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Melo-Fonseca F, Gasik M, Cruz A, Moreira D, S. Silva F, Miranda G, Mendes Pinto I. Engineering a Hybrid Ti6Al4V-Based System for Responsive and Consistent Osteogenesis. ACS OMEGA 2024; 9:8985-8994. [PMID: 38434873 PMCID: PMC10905591 DOI: 10.1021/acsomega.3c07232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/17/2023] [Accepted: 01/05/2024] [Indexed: 03/05/2024]
Abstract
As the aging population increases worldwide, the incidence of musculoskeletal diseases and the need for orthopedic implants also arise. One of the most desirable goals in orthopedic reconstructive therapies is de novo bone formation. Yet, reproducible, long-lasting, and cost-effective strategies for implants that strongly induce osteogenesis are still in need. Nanoengineered titanium substrates (and their alloys) are among the most used materials in orthopedic implants. Although having high biocompatibility, titanium alloys hold a low bioactivity profile. The osteogenic capacity and osseointegration of Ti-based implantable systems are limited, as they critically depend on the body-substrate interactions defined by blood proteins adsorbed into implant surfaces that ultimately lead to the recruitment, proliferation, and differentiation of mesenchymal stem cells (MSCs) to comply bone formation and regeneration. In this work, a hybrid Ti6Al4V system combining micro- and nanoscale modifications induced by hydrothermal treatment followed by functionalization with a bioactive compound (fibronectin derived from human plasma) is proposed, aiming for bioactivity improvement. An evaluation of the biological activity and cellular responses in vitro with respect to bone regeneration indicated that the integration of morphological and chemical modifications into Ti6Al4V surfaces induces the osteogenic differentiation of MSCs to improve bone regeneration by an enhancement of mineral matrix formation that accelerates the osseointegration process. Overall, this hybrid system has numerous competitive advantages over more complex treatments, including reproducibility, low production cost, and potential for improved long-term maintenance of the implant.
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Affiliation(s)
- Francisca Melo-Fonseca
- Center
for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Guimarães 4800-058, Portugal
- LABBELS—Associate
Laboratory, Braga, Guimarães 4710-057, Portugal
- International
Iberian Nanotechnology Laboratory (INL), Braga 4715-330, Portugal
| | - Michael Gasik
- School
of Chemical Engineering, Aalto University
Foundation, Espoo 00076, Finland
| | - Andrea Cruz
- International
Iberian Nanotechnology Laboratory (INL), Braga 4715-330, Portugal
| | - Daniel Moreira
- Institute
for Research and Innovation in Health (i3S), Porto 4200-135, Portugal
| | - Filipe S. Silva
- Center
for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Guimarães 4800-058, Portugal
- LABBELS—Associate
Laboratory, Braga, Guimarães 4710-057, Portugal
| | - Georgina Miranda
- CICECO, Aveiro
Institute of Materials, Department of Materials and Ceramic Engineering, University of Aveiro, Aveiro 3810-193, Portugal
| | - Inês Mendes Pinto
- International
Iberian Nanotechnology Laboratory (INL), Braga 4715-330, Portugal
- Institute
for Research and Innovation in Health (i3S), Porto 4200-135, Portugal
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Cai B, Huang L, Zhou X, Zhou X, Lei K, Han M, Zhang Z, Li X, Li G. Black phosphorus-incorporated novel Ti-12Mo-10Zr implant for multimodal treatment of osteosarcoma. Biometals 2024; 37:131-142. [PMID: 37682402 DOI: 10.1007/s10534-023-00533-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/27/2023] [Indexed: 09/09/2023]
Abstract
The repair and reconstruction of large bone defects after bone tumor resection is still a great clinical challenge. At present, orthopedic implant reconstruction is the mainstream treatment for repairing bone defects. However, according to clinical feedback, local tumor recurrence and nonunion of bone graft are common reasons leading to the failure of bone defect repair and reconstruction after bone tumor resection, which seriously threaten the physical and mental health of patients. On this basis, here the self-developed low modulus Ti-12Mo-10Zr alloy (TMZ) was chosen as substrate material. To improve its biological activity and osteointegration, calcium, oxygen, and phosphorus co-doped microporous coating was prepared on TMZ alloy by microarc oxidation (MAO). Then, black phosphorus (BP) nanosheets were incorporated onto MAO treated TMZ alloy to obtain multifunctional composites. The obtained BP-MAO-TMZ implant exhibited excellent photothermal effects and effective ablation of osteosarcoma cancer cells under the irradiation of 808 nm near infrared laser, while no photothermal or therapeutic effects were observed for TMZ alloy. Meanwhile, the structure/component bionic coating obtained after MAO treatment as well as the P-driven in situ biomineralization performance after incorporation of BP nanosheets endowed BP-MAO-TMZ implant with synergistic promoting effect on MC3T3-E1 osteoblasts' activity, proliferation and differentiation ability. This study is expected to provide effective clinical solutions for problems of difficult bone regeneration and tumor recurrence after tumor resection in patients with bone tumors and to solve a series of medical problems such as poor prognosis and poor postoperative quality of patients life with malignant bone tumors.
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Affiliation(s)
- Bianyun Cai
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China
| | - Leizhen Huang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xueke Zhou
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China
| | - Xuan Zhou
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China
| | - Kun Lei
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China
| | - Meng Han
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China
| | - Zilin Zhang
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China
| | - Xiaofang Li
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China
| | - Guangda Li
- College of Medical Technology and Engineering, Henan University of Science and Technology, 263 Kaiyuan Avenue, Luoyang, 471023, China.
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Wen X, Liu Y, Xi F, Zhang X, Kang Y. Micro-arc oxidation (MAO) and its potential for improving the performance of titanium implants in biomedical applications. Front Bioeng Biotechnol 2023; 11:1282590. [PMID: 38026886 PMCID: PMC10662315 DOI: 10.3389/fbioe.2023.1282590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Titanium (Ti) and its alloys have good biocompatibility, mechanical properties and corrosion resistance, making them attractive for biomedical applications. However, their biological inertness and lack of antimicrobial properties may compromise the success of implants. In this review, the potential of micro-arc oxidation (MAO) technology to create bioactive coatings on Ti implants is discussed. The review covers the following aspects: 1) different factors, such as electrolyte, voltage and current, affect the properties of MAO coatings; 2) MAO coatings affect biocompatibility, including cytocompatibility, hemocompatibility, angiogenic activity, corrosion resistance, osteogenic activity and osseointegration; 3) antibacterial properties can be achieved by adding copper (Cu), silver (Ag), zinc (Zn) and other elements to achieve antimicrobial properties; and 4) MAO can be combined with other physical and chemical techniques to enhance the performance of MAO coatings. It is concluded that MAO coatings offer new opportunities for improving the use of Ti and its alloys in biomedical applications, and some suggestions for future research are provided.
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Affiliation(s)
- Xueying Wen
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yan Liu
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Fangquan Xi
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China
| | - Xingwan Zhang
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China
| | - Yuanyuan Kang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
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Nikolova MP, Apostolova MD. Advances in Multifunctional Bioactive Coatings for Metallic Bone Implants. MATERIALS (BASEL, SWITZERLAND) 2022; 16:183. [PMID: 36614523 PMCID: PMC9821663 DOI: 10.3390/ma16010183] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
To fix the bone in orthopedics, it is almost always necessary to use implants. Metals provide the needed physical and mechanical properties for load-bearing applications. Although widely used as biomedical materials for the replacement of hard tissue, metallic implants still confront challenges, among which the foremost is their low biocompatibility. Some of them also suffer from excessive wear, low corrosion resistance, infections and shielding stress. To address these issues, various coatings have been applied to enhance their in vitro and in vivo performance. When merged with the beneficial properties of various bio-ceramic or polymer coatings remarkable bioactive, osteogenic, antibacterial, or biodegradable composite implants can be created. In this review, bioactive and high-performance coatings for metallic bone implants are systematically reviewed and their biocompatibility is discussed. Updates in coating materials and formulations for metallic implants, as well as their production routes, have been provided. The ways of improving the bioactive coating performance by incorporating bioactive moieties such as growth factors, osteogenic factors, immunomodulatory factors, antibiotics, or other drugs that are locally released in a controlled manner have also been addressed.
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Affiliation(s)
- Maria P. Nikolova
- Department of Material Science and Technology, University of Ruse “A. Kanchev”, 8 Studentska Str., 7017 Ruse, Bulgaria
| | - Margarita D. Apostolova
- Medical and Biological Research Lab., “Roumen Tsanev” Institute of Molecular Biology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
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Wang R, Ni S, Ma L, Li M. Porous construction and surface modification of titanium-based materials for osteogenesis: A review. Front Bioeng Biotechnol 2022; 10:973297. [PMID: 36091459 PMCID: PMC9452912 DOI: 10.3389/fbioe.2022.973297] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Titanium and titanium alloy implants are essential for bone tissue regeneration engineering. The current trend is toward the manufacture of implants from materials that mimic the structure, composition and elasticity of bones. Titanium and titanium alloy implants, the most common materials for implants, can be used as a bone conduction material but cannot promote osteogenesis. In clinical practice, there is a high demand for implant surfaces that stimulate bone formation and accelerate bone binding, thus shortening the implantation-to-loading time and enhancing implantation success. To avoid stress shielding, the elastic modulus of porous titanium and titanium alloy implants must match that of bone. Micro-arc oxidation technology has been utilized to increase the surface activity and build a somewhat hard coating on porous titanium and titanium alloy implants. More recently, a growing number of researchers have combined micro-arc oxidation with hydrothermal, ultrasonic, and laser treatments, coatings that inhibit bacterial growth, and acid etching with sand blasting methods to improve bonding to bone. This paper summarizes the reaction at the interface between bone and implant material, the porous design principle of scaffold material, MAO technology and the combination of MAO with other technologies in the field of porous titanium and titanium alloys to encourage their application in the development of medical implants.
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Affiliation(s)
- Rui Wang
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, China
| | - Shilei Ni
- Department of Plastic and Aesthetic Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Li Ma
- Department of Fever Clinic, The Second Hospital of Jilin University, Changchun, China
| | - Meihua Li
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, China
- *Correspondence: Meihua Li,
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Zhao Y, Wang Z, Zhao J, Hussain M, Wang M. Additive Manufacturing in Orthopedics: A Review. ACS Biomater Sci Eng 2022; 8:1367-1380. [PMID: 35266709 DOI: 10.1021/acsbiomaterials.1c01072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Additive manufacturing is an advanced manufacturing manner that seems like the industrial revolution. It has the inborn benefit of producing complex formations, which are distinct from traditional machining technology. Its manufacturing strategy is flexible, including a wide range of materials, and its manufacturing cycle is short. Additive manufacturing techniques are progressively used in bone research and orthopedic operation as more innovative materials are developed. This Review lists the recent research results, analyzes the strengths and weaknesses of diverse three-dimensional printing strategies in orthopedics, and sums up the use of varying 3D printing strategies in surgical guides, surgical implants, surgical predictive models, and bone tissue engineering. Moreover, various postprocessing methods for additive manufacturing for orthopedics are described.
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Affiliation(s)
- Yingchao Zhao
- Xiangya School of Medicine, Central South University, No.172 Yinpenling Street, Tongzipo Road, Changsha 410013, China
| | - Zhen Wang
- Xiangya School of Medicine, Central South University, No.172 Yinpenling Street, Tongzipo Road, Changsha 410013, China
| | - Jingzhou Zhao
- Department of Chemical & Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
| | - Mubashir Hussain
- Postdoctoral Innovation Practice, Shenzhen Polytechnic, No.4089 Shahe West Road, Xinwei Nanshan District, Shenzhen 518055, China
| | - Maonan Wang
- Department of Chemical & Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
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Hou C, An J, Zhao D, Ma X, Zhang W, Zhao W, Wu M, Zhang Z, Yuan F. Surface Modification Techniques to Produce Micro/Nano-scale Topographies on Ti-Based Implant Surfaces for Improved Osseointegration. Front Bioeng Biotechnol 2022; 10:835008. [PMID: 35402405 PMCID: PMC8990803 DOI: 10.3389/fbioe.2022.835008] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/08/2022] [Indexed: 12/24/2022] Open
Abstract
Titanium and titanium alloys are used as artificial bone substitutes due to the good mechanical properties and biocompatibility, and are widely applied in the treatment of bone defects in clinic. However, Pure titanium has stress shielding effect on bone, and the effect of titanium-based materials on promoting bone healing is not significant. To solve this problem, several studies have proposed that the surface of titanium-based implants can be modified to generate micro or nano structures and improve mechanical properties, which will have positive effects on bone healing. This article reviews the application and characteristics of several titanium processing methods, and explores the effects of different technologies on the surface characteristics, mechanical properties, cell behavior and osseointegration. The future research prospects in this field and the characteristics of ideal titanium-based implants are proposed.
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Affiliation(s)
- Chuang Hou
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing An
- Nursing Teaching and Research Department, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Duoyi Zhao
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiao Ma
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Weilin Zhang
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Wei Zhao
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Meng Wu
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhiyu Zhang
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Zhiyu Zhang, ; Fusheng Yuan,
| | - Fusheng Yuan
- Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Zhiyu Zhang, ; Fusheng Yuan,
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8
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Rajendran A, Pattanayak DK. Bioactive and antimicrobial macro-/micro-nanoporous selective laser melted Ti-6Al-4V alloy for biomedical applications. Heliyon 2022; 8:e09122. [PMID: 35345400 PMCID: PMC8956888 DOI: 10.1016/j.heliyon.2022.e09122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/31/2021] [Accepted: 03/11/2022] [Indexed: 11/22/2022] Open
Abstract
Metal Additive Manufacturing (AM) technology is an emerging technology in biomedical field due to its unique ability to manufacture customized implants [Patients-specific Implants (PSIs)] replicating the complex bone structure from the relevant metal powders. PSIs could be developed through any AM technology, but the ultimate challenge lies in integrating the metallic implant with the living bone. Considering this aspect, in the present study, Ti alloy (Ti–6Al–4V) powder has been used to fabricate scaffolds of channel type macropores with 0–60% porosity using selective laser melting (SLM) and subsequent post-treatments paving way for surface microporosities. Surface chemical and subsequent heat treatments were carried out on thus developed Ti alloy scaffolds to improve its bioactivity, antibacterial activity and osteoblastic cell compatibility. NaOH and subsequent Ca(NO3)2/AgNO3 treatment induced the formation of a nanoporous network structure decorated with Ca–Ag ions. Ag nanoparticles covering the entire scaffold provided antibacterial activity and the presence of Ca2+ ions with anatase TiO2 layer further improved the bioactivity and osteoblastic cell compatibility of the scaffold. Therefore, SLM technology combined with heat treatment and surface modification could be effectively utilized to create macro-micro-nano structure scaffolds of Ti alloy that are bioactive, antibacterial, and cytocompatible.
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Affiliation(s)
- Archana Rajendran
- CSIR-Central Electrochemical Research Institute, Karaikudi, Tamil Nadu, 630006, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Deepak K. Pattanayak
- CSIR-Central Electrochemical Research Institute, Karaikudi, Tamil Nadu, 630006, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
- Corresponding author.
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Wang X, Li Z, Wang Z, Liu H, Cui Y, Liu Y, Ren M, Zhan H, Li Z, Wu M, Wang J. Incorporation of Bone Morphogenetic Protein-2 and Osteoprotegerin in 3D-Printed Ti6Al4V Scaffolds Enhances Osseointegration Under Osteoporotic Conditions. Front Bioeng Biotechnol 2021; 9:754205. [PMID: 34805113 PMCID: PMC8600075 DOI: 10.3389/fbioe.2021.754205] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/12/2021] [Indexed: 01/23/2023] Open
Abstract
Osteoporosis is an age-related metabolic disease that results in limited bone regeneration capacity and excessive osteoclast activity. After arthroplasty in patients with osteoporosis, poor interface osseointegration resulting from insufficient bone regeneration ability often leads to catastrophic complications such as prosthesis displacement and loosening and periprosthetic fractures. In this study, we prepared a thermosensitive hydrogel loaded with bone morphogenetic protein-2 (BMP-2) to promote osteogenesis and osteoprotegerin (OPG) to inhibit excessive osteoclast activity. To construct three-dimensional (3D)-printed composite scaffolds for implantation, a hydrogel loaded with drugs was injected into porous Ti6Al4V scaffolds. The 3D-printed composite scaffolds showed good biocompatibility and sustained release of BMP-2 and OPG for more than 20 days. In vitro experiments indicated that composite scaffolds promoted osteogenic differentiation and reduced the osteoclastic activation simultaneously. Remarkably, immunofluorescence staining, micro-CT, histological, and biomechanical tests demonstrated that the sustained release of both BMP-2 and OPG from composite scaffolds significantly improved bone ingrowth and osseointegration in osteoporotic defects. In conclusion, this study demonstrated that the BMP-2- and OPG-loaded 3D-printed composite scaffolds can potentially promote osseointegration for osteoporotic patients after joint replacement.
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Affiliation(s)
- Xianggang Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Zhengyan Li
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
- Institute of Traumatology, Shanghai Academy of TCM, Shanghai, China
| | - Zhonghan Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - He Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Yutao Cui
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Yuzhe Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Ming Ren
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Hongsheng Zhan
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
- Institute of Traumatology, Shanghai Academy of TCM, Shanghai, China
| | - Zuhao Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Minfei Wu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Jincheng Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
- Orthopaedic Research Institute of Jilin Province, Changchun, China
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