Bond strength of plasma-sprayed hydroxyapatite/Ti composite coatings

Effect of Reaction Temperature on the Microstructure and Properties of Magnesium Phosphate Chemical Conversion Coatings on Titanium

Magnesium phosphate (MgP) has garnered growing interest in hard tissue replacement processes due to having similar biological characteristics to calcium phosphate (CaP). In this study, an MgP coating with the newberyite (MgHPO₄·3H₂O) was prepared on the surface of pure titanium (Ti) using the phosphate chemical conversion (PCC) method. The influence of reaction temperature on the phase composition, microstructure, and properties of coatings was systematically researched with the use of an X-ray diffractometer (XRD), a scanning electron microscope (SEM), a laser scanning confocal microscope (LSCM), a contact angle goniometer, and a tensile testing machine. The formation mechanism of MgP coating on Ti was also explored. In addition, the corrosion resistance of the coatings on Ti was researched by assessing the electrochemical behavior in 0.9% NaCl solution using an electrochemical workstation. The results showed that temperature did not obviously affect the phase composition of the MgP coatings, but affected the growth and nucleation of newberyite crystals. In addition, an increase in reaction temperature had a great impact on properties including surface roughness, thickness, bonding strength, and corrosion resistance. Higher reaction temperatures resulted in more continuous MgP, larger grain size, higher density, and better corrosion resistance.

Thermally Sprayed Functional Coatings and Multilayers: A Selection of Historical Applications and Potential Pathways for Future Innovation

Thermal spray coatings are material systems with unique structures and properties that have enabled the growth and evolution of key modern technologies (i.e., gas turbines, structurally integrated components, etc.). The inherent nature of these sprayed coatings, such as their distinctive thermal and mechanical properties, has been a driving force for maintaining industrial interest. Despite these benefits and proven success in several fields, the adoption of thermal spray technology in new applications (i.e., clean energy conversion, semiconductor thermally sprayed materials, biomedical applications, etc.) at times, however, has been hindered. One possible cause could be the difficulty in concurrently maintaining coating design considerations while overcoming the complexities of the coatings and their fabrication. For instance, a coating designer must consider inherent property anisotropy, in-flight decomposition of molten material (i.e., loss of stoichiometry), and occasionally the formation of amorphous materials during deposition. It is surmisable for these challenges to increase the risk of adoption of thermal spray technology in new fields. Nevertheless, industries other than those already mentioned have benefited from taking on the risk of implementing thermal spray coatings in their infrastructure. Benefits can be quantified, for example, based on reduced manufacturing cost or enhanced component performance. In this overview paper, a historical presentation of the technological development of thermal spray coatings in several of these industries is presented. Additionally, emerging industries that have not yet attained this level of thermal spray maturation will also be discussed. Finally, where applicable, the utility and benefits of multilayer functional thermal spray coating designs will be demonstrated.

Effect of femoral stem surface coating on clinical and radiographic outcomes of cementless primary total hip arthroplasty: a patient-matched retrospective study

PURPOSE

This study aims to determine whether changing the stem coating grants superior outcomes at a minimum follow-up of five years.

METHODS

Retrospective review of a consecutive series of primary total hip arthroplasties (THAs) operated by direct anterior approach between 01/01/2013 and 31/12/2014. Two stems were compared, which were identical except for their surface coating; "the Original stem" was fully coated with hydroxyapatite (HA), while "the ProxCoat stem" was proximally coated with plasma-sprayed titanium and HA. Matching was performed. Clinical assessment included modified Harris hip score (mHHS), Oxford hip score (OHS), and forgotten joint score (FJS). Radiographic assessment evaluated alignment, subsidence, pedestal formation, heterotopic ossification, radiolucent lines ≥ 2 mm, spot welds, cortical hypertrophy, and osteolysis.

RESULTS

232 hips received the Original stem and 167 the ProxCoat stem, from which respectively five hips (2.2%) and no hips (0%) underwent revision. Matching identified two groups of 91 patients, with comparable patient demographics. At > five years follow-up, there were no differences in OHS (16 ± 6 vs 15 ± 5; p = 0.075) nor FJS (81 ± 26 vs 84 ± 22; p = 0.521), but there were differences in mHHS (89 ± 15 vs 92 ± 12; p = 0.042). There were no differences in alignment, subsidence, pedestal formation, heterotopic ossification, cortical hypertrophy, and osteolysis. There were differences in prevalence of proximal radiolucent lines (12% vs 0%; p < 0.001) and distal spot welds (24% vs 54%; p < 0.001).

CONCLUSION

At a minimum follow-up of five years, this study on matched patients undergoing primary THA found that ProxCoat stems results in significantly fewer radiolucent lines, more spot welds, and less revisions than Original stems, thus suggesting better bone ingrowth.

Engineering Stem Cell Recruitment and Osteoinduction via Bioadhesive Molecular Mimics to Improve Osteoporotic Bone-Implant Integration

For patients with osteoporosis, the therapeutic outcomes of osteoimplants are substantially affected by the impaired proliferation, migration, and osteogenic differentiation abilities of bone marrow mesenchymal stem cells (BMSCs). To improve bone-implant integration in osteoporotic condition, here we reported a one-step biomimetic surface strategy to introduce BMSC recruiting and osteoinductive abilities onto metallic osteoimplants. In our design, the bioadhesive molecular peptide mimic inspired by mussel foot proteins (Mfps) was used as molecular bridging for surface functionalization. Specifically, a BMSC-targeting peptide sequence (E7) and an osteogenic growth peptide (Y5) were grafted onto the titanium implant surfaces through a mussel adhesion mechanism. We found that a rational E7/Y5 feeding ratio could lead to an optimal dual functionalization capable of not only significantly improving the biocompatibility of the implant but also enabling it to recruit endogenous BMSCs for colonization, proliferation, and osteogenic differentiation. Mechanistically, the E7-assisted in situ recruitment of endogenous BMSCs as well as the enhanced interfacial osteogenesis and osteointegration was associated with activation of the C-X-C chemokine receptor type 4 (CXCR4) receptor on the cell surface and promotion of stromal cell-derived factor (SDF-1α) autocrine secretion. We anticipated that rational dual-functional surfaces through bioadhesive molecular mimics will provide a simple, effective, nonimmunogenic, and safe means to improve the clinical outcomes of intraosseous implants, especially under osteoporotic conditions.

Bioactive Surface Modifications through Thermally Sprayed Hydroxyapatite Composite Coatings: A Review over Selective Reinforcements

Hydroxyapatite (HA) has been an excellent replacement for the natural bone in orthopedic applications, owing to its close resemblance; however, it is brittle and has low strength. Surface modification techniques...

Microbially Catalyzed Biomaterials for Bone Regeneration

Bone is a complex mineralized tissue composed of various organic (proteins, cells) and inorganic (hydroxyapatite, calcium carbonate) substances with micro/nanoscale structures. To improve interfacial bioactivity of bone-implanted biomaterials, extensive efforts are being made to fabricate favorable biointerface via surface modification. Inspired by microbially catalyzed mineralization, a novel concept to biologically synthesize the micro/nanostructures on bioceramics, microbial-assisted catalysis, is presented. It involves three processes: bacterial adhesion on biomaterials, production of CO₃ ^2- assisted by bacteria, and nucleation and growth of CaCO₃ nanocrystals on the surface of bioceramics. The microbially catalyzed biominerals exhibit relatively uniform micro/nanostructures on the surface of both 2D and 3D α-CaSiO₃ bioceramics. The topographic and chemical cues of the grown micro/nanostructures present excellent in vitro and in vivo bone-forming bioactivity. The underlying mechanism is closely related to the activation of multiple biological processes associated with bone regeneration. The study offers a microbially catalytic concept and strategy of fabricating micro/nanostructured biomaterials for tissue regeneration.

Use of a Plasma-Sprayed Titanium-Hydroxyapatite Femoral Stem in Hip Arthroplasty in Patients Older than 70 Years. Is Cementless Fixation a Reliable Option in the Elderly?

Background: Although cementless implants are increasing in popularity, the use of cementless femoral stems for total hip arthroplasty (THA) and hip hemiarthroplasty (HH) in elderly patients remains controversial. The aim of this study was to report the outcomes of a cementless stem used in a large multicentric cohort of elderly patients receiving elective THA and HH for displaced femoral neck fracture. Methods: A total of 293 patients (301 hips) aged 70 years or older (mean age, 78 years; range, 70–93) who received the same cementless plasma-sprayed porous titanium–hydroxyapatite stem were retrospectively evaluated after primary THA and HH to investigate stem survival, complications, and clinical and radiographic results. Results: Cumulative stem survival was 98.5% (95% CI, 96.4–99.4%; 91 hips at risks) with revision due to any reason as the end-point at 10-year follow-up (mean 8.6 years, range 4–12). No stem was revised due to aseptic loosening. The mean Forgotten Joint Score was 98.7. Radiographically, the implants showed complete osseointegration, with slight stress-shieling signs in less than 10% of the hips. Conclusion: The use of cementless stems was proven to be a reliable and versatile option even in elderly patients for elective THA and HH for femoral neck fracture.

Stable sol-gel hydroxyapatite coating on zirconia dental implant for improved osseointegration

Aside from being known for its excellent mechanical properties and aesthetic effect, zirconia has recently attracted attention as a new dental implant material. Many studies have focused on hydroxyapatite (HA) coating for obtaining improved biocompatibility, however the coating stability was reduced by a byproduct produced during the high-temperature sintering process. In this study, to overcome this problem, we simply coated the zirconia surface with a sol-gel-derived hydroxyapatite (HA) layer and then sintered it at a varied temperature (<1000 °C). The surface showed a nanoporous structure, and there was no crystalline phase other than HA and zirconia when the sintering temperature was 800 °C. The adhesion strength of the HA layer (>40 MPa) was also appropriate as a dental implant application. In addition, in vitro cell experiments using a preosteoblast cell line revealed that the HA-coated zirconia surface acts as a preferable surface for cell attachment and proliferation than bare zirconia surface. In vivo animal experiments also demonstrated that the osteoconductivity of zirconia were dramatically enhanced by HA coating, which was comparable to that of Ti implant. These results suggest that the sol-gel-based HA-coated zirconia has a great potential for use as a dental implant material.

Innovative Coatings of Metallic Alloys Used as Bioactive Surfaces in Implantology: A Review

Metallic implants are widely used in the field of implantology, but there are still problems leading to implant failures due to weak osseointegration, low mechanical strength for the implant, inadequate antibacterial properties, and low patient satisfaction. Implant failure can be caused by bacterial infections and poor osteointegration. To improve the implant functionalization, many researchers focus on surface modifications to prepare the proper physical and chemical conditions able to increase biocompatibility and osteointegration between implant and bone. Improving the antibacterial performance is also a key factor to avoid the inflammation in the human body. This paper is a brief review for the types of coatings used to increase osseointegration and biocompatibility for the successful use of metal alloys in the field of implantology.

The Synergy of Topographical Micropatterning and Ta|TaCu Bilayered Thin Film on Titanium Implants Enables Dual-Functions of Enhanced Osteogenesis and Anti-Infection

Poor osteogenesis and implant-associated infection are the two leading causes of failure for dental and orthopedic implants. Surface design with enhanced osteogenesis often fails in antibacterial activity, or vice versa. Herein, a surface design strategy, which overcomes this trade-off via the synergistic effects of topographical micropatterning and a bilayered nanostructured metallic thin film is presented. A specific microgrooved pattern is fabricated on the titanium surface, followed by sequential deposition of a nanostructured copper (Cu)-containing tantalum (Ta) (TaCu) layer and a pure Ta cap layer. The microgrooved patterns coupled with the nanorough Ta cap layer shows strong contact guidance to preosteoblasts and significantly enhances the osteogenic differentiation in vitro, while the controlled local sustained release of Cu ions is responsible for high antibacterial activity. Importantly, rat calvarial defect models in vivo further confirm that the synergy of microgrooved patterns and the Ta|TaCu bilayered thin film on titanium surface could effectively promote bone regeneration. The present effective and versatile surface design strategy provides significant insight into intelligent surface engineering that can control biological response at the site of healing in dental and orthopedic implants.

Surface engineering of biomaterials in orthopedic and dental implants: Strategies to improve osteointegration, bacteriostatic and bactericidal activities

BACKGROUND

The success of biomedical implants in orthopedic and dental applications is usually limited due to insufficient bone-implant integration, and implant-related infections. Biointerfaces are critical in regulating their interactions and the desirable performance of biomaterials in biological environment. Surface engineering has been widely studied to realize better control of the interface interaction to further enhance the desired behavior of biomaterials.

PURPOSE AND SCOPE

This review aims to investigate surface coating strategies in hard tissue applications to address insufficient osteointegration and implant-related infection problems.

SUMMARY

We first focused on surface coatings to enhance the osteointegration and biocompatibility of implants by emphasizing calcium phosphate-related, nanoscale TiO₂ -related, bioactive tantalum-based and biomolecules incorporated coatings. Different coating strategies such as plasma spraying, biomimetic deposition, electrochemical anodization and LENS are discussed. We then discussed techniques to construct anti-adhesive and bactericidal surface while emphasizing multifunctional surface coating techniques that combine potential osteointegration and antibacterial activities. The effects of nanotopography via TiO₂ coatings on antibacterial performance are interesting and included. A smart bacteria-responsive titanium dioxide nanotubes coating is also attractive and elaborated.

CONCLUSION

Developing multifunctional surface coatings combining osteogenesis and antimicrobial activity is the current trend. Surface engineering methods are usually combined to obtain hierarchical multiscale surface structures with better biofunctionalization outcomes.

Current Challenges and Innovative Developments in Hydroxyapatite-Based Coatings on Metallic Materials for Bone Implantation: A Review

Biomaterials are in use for the replacement and reconstruction of several tissues and organs as treatment and enhancement. Metallic, organic, and composites are some of the common materials currently in practice. Metallic materials contribute a big share of their mechanical strength and resistance to corrosion properties, while organic polymeric materials stand high due to their biocompatibility, biodegradability, and natural availability. To enhance the biocompatibility of these metals and alloys, coatings are frequently applied. Organic polymeric materials and ceramics are extensively utilized for this purpose due to their outstanding characteristics of biocompatibility and biodegradability. Hydroxyapatite (HAp) is the material from the ceramic class which is an ultimate candidate for coating on these metals for biomedical applications. HAp possesses similar chemical and structural characteristics to normal human bone. Due to the bioactivity and biocompatibility of HAp, it is used for bone implants for regenerating bone tissues. This review covers an extensive study of the development of HAp coatings specifically for the orthopaedic applications that include different coating techniques and the process parameters of these coating techniques. Additionally, the future direction and challenges have been also discussed briefly in this review, including the coating of HAp in combination with other calcium magnesium phosphates that occur naturally in human bone.

Corrosion Protection of Nano-biphasic Calcium Phosphate Coating on Titanium Substrate

Background:

Increasing the bioactivity of metallic implants is necessary for biomaterial applications where hydroxyapatite (HA) is used as a surface coating. In industry, HA is currently coated by plasma spraying, but this technique has a high cost and produces coating with short-term stability.

Objectives:

In the present study, electrophoretic deposition (EPD) was used to deposit nano-biphasic calcium phosphate compound (β-tri-calcium phosphate (β-TCP) /hydroxyapatite (HA)) bio-ceramics on the titanium surface. The microstructural, chemical compositions and bioactivity of the β- TCP/HA coatings were studied in a simulated body fluid solution (SBF).

Methods:

Scanning electron microscopy (SEM) equipped with energy-dispersive X-ray spectroscopy (EDX) and Fourier transform infrared spectroscopy (FTIR) were used. Additionally, the antibacterial effect was studied by the agar diffusion method. The corrosion behavior of the β-TCP/HA coating on titanium surface (Ti) in the SBF solution at 37oC was investigated by means of electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization tests.

Results:

The Ti surface modification increased its biocompatibility and corrosion resistance in the simulated body fluid. The antibacterial inhibition activity of the β-TCP/HA bio-ceramic was enhanced by electroless silver deposition. The enhanced properties could be attributed to the use of nano-sized biphasic calcium phosphates in a low-temperature EPD process.

Conclusions:

The β-TCP/HA and β-TCP/HA/Ag coatings well protect Ti from the corrosion in SBF and endow Ti with biocompatibility. The β-4-TCP/HA/Ag/Ti substrate shows good antibacterial activity.

Characterization of Newly Developed Zinc Composite with the Content of 8 wt.% of Hydroxyapatite Particles Processed by Extrusion

Zinc and its alloys belong to a group of biodegradable materials, which can be potentially used for the preparation of temporary orthopedic implants. The research of biodegradable zinc materials revealed a lot of limitations; however, the new processing approaches of those materials can enhance their properties, which are insufficient for now. In this study, the zinc composite with 8 wt.% of hydroxyapatite (Zn/HA8) prepared for the first time by extrusion process was characterized from the point of view of the structural, mechanical and corrosion properties. The extrusion process led to good integrity of the interfaces between the zinc and hydroxyapatite particles. Mechanical behavior confirmed the role of hydroxyapatite as a defect in the material structure, which led to a decrease of the Zn/HA8 mechanical properties by approximately 30% (compressive yield strength (CYS) = 154 MPa Zn, 113 MPa Zn/HA8). Despite that, the Zn/HA8 composite showed sufficient mechanical properties for cancellous bone replacement and reached the lower limit for cortical bone. Additionally, the presence of hydroxyapatite caused the preferential precipitation of hydroxyapatite (HA) from the solution and can lead to a significant enhancement of the tissue/implant interface interactions.

The Preparation and Properties of Multilayer Cu-MTa2O5 Composite Coatings on Ti6Al4V for Biomedical Applications

For the enhancement of the anticorrosion and antibacterial performance of the biomedical alloy Ti6Al4V, a novel Cu incorporated multilayer Ta2O5ceramic composite coating Cu-Ta2O5/Ta2O5/Ta2O5-TiO2/TiO2/Ti (coating codeCu-MTa2O5) was developed by radio frequency (RF) and direct current (DC) reactive magnetron sputtering. Meanwhile, to better display the multilayer Ta2O5 coating mentioned above, a monolayer Ta2O5 ceramic coating was deposited onto the surface of Ti6Al4V alloy as a reference. The surface morphology, microstructure, phase constituents, and elemental states of the coating were evaluated by atomic force microscopy, scanning electron microscopy, X-ray diffraction, and X-ray photoelectron spectroscopy, respectively. The adhesion strength, wettability, anticorrosion and antibacterial properties of the coating were examined by a scratch tester, contact angle measurement, electrochemical workstations, and plate counting method, respectively. The results showed that the deposited coatings were amorphous and hydrophobic. Cu doped into the Ta2O5 coating existed as CuO and Cu2O. A Ta2O5-TiO2/TiO2/Ti multi-interlayer massively enhanced the adhesion strength of the coating, which was 2.9 times stronger than that of the monolayer Ta2O5coating. The multilayer Cu-MTa2O5 coating revealed a higher corrosion potential and smaller corrosion current density as compared to the uncoated Ti6Al4V, indicating the better anticorrosion performance of Ti6Al4V. Moreover, a 99.8% antibacterial effect of Cu-MTa2O5 coated against Staphylococcus aureuswas obtained.

Coating Techniques for Functional Enhancement of Metal Implants for Bone Replacement: A Review

To facilitate patient healing in injuries and bone fractures, metallic implants have been in use for a long time. As metallic biomaterials have offered desirable mechanical strength higher than the stiffness of human bone, they have maintained their place. However, in many case studies, it has been observed that these metallic biomaterials undergo a series of corrosion reactions in human body fluid. The products of these reactions are released metallic ions, which are toxic in high dosages. On the other hand, as these metallic implants have different material structures and compositions than that of human bone, the process of healing takes a longer time and bone/implant interface forms slower. To resolve this issue, researchers have proposed depositing coatings, such as hydroxyapatite (HA), polycaprolactone (PCL), metallic oxides (e.g., TiO2, Al2O3), etc., on implant substrates in order to enhance bone/implant interaction while covering the substrate from corrosion. Due to many useful HA characteristics, the outcome of various studies has proved that after coating with HA, the implants enjoy enhanced corrosion resistance and less metallic ion release while the bone ingrowth has been increased. As a result, a significant reduction in patient healing time with less loss of mechanical strength of implants has been achieved. Some of the most reliable coating processes for biomaterials, to date, capable of depositing HA on implant substrate are known as sol-gel, high-velocity oxy-fuel-based deposition, plasma spraying, and electrochemical coatings. In this article, all these coating methods are categorized and investigated, and a comparative study of these techniques is presented.

Nano-to-Submicron Hydroxyapatite Coatings for Magnesium-based Bioresorbable Implants - Deposition, Characterization, Degradation, Mechanical Properties, and Cytocompatibility

Magnesium (Mg) and its alloys have shown attractive biocompatibility and mechanical strength for medical applications, but low corrosion resistance of Mg in physiological environment limits its broad clinical translation. Hydroxyapatite (HA) nanoparticles (nHA) are promising coating materials for decreasing degradation rates and prolonging mechanical strength of Mg-based implants while enhancing bone healing due to their osteoconductivity and osteoinductivity. Conformal HA coatings with nano-to-submicron structures, namely nHA and mHA coatings, were deposited successfully on Mg plates and rods using a transonic particle acceleration (TPA) process under two different conditions, characterized, and investigated for their effects on Mg degradation in vitro. The nHA and mHA coatings enhanced corrosion resistance of Mg and retained 86-90% of ultimate compressive strength after in vitro immersion in rSBF for 6 weeks, much greater than non-coated Mg that only retained 66% of strength. Mg-based rods with or without coatings showed slower degradation than the respective Mg-based plates in rSBF after 6 weeks, likely because of the greater surface-to-volume ratio of Mg plates than Mg rods. This indicates that Mg-based plate and screw devices may undergo different degradation even when they have the same coatings and are implanted at the same or similar anatomical locations. Therefore, in addition to locations of implantation, the geometry, dimension, surface area, volume, and mass of Mg-based implants and devices should be carefully considered in their design and processing to ensure that they not only provide adequate structural and mechanical stability for bone fixation, but also support the functions of bone cells, as clinically required for craniomaxillofacial (CMF) and orthopedic implants. When the nHA and mHA coated Mg and non-coated Mg plates were cultured with bone marrow derived mesenchymal stem cells (BMSCs) using the in vitro direct culture method, greater cell adhesion densities were observed under indirect contact conditions than that under direct contact conditions for the nHA and mHA coated Mg. In comparison with non-coated Mg, the nHA and mHA coated Mg reduced BMSC adhesion densities directly on the surface, but increased the average BMSC adhesion densities under indirect contact. Further long-term studies in vitro and in vivo are necessary to elucidate the effects of nHA and mHA coatings on cell functions and tissue healing.

Compositionally graded doped hydroxyapatite coating on titanium using laser and plasma spray deposition for bone implants

Plasma sprayed hydroxyapatite (HA) coating is known to improve the osteoconductivity of metallic implants. However, the adhesive bond strength of the coating is affected due to a mismatch in coefficients of thermal expansion (CTE) between the metal and HA ceramic. In this study, a gradient HA coating was prepared on Ti6Al4V by laser engineered net shaping (LENS™) followed by plasma spray deposition. In addition, 1 wt% MgO and 2 wt% Ag2O were mixed with HA to improve the biological and antibacterial properties of the coated implant. Results showed that the presence of an interfacial layer by LENS™ enhanced adhesive bond strength from 26 ± 2 MPa for just plasma spray coating to 39 ± 4 MPa for LENS™ and plasma spray coatings. Presence of MgO and Ag2O did not influence the adhesive bond strength. Also, Ag+ ions release dropped by 70% less with a gradient HA LENS™ layer due to enhanced crystallization of the HA layer. In vitro human osteoblast cell culture revealed presence of Ag2O had no deleterious effect on proliferation and differentiation when compared to pure HA as control and provided antibacterial properties against E. coli and S. aureus bacterial strands. This study presents an innovative way to improve interfacial mechanical and antibacterial properties of plasma sprayed HA coating for load-bearing orthopedic as well as dental implants. STATEMENT OF SIGNIFICANCE: Implants are commonly composed of metals that lack osteoconductivity. Osteoconductivity is a property where bone grows on the surface meaning the material is compatible with the surrounding bone tissue. Plasma sprayed hydroxyapatite (HA) coating improves the osteoconductivity of metallic implants, however, the adhesive bond strength can be weak. This study incorporates a gradient HA coating by using an additive manufacturing technique, laser engineered net shaping (LENS™), followed by plasma spray deposition to enhance the adhesive bond strength by incorporating a thermal barrier. The proposed system has not been well studied in the current literature and the results presented bring forth an innovative way to improve the interfacial mechanical and antibacterial properties of plasma sprayed HA coating for load-bearing orthopedic implants.

Surface Modifications of the PMMA Optic of a Keratoprosthesis to Improve Biointegration

Biointegration of a keratoprosthesis (KPro) is critical for the mitigation of various long-term postoperative complications. Biointegration of a KPro occurs between the haptic skirt (corneal graft) and the central optic [poly(methyl methacrylate) (PMMA)]. Various studies have highlighted common problems associated with poor bonding and biointegration between these 2 incompatible biomaterials. Resolution of these issues could be achieved by surface modification of the inert material (PMMA). A calcium phosphate (CaP) coating deposited on dopamine-activated PMMA sheets by simulated body fluid incubation (d-CaP coating) was shown to improve adhesion to collagen type I (main component of corneal stroma) compared with untreated PMMA and PMMA with other surface modifications. However, the d-CaP coating could easily undergo delamination, thereby reducing its potential for modification of KPro optical cylinders. In addition, the coating did not resemble the Ca and P composition of hydroxyapatite (HAp). A novel dip-coating method that involves the creation of cavities to trap and immobilize HAp nanoparticles on the PMMA surface was introduced to address the problems associated with the d-CaP coating. The newly obtained coating offered high hydrophilicity, resistance to delamination, and preservation of the Ca and P composition of HAp. These advantages resulted in improved adhesion strength by more than 1 order of magnitude compared with untreated PMMA. With respect to biointegration, human corneal stromal fibroblasts were able to adhere strongly and proliferate on HAp-coated PMMA. Furthermore, the new coating technique could be extended to immobilization of HAp nanoparticles on 3-mm-diameter PMMA cylinders, bringing it closer to clinical application.

In-situ preparation of scholzite conversion coatings on titanium and Ti-6Al-4V for biomedical applications

A scholzite (CaZn₂(PO₄)₂·2H₂O) coating was prepared in situ on commercially pure titanium (cpTi) and Ti-6Al-4V (Ti64) substrates using the chemical conversion technology, and its phase composition and microstructure, as well as mechanical, chemical and biological properties were investigated to explore potential applications as a bioactive coating on bone implants. It is indicated that the coating consists mainly of monoclinic scholzite crystals with nano-thick laminar morphology. The crystals on cpTi aggregate to flower-like particles with the diameter of 5-10μm, while form a network structure homogeneously on Ti64. The scratch test shows that the interfacial bonding strength between the coatings and substrates is higher than 40N. Electrochemical measurements indicate that the corrosion behavior of the coatings is not inferior compared with that of oxide film on substrates. MG63 osteoblast-like cells show good adherence and significantly proliferation and differentiation characteristics on the scholzite coated cpTi and Ti64 (p<0.05) in in-vitro cell tests, demonstrating the cytocompatibility of Ti is significantly improved by the scholzite coating. It is suggested that the scholzite coating might be a promising option in hard tissue replacements for early osteogenesis.

Functionalization of the Polymeric Surface with Bioceramic Nanoparticles via a Novel, Nonthermal Dip Coating Method

The only nonthermal method of depositing a bioceramic-based coating on polymeric substrates is by incubation in liquid, e.g., simulated body fluid to form an apatite-like layer. The drawbacks of this method include the long processing time, the production of low scratch resistant coating, and an end product that does not resemble the intended bioceramic composition. Techniques, such as plasma spraying and magnetron sputtering, involving high processing temperature are unsuitable for polymers, e.g., PMMA. Here, we introduce a nonthermal coating method to immobilize hydroxyapatite (HAp) and TiO₂ nanoparticles on PMMA via a simple and fast dip coating method. Cavities that formed on the PMMA, induced by chloroform, appeared to trap the nanoparticles which accumulated to form layers of bioceramic coating only after 60 s. The resulting coating was hydrophilic and highly resistant to delamination. In the context of our research and to address the current clinical need, we demonstrate that the HAp-coated PMMA, which is intended to be used as a visual optic of a corneal prosthetic device, improves its bonding and biointegration with collagen, the main component of a corneal stroma. The HAp-coated PMMA resulted in better adhesion with the collagen than untreated PMMA in artificial tear fluid over 28 days. Human corneal stromal fibroblasts showed better attachment, viability, and proliferation rate on the HAp-coated PMMA than on untreated PMMA. This coating method is an innovative solution to immobilize various bioceramic nanoparticles on polymers and may be used in other biomedical implants.

Design of magnesium alloys with controllable degradation for biomedical implants: From bulk to surface

The combination of high strength, light weight, and natural biodegradability renders magnesium (Mg)-based alloys promising in orthopedic implants and cardiovascular stents. Being metallic materials, Mg and Mg alloys made for scaffolds provide the necessary mechanical support for tissue healing and cell growth in the early stage, while natural degradation and reabsorption by surrounding tissues in the later stage make an unnecessarily follow-up removal surgery. However, uncontrolled degradation may collapse the scaffolds resulting in premature implant failure, and there has been much research in controlling the degradation rates of Mg alloys. This paper reviews recent progress in the design of novel Mg alloys, surface modification and corrosion mechanisms under different conditions, and describes the effects of the structure, composition, and surface conditions on the degradation behavior in vitro and in vivo.

STATEMENT OF SIGNIFICANCE

Owing to their unique mechanical properties, biodegradability, biocompatibility, Mg based biomaterials are becoming the most promising substitutes for tissue regeneration for impaired bone, vascular and other tissues because these scaffolds can provide not only ideal space for the growth and differentiation of seeded cells but also enough strength before the formation of normal tissues. The most important is that these scaffolds can be fully degraded after tissue regeneration, which can satisfy the increasing demand for better biomedical devices and functional tissue engineering biomaterials in the world. However, the rapid degradation rate of these scaffolds restricts the wide application in clinic. This paper reviews recent progress on how to control the degrdation rate based on the relevant corrosion mechanisms through the design of porous structure, phase structure, grains, and amorphous structure as well as surface modification, which will be beneficial to the better understanding and functional design of Mg-based scaffolds for wide clinical applications in tissue reconstruction in near futures.

Corrosion behavior of plasma electrolytically oxidized gamma titanium aluminide alloy in simulated body fluid

Plasma electrolytic oxidized (PEO) γTiAl alloy samples were electrochemically characterized by open circuit potential (OCP), cyclic polarization and electrochemical impedance spectroscopy (EIS) to evaluate their corrosion resistance in simulated body fluid (SBF) in order to gauge their potential for biomedical applications. Experimental results through OCP and cyclic polarization studies demonstrated the protective nature and the beneficial effect of the PEO coatings on γTiAl. The PEO surface increased corrosion resistance of these surface modified alloys. EIS data indicated the presence of an underlying compact oxide layer with surface pores represented by two domes in the Nyquist plots. Electrical equivalent circuits to describe the EIS results are proposed.

Ion-Doped Silicate Bioceramic Coating of Ti-Based Implant

Titanium and its alloy are known as important load-bearing biomaterials. The major drawbacks of these metals are fibrous formation and low corrosion rate after implantation. The surface modification of biomedical implants through various methods such as plasma spray improves their osseointegration and clinical lifetime. Different materials have been already used as coatings on biomedical implant, including calcium phosphates and bioglass. However, these materials have been reported to have limited clinical success. The excellent bioactivity of calcium silicate (Ca-Si) has been also regarded as coating material. However, their high degradation rate and low mechanical strength limit their further coating application. Trace element modification of (Ca-Si) bioceramics is a promising method, which improves their mechanical strength and chemical stability. In this review, the potential of trace element-modified silicate coatings on better bone formation of titanium implant is investigated.

Plasma sprayed cerium oxide coating inhibits H2O2-induced oxidative stress and supports cell viability

Oxidative stress is a risk factor in the pathogenesis of osteoporosis, and plays a major role in bone regeneration of osteoporotic patients. Cerium oxide (CeO2) ceramics have the unique ability to protect various types of cells from oxidative damage, making them attractive for biomedical applications. In this study, we developed a plasma sprayed CeO2 coating with a hierarchical topography where ceria nanoparticles were superimposed in the micro-rough coating surface. The protective effects of the CeO2 coating on the response of osteoblasts to H2O2-induced oxidative stress have been demonstrated in terms of cell viability, apoptosis and differentiation. The CeO2 coating reversed the reduced superoxide dismutase activity, decreased reactive oxygen species production and suppressed malondialdehyde formation in H2O2-treated osteoblasts. It indicated that the CeO2 coating can preserve the intracellular antioxidant defense system. The cytocompatibility of the CeO2 coating was further assessed in vitro by cell viability assay and scanning electron microscopy analysis. Taken together, the CeO2 coating could provide an opportunity to be utilized as a potential candidate for bone regeneration under oxidative stress.

Influence of Silver-hydroxyapatite Nanocomposite Coating on Biofilm Formation of Joint Prosthesis and Its Mechanism

Background

The main reason for biomaterial related refractory infections is biofilm formation caused by bacterial adhesion on the surface of materials. Silver-hydroxyapatite (Ag/HA) nanocomposite coating can inhibit the formation of biofilm, but its mechanism is not clear.

Material and method

In order to clarify the mechanism, the amounts of biofilm on the Ag/HA composite coating and HA coating were determined, the release rates of silver nanoparticles in simulated body fluid (SBF) were detected by atomic absorption spectrometry, and the expression values of atlE, fbe, sap, iapB genes of Staphylococcus aureus were studied when they grew on Ag/HA composite coating and HA coating.

Results

The amount of the biofilm on the Ag/HA composite coating was significantly less than that on the HA coating, and the bacterial adhesion was decreased. The silver nanoparticles were released continuously in SBF and the release rate decreased gradually with time. The expression values of atlE, fbe and sap were high in the initial stage of adhesion and the expression value of iapB was high in the colonies-gathering stage in the control group, but they were all significantly inhibited in the presence of Ag.

Conclusion

These results indicated that the main antibacterial effect of Ag/HA composite coating was achieved by the release of silver nanoparticles. The addition of Ag inhibited the expression of genes related to biofilm formation, which in turn inhibited the formation of biofilms. This provided theoretical support for the clinical application of Ag/HA composite coating.

Adhesive strength of bioactive oxide layers fabricated on TNTZ alloy by three different alkali-solution treatments

Bioactive oxide layers were fabricated on Ti-29Nb-13Ta-4.6Zr alloy (TNTZ) by three different alkali solution treatments: hydrothermal (H), electrochemical (E), and hydrothermal-electrochemical (HE). The adhesive strength of the oxide layer to the TNTZ substrate was measured to determine whether this process achieves sufficient adhesive strength for implant materials. Samples subjected to the HE process, in which a current of 15mA/cm(2) was applied at 90°C for 1h (HE90-1h), exhibited a comparatively higher adhesive strength of approximately 18MPa while still maintaining a sufficiently high bioactivity. Based on these results, an oxide layer fabricated on TNTZ by HE90-1h is considered appropriate for practical biomaterial application, though thicker oxide layers with many cracks can lead to a reduced adhesive strength.

Preparation of a Ni–Mo–P–PCTFE nanocomposite coating and evaluation of its nano-tribological, mechanical and electrochemical performance

In this study, the tribological, mechanical and electrochemical performances of electrodeposited nickel–molybdenum–phosphorus (Ni–Mo–P) coating containing polychlorotrifluoroethylene (PCTFE) nanoparticles were investigated.

A review of hydroxyapatite-based coating techniques: Sol-gel and electrochemical depositions on biocompatible metals

New promising techniques for depositing biocompatible hydroxyapatite-based coatings on biocompatible metal substrates for biomedical applications have continuously been exploited for more than two decades. Currently, various experimental deposition processes have been employed. In this review, the two most frequently used deposition processes will be discussed: a sol-gel dip coating and an electrochemical deposition. This study deliberates the surface morphologies and chemical composition, mechanical performance and biological responses of sol-gel dip coating as well as the electrochemical deposition for two different sample conditions, with and without coating. The review shows that sol-gel dip coatings and electrochemical deposition were able to obtain the uniform and homogeneous coating thickness and high adherent biocompatible coatings even in complex shapes. It has been accepted that both coating techniques improve bone strength and initial osseointegration rate. The main advantages and limitations of those techniques of hydroxyapatite-based coatings are presented. Furthermore, the most significant challenges and critical issues are also highlighted.

Clinoenstatite coatings have high bonding strength, bioactive ion release, and osteoimmunomodulatory effects that enhance in vivo osseointegration

A number of coating materials have been developed over past two decades seeking to improve the osseointegration of orthopedic metal implants. Despite the many candidate materials trialed, their low rate of translation into clinical applications suggests there is room for improving the current strategies for their development. We therefore propose that the ideal coating material(s) should possess the following three properties: (i) high bonding strength, (ii) release of functional ions, and (iii) favourable osteoimmunomodulatory effects. To test this proposal, we developed clinoenstatite (CLT, MgSiO3), which as a coating material has high bonding strength, cytocompability and immunomodulatory effects that are favourable for in vivo osteogenesis. The bonding strength of CLT coatings was 50.1 ± 3.2 MPa, more than twice that of hydroxyapatite (HA) coatings, at 23.5 ± 3.5 MPa. CLT coatings released Mg and Si ions, and compared to HA coatings, induced an immunomodulation more conducive for osseointegration, demonstrated by downregurelation of pro-inflammatory cytokines, enhancement of osteogenesis, and inhibition of osteoclastogenesis. In vivo studies demonstrated that CLT coatings improved osseointegration with host bone, as shown by the enhanced biomechanical strength and increased de novo bone formation, when compared with HA coatings. These results support the notion that coating materials with the proposed properties can induce an in vivo environment better suited for osseointegration. These properties could, therefore, be fundamental when developing high-performance coating materials.

HAp/Ti2Ni coatings of high bonding strength on Ti-6Al-4V prepared by the eutectic melting bonding method

Eutectic melting bonding (EMB) method is a useful technique for fabricating bioactive coatings with relatively high crystallinity and bonding strength with substrate on titanium substrates. Using the EMB method, hydroxyapatite/Ti2Ni coatings were prepared on the surface of Ti-6Al-4V at a relatively low temperature (1,050 °C) in a vacuum furnace. The coatings were then characterized in terms of phase components, microstructure, bonding strength and cytotoxicity. The results showed that the coatings were mainly composed of HAp and Ti2Ni, and the thickness of the coatings was approximately 300 μm. X-ray diffraction analysis showed that the coatings exhibited relatively high crystallinity. The tensile bonding strength between the coatings and the substrates was 69.68±5.15 MPa. The coatings had a porous and rough surface which is suitable for cell attachment and filopodia growth. The cell culture study showed that the number of MG-63 cells increased, and the cell morphology changed with the incubation time. This study showed that the EMB method can be utilized as a potentially powerful method to obtain high quality hydroxyapatite coatings with desired mechanical and biocompatibility properties on Ti-alloy substrates.

Fabrication of nano-structured calcium silicate coatings with enhanced stability, bioactivity and osteogenic and angiogenic activity

The bioactivity and stability of coatings on alloy implants play critical roles in the fast osseointegration and maintenance of a long-term life span of the implants, respectively. Herein, nano-sheet surface on bioactive calcium silicate (CaSiO3, CS) coatings on metal substrates was fabricated by combining atmosphere plasma spraying (APS) and hydrothermal technology (HT). The glassy phase in CS coatings generated by APS was converted into crystalline sheet-like nano-structures after HT treatment. Compared with the original CS coating samples, HT treatment decreased the degradation rate of the CS coatings. Moreover, the fabricated nano-structured topography of CS coatings increased the apatite mineralization ability and significantly enhanced the cell attachment, proliferation, differentiation, alkaline phosphatase (ALP) activity and expression of osteogenic genes and angiogenic factors of rat bone marrow stromal cells (bMSCs). Our results suggest that the nano-structured CS coatings have immense potential in improving the clinical performance of medical implants.

Multidirectional effects of Sr-, Mg-, and Si-containing bioceramic coatings with high bonding strength on inflammation, osteoclastogenesis, and osteogenesis

Ideal coating materials for implants should be able to induce excellent osseointegration, which requires several important parameters, such as good bonding strength, limited inflammatory reaction, and balanced osteoclastogenesis and osteogenesis, to gain well-functioning coated implants with long-term life span after implantation. Bioactive elements, like Sr, Mg, and Si, have been found to play important roles in regulating the biological responses. It is of great interest to combine bioactive elements for developing bioactive coatings on Ti-6Al-4 V orthopedic implants to elicit multidirectional effects on the osseointegration. In this study, Sr-, Mg-, and Si-containing bioactive Sr2MgSi2O7 (SMS) ceramic coatings on Ti-6Al-4 V were successfully prepared by the plasma-spray coating method. The prepared SMS coatings have significantly higher bonding strength (∼37 MPa) than conventional pure hydroxyapatite (HA) coatings (mostly in the range of 15-25 MPa). It was also found that the prepared SMS coatings switch the macrophage phenotype into M2 extreme, inhibiting the inflammatory reaction via the inhibition of Wnt5A/Ca(2+) and Toll-like receptor (TLR) pathways of macrophages. In addition, the osteoclastic activities were also inhibited by SMS coatings. The expression of osteoclastogenesis-related genes (RANKL and MCSF) in bone-marrow-derived mesenchymal cells (BMSCs) with the involvement of macrophages was decreased, whereas OPG expression was enhanced on SMS coatings compared to HA coatings, indicating that SMS coatings also downregulated the osteoclastogenesis. However, the osteogenic differentiation of BMSCs with the involvement of macrophages was comparable between SMS and HA coatings. Therefore, the prepared SMS coatings showed multidirectional effects, such as improving bonding strength, reducing inflammatory reaction, and downregulating osteoclastic activities, but maintaining a comparable osteogenesis, as compared with HA coatings. The combination of bioactive elements of Sr, Mg, and Si into bioceramic coatings can be a promising method to develop bioactive implants with multifunctional properties for orthopedic application.