on the characteristic of porous structure but also on the macro design of the femoral stem; for example, the distribution of the porous structure, the stem geometric shape, the material, and the manufacturing process. This review focuses on porous femoral stems, including the porous structure, macro geometric design of the stem, performance evaluation, research methods used for designing and evaluating the femoral stems, materials and manufacturing techniques. In addition, this review will evaluate whether porous femoral stems can reduce stress shielding and increase bone ingrowth, in addition to analyzing their shortcomings and related risks and providing ideas for potential design improvements.

Three-Dimensionally Printed Ti2448 With Low Stiffness Enhanced Angiogenesis and Osteogenesis by Regulating Macrophage Polarization via Piezo1/YAP Signaling Axis

Previous studies have found that the novel low-elastic-modulus Ti2448 alloy can significantly reduce stress shielding and contribute to better bone repair than the conventional Ti6Al4V alloy. In this study, the promotion of osteogenesis and angiogenesis by three-dimensionally printed Ti2448 were also observed in vivo. However, these were not significant in a series of in vitro tests. The stiffness of materials has been reported to greatly affect the response of macrophages, and the immunological regulation mediated by macrophages directly determines the fate of bone implants. Therefore, we designed more experiments to explore the role of three-dimensionally printed Ti2448 in macrophage activation and related osteogenesis and angiogenesis. As expected, we found a significant increase in the number of M2 macrophages around Ti2448 implants, as well as better osteogenesis and angiogenesis in vivo. In vitro studies also showed that macrophages pre-treated with Ti2448 alloy significantly promoted angiogenesis and osteogenic differentiation through increased PDGF-BB and BMP-2 secretion, and the polarization of M2 macrophages was enhanced. We deduced that Ti2448 promotes angiogenesis and osteogenesis through Piezo1/YAP signaling axis-mediated macrophage polarization and related cytokine secretion. This research might provide insight into the biological properties of Ti2448 and provide a powerful theoretical supplement for the future application of three-dimensionally printed Ti2448 implants in orthopaedic surgery.

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.

Design, Synthesis, and Preliminary Evaluation for Ti-Mo-Zr-Ta-Si Alloys for Potential Implant Applications

Considering the future trends of biomaterials, current studies are focused on the corrosion resistance and the mechanical properties of new materials that need to be considered in the process of strengthening alloys with additive non-toxic elements. Many kinds of titanium alloys with different biocompatible elements (Mo, Si, Zr, etc.,) have been recently developed for their similar properties with human bone. Four new different alloys were obtained and investigated regarding their microstructure, mechanical, chemical, and biological behavior (in vitro and in vivo evaluation), the alloys are as follows: Ti15Mo7Zr15Ta, Ti15Mo7Zr15Ta0.5Si, Ti15Mo7Zr15Ta0.75Si, and Ti15Mo7Zr15Ta1Si. There were changes with the addition of the silicon element such as the hardness and the modulus of elasticity increased. An MTT assay confirmed the in vitro cytocompatibility of the prepared alloys.

Biofunctionalization of Porous Ti Substrates Coated with Ag Nanoparticles for Potential Antibacterial Behavior

Ti prosthesis have shown better biological compatibility, mechanical performance, and resistance to corrosion in cases of bone replacements. Nevertheless, fully dense Ti in connection with bone-host tissues show stress-shielding phenomenon that, together with the development of frequent undesirable microbial infections, may lead to implant failures. To overcome these issues, the present study aimed at the development of a novel combination of a chemically functionalized porous Ti substrate with a potentially therapeutic AgNPs coating. Fully dense and porous Ti substrates (30 and 60 vol.%, 100–200 and 355–500 μm, as spacer particles) were studied. Ti surface was treated with acid or basic medium followed by silanization and deposition of AgNPs by “submerged” and “in situ” methods. In general, for similar porosity, mechanical resistance decreased as pore size increased. Acidic reagent and submerged methodology were the best combination for fully dense Ti substrates. Hence, they were also employed for porous Ti substrates. Depending on the porosity of the substrates, variations can be observed both in the size and degree of agglomeration of the deposited AgNPs, entailing differences in the antibacterial behavior of the samples.