Nanostructured ceramics for biomedical implants

Pioneering nanomedicine in orthopedic treatment care: a review of current research and practices

A developing use of nanotechnology in medicine involves using nanoparticles to administer drugs, genes, biologicals, or other materials to targeted cell types, such as cancer cells. In healthcare, nanotechnology has brought about revolutionary changes in the treatment of various medical and surgical conditions, including in orthopedic. Its clinical applications in surgery range from developing surgical instruments and suture materials to enhancing imaging techniques, targeted drug delivery, visualization methods, and wound healing procedures. Notably, nanotechnology plays a significant role in preventing, diagnosing, and treating orthopedic disorders, which is crucial for patients' functional rehabilitation. The integration of nanotechnology improves standards of patient care, fuels research endeavors, facilitates clinical trials, and eventually improves the patient's quality of life. Looking ahead, nanotechnology holds promise for achieving sustained success in numerous surgical disciplines, including orthopedic surgery, in the years to come. This review aims to focus on the application of nanotechnology in orthopedic surgery, highlighting the recent development and future perspective to bridge the bridge for clinical translation.

Nanotechnology development in surgical applications: recent trends and developments

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

The advances in nanomedicine for bone and cartilage repair

With the gradual demographic shift toward an aging and obese society, an increasing number of patients are suffering from bone and cartilage injuries. However, conventional therapies are hindered by the defects of materials, failing to adequately stimulate the necessary cellular response to promote sufficient cartilage regeneration, bone remodeling and osseointegration. In recent years, the rapid development of nanomedicine has initiated a revolution in orthopedics, especially in tissue engineering and regenerative medicine, due to their capacity to effectively stimulate cellular responses on a nanoscale with enhanced drug loading efficiency, targeted capability, increased mechanical properties and improved uptake rate, resulting in an improved therapeutic effect. Therefore, a comprehensive review of advancements in nanomedicine for bone and cartilage diseases is timely and beneficial. This review firstly summarized the wide range of existing nanotechnology applications in the medical field. The progressive development of nano delivery systems in nanomedicine, including nanoparticles and biomimetic techniques, which are lacking in the current literature, is further described. More importantly, we also highlighted the research advancements of nanomedicine in bone and cartilage repair using the latest preclinical and clinical examples, and further discussed the research directions of nano-therapies in future clinical practice.

A Biocompatible Ultrananocrystalline Diamond (UNCD) Coating for a New Generation of Dental Implants

Implant therapy using osseointegratable titanium (Ti) dental implants has revolutionized clinical dental practice and has shown a high rate of success. However, because a metallic implant is in contact with body tissues and fluids in vivo, ions/particles can be released into the biological milieu as a result of corrosion or biotribocorrosion. Ultrananocrystalline diamond (UNCD) coatings possess a synergistic combination of mechanical, tribological, and chemical properties, which makes UNCD highly biocompatible. In addition, because the UNCD coating is made of carbon (C), a component of human DNA, cells, and molecules, it is potentially a highly biocompatible coating for medical implant devices. The aim of the present research was to evaluate tissue response to UNCD-coated titanium micro-implants using a murine model designed to evaluate biocompatibility. Non-coated (n = 10) and UNCD-coated (n = 10) orthodontic Ti micro-implants were placed in the hematopoietic bone marrow of the tibia of male Wistar rats. The animals were euthanized 30 days post implantation. The tibiae were resected, and ground histologic sections were obtained and stained with toluidine blue. Histologically, both groups showed lamellar bone tissue in contact with the implants (osseointegration). No inflammatory or multinucleated giant cells were observed. Histomorphometric evaluation showed no statistically significant differences in the percentage of BIC between groups (C: 53.40 ± 13% vs. UNCD: 58.82 ± 9%, p > 0.05). UNCD showed good biocompatibility properties. Although the percentage of BIC (osseointegration) was similar in UNCD-coated and control Ti micro-implants, the documented tribological properties of UNCD make it a superior implant coating material. Given the current surge in the use of nano-coatings, nanofilms, and nanostructured surfaces to enhance the biocompatibility of biomedical implants, the results of the present study contribute valuable data for the manufacture of UNCD coatings as a new generation of superior dental implants.

Influence of surface termination of ultrananocrystalline diamond films coated on titanium on response of human osteoblast cells: A proteome study

Successful osseointegration, i.e. the fully functional connection of patient's bone and artificial implant depends on the response of the cells to the direct contact with the surface of the implant. The surface properties of the implant which trigger cell responses leading to its integration into the surrounding bone can be tailored by surface modifications or coating with thin layers. One potential material for such applications is ultrananocrystalline diamond (UNCD). It combines the exceptional mechanical properties of diamond with good biocompatibility and possibility of coating as thin uniform films on different substrates of biological interest. In the current work we firstly deposited UNCD films on titanium-coated substrates and applied oxygen or ammonia plasma to modify their surface properties. The as-grown and modified UNCD exhibited relatively smooth surfaces with topography dominated by rounded features. The modifications induced oxygen- or amino-terminated surfaces with increased hydrophilicity. In addition, the UNCD coatings exhibited very low coefficient of friction when diamond was used as a counterpart. As-grown and modified UNCD samples were applied to study the responses of human osteoblast MG63 cells triggered by surfaces with various terminations assessed by proteomic analysis. The results revealed that the coating of Ti with UNCD as well as the plasma modifications resulting in O- or NH₂-terminated UNCD induced upregulation of proteins specific for cytoskeleton, cell membrane, and extracellular matrix (ECM) involved in the cell-ECM-surface interactions. Proteins from each of these groups, namely, vimentin, cadherin and fibronectin were further studied immunocytochemically and the results confirmed their increased abundance leading to improved cell-to-surface adhesion and cell-to-cell interactions. These findings demonstrate the potential of implant coating with UNCD and its surface modifications for better osseointegration and bone formation.

Current trends in Nanotechnology applications in surgical specialties and orthopedic surgery

Nanotechnology is manipulation of matter on atomic, molecular and supramolecular scale. It has extensive range of applications in various branches of science including molecular biology, Health and medicine, materials, electronics, transportation, drugs and drug delivery, chemical sensing, space exploration, energy, environment, sensors, diagnostics, microfabrication, organic chemistry and biomaterials. Nanotechnology involves innovations in drug delivery,fabric design, reactivity and strength of material and molecular manufacturing. Nanotechnology applications are spread over almost all surgical specialties and have revolutionized treatment of various medical and surgical conditions. Clinically relevant applications of nanotechnology in surgical specialties include development of surgical instruments, suture materials, imaging, targeted drug therapy, visualization methods and wound healing techniques. Management of burn wounds and scar is an important application of nanotechnology.Prevention, diagnosis, and treatment of various orthopedic conditions are crucial aspects of technology for functional recovery of patients. Improvement in standard of patient care,clinical trials, research, and development of medical equipments for safe use are improved with nanotechnology. They have a potential for long-term good results in a variety of surgical specialties including orthopedic surgery in the years to come.

A comprehensive review of biodegradable synthetic polymer-ceramic composites and their manufacture for biomedical applications

The application of various materials in biomedical procedures has recently experienced rapid growth. One area that is currently receiving significant attention from the scientific community is the treatment of a number of different types of bone-related diseases and disorders by using biodegradable polymer-ceramic composites. Biomaterials, the most common materials used to repair or replace damaged parts of the human body, can be categorized into three major groups: metals, ceramics, and polymers. Composites can be manufactured by combining two or more materials to achieve enhanced biocompatibility and biomechanical properties for specific applications. Biomaterials must display suitable properties for their applications, about strength, durability, and biological influence. Metals and their alloys such as titanium, stainless steel, and cobalt-based alloys have been widely investigated for implant-device applications because of their excellent mechanical properties. However, these materials may also manifest biological issues such as toxicity, poor tissue adhesion and stress shielding effect due to their high elastic modulus. To mitigate these issues, hydroxyapatite (HA) coatings have been used on metals because their chemical composition is similar to that of bone and teeth. Recently, a wide range of synthetic polymers such as poly (l-lactic acid) and poly (l-lactide-co-glycolide) have been studied for different biomedical applications, owing to their promising biocompatibility and biodegradability. This article gives an overview of synthetic polymer-ceramic composites with a particular emphasis on calcium phosphate group and their potential applications in tissue engineering. It is hoped that synthetic polymer-ceramic composites such as PLLA/HA and PCL/HA will provide advantages such as eliminating the stress shielding effect and the consequent need for revision surgery.

A review of nanostructured surfaces and materials for dental implants: surface coating, patterning and functionalization for improved performance

The emerging field of nanostructured implants has enormous scope in the areas of medical science and dental implants. Surface nanofeatures provide significant potential solutions to medical problems by the introduction of better biomaterials, improved implant design, and surface engineering techniques such as coating, patterning, functionalization and molecular grafting at the nanoscale. This review is of an interdisciplinary nature, addressing the history and development of dental implants and the emerging area of nanotechnology in dental implants. After a brief introduction to nanotechnology in dental implants and the main classes of dental implants, an overview of different types of nanomaterials (i.e. metals, metal oxides, ceramics, polymers and hydrides) used in dental implant together with their unique properties, the influence of elemental compositions, and surface morphologies and possible applications are presented from a chemical point of view. In the core of this review, the dental implant materials, physical and chemical fabrication techniques and the role of nanotechnology in achieving ideal dental implants have been discussed. Finally, the critical parameters in dental implant design and available data on the current dental implant surfaces that use nanotopography in clinical dentistry have been discussed.

Mesoporous and hollow hydroxyapatite nanostructured particles as a drug delivery vehicle for the local release of ibuprofen

The high risk of infection caused by implantation of orthopedic bio-metals is still a daunting challenge for surgeons as it can lead to implant failure. One approach to overcome this issue is the local release of antibacterial drug through coating on the surface of a metallic implant. One ideal carrier for this purpose is hydroxyapatite (HA) particles which are bioactive, biodegradable, biocompatible and have the potential to bond to bone. In the current study, highly crystalline mesoporous HA nanostructure particles were successfully synthesized in a low-temperature solvent process with the aid of an inorganic CaCO₃ template and then fully characterized. The specific surface area and the average size of the cavities of the nanostructured mesoporous HA particles were 85 m²/g and 20 nm, respectively. The feasibility of the prepared HA mesoporous nanostructures for drug delivery, using ibuprofen as a model drug, was also investigated. The as-prepared HA mesoporous nanostructures showed a high drug-loading capacity, as well as sustained drug release in a phosphate buffered saline (PBS) at a pH of 7.4. Overall, results show that HA mesoporous nanostructures gave great potential in bone regeneration and local delivery of either drugs or biomolecules.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

Hierarchical Spring-Block Model for Multiscale Friction Problems

A primary issue in biomaterials science is to design materials with ad hoc properties, depending on the specific application. Among these properties, friction is recognized as a fundamental aspect characterizing materials for many practical purposes. Recently, new and unexpected frictional properties have been obtained by exploiting hierarchical multiscale structures, inspired by those observed in many biological systems. In order to understand the emergent frictional behavior of these materials at the macroscale, it is fundamental to investigate their hierarchical structure, spanning across different length scales. In this article, we introduce a statistical multiscale approach, based on a one-dimensional formulation of the spring-block model, in which friction is modeled at each hierarchical scale through the classical Amontons-Coulomb force with statistical dispersion on the friction coefficients of the microscopic components. By means of numerical simulations, we deduce the global statistical distributions of the elementary structure at micrometric scale and use them as input distributions for the simulations at the next scale levels. We thus study the influence of microscopic artificial patterning on macroscopic friction coefficients. We show that it is possible to tune the friction properties of a hierarchical surface and provide some insight on the mechanisms involved at different length scales.

Nanomedicine applications in orthopedic medicine: state of the art

The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges.

Poly(Epsilon-lysine) dendrons tethered with phosphoserine increase mesenchymal stem cell differentiation potential of calcium phosphate gels

Calcium phosphates (CaP) are considered as biomaterials of choice for the treatment of critical-sized bone defects. Novel injectable CaP materials integrating poly(epsilon-lysine) generation 3 dendrons tethered with phosphoserine were obtained by sol-gel synthesis. This type of dendron was integrated to mimic the biochemical structure of noncollagenous proteins present in the forming osteoids during bone repair. Sol-gel synthesis was coupled with a dialysis process able to equilibrate the materials at a physiological pH value. Fourier transform infrared spectroscopy (FTIR) showed the successful retention of the dendrons after gel dialysis, whereas X-ray diffraction analysis demonstrated both the pH-tuned formation of a hydroxyapatite crystalline phase within the gel and the complete removal of ammonium nitrate deriving from the sol-gel reaction solvent. Scanning electron microscopy images confirmed the presence of crystalline domains in gels synthesized at pH 9.0. Injectability tests showed that the optimized formulations fulfilled the rheological properties required to minimally invasive surgical procedures. Cytotoxicity tests on osteoblast-like MG-63 cells as well as morphology and viability studies showed that the dendrons induced a significantly higher level of cell proliferation at early incubation time. Differentiation of the cell was also clearly enhanced at longer incubation time as demonstrated by both alkaline phosphatase activity and expression of typical markers. Altogether, the data from this work indicate the clinical potential of the osteoid-mimicking CaP cements in minimally invasive bone surgery.

Development of implantable medical devices: from an engineering perspective

From the first pacemaker implant in 1958, numerous engineering and medical activities for implantable medical device development have faced challenges in materials, battery power, functionality, electrical power consumption, size shrinkage, system delivery, and wireless communication. With explosive advances in scientific and engineering technology, many implantable medical devices such as the pacemaker, cochlear implant, and real-time blood pressure sensors have been developed and improved. This trend of progress in medical devices will continue because of the coming super-aged society, which will result in more consumers for the devices. The inner body is a special space filled with electrical, chemical, mechanical, and marine-salted reactions. Therefore, electrical connectivity and communication, corrosion, robustness, and hermeticity are key factors to be considered during the development stage. The main participants in the development stage are the user, the medical staff, and the engineer or technician. Thus, there are three different viewpoints in the development of implantable devices. In this review paper, considerations in the development of implantable medical devices will be presented from the viewpoint of an engineering mind.

Nanostructured hydroxyapatite/poly(lactic-co-glycolic acid) composite coating for controlling magnesium degradation in simulated body fluid

Biodegradable magnesium (Mg) and its alloys have many attractive properties (e.g. comparable mechanical properties to cortical bone) for orthopedic implant applications, but they degrade too rapidly in the human body to meet clinical requirements. Nanostructured hydroxyapatite (nHA)/poly(lactic-co-glycolic acid) (PLGA) composite coatings provide synergistic properties for controlling degradation of Mg-based substrates and improving bone-implant integration. In this study, nHA/PLGA composites were spin coated onto Mg-based substrates and the results showed that the nHA/PLGA coatings retained nano-scale features with nHA dispersed in PLGA matrix. In comparison with non-coated Mg, the nHA/PLGA composite coated Mg increased the corrosion potential and decreased the corrosion current in revised simulated body fluid (rSBF). After 24 h of immersion in rSBF, increased calcium phosphate (CaP) deposition and formation of Mg-substituted CaP rosettes were observed on the surface of the nHA/PLGA coated Mg, indicating greater bioactivity. In contrast, no significant CaP was deposited on the PLGA coated Mg. Since both PLGA coating and nHA/PLGA coating showed some degree of delamination from Mg-based substrates during extended immersion in rSBF, the coating processing and properties should be further optimized in order to take full advantage of biodegradable Mg and nHA/PLGA nanocomposites for orthopedic applications.

Chondroitin sulfate and sulfated hyaluronan-containing collagen coatings of titanium implants influence peri-implant bone formation in a minipig model

An improved osseous integration of dental implants in patients with lower bone quality is of particular interest. The aim of this study was to evaluate the effect of artificial extracellular matrix implant coatings on early bone formation. The coatings contained collagen (coll) in conjunction with either chondroitin sulfate (CS) or sulfated hyaluronan (sHya). Thirty-six screw-type, grit-blasted, and acid-etched titanium implants were inserted in the mandible of 6 minipigs. Three surface states were tested: (1) uncoated control (2) coll/CS (3) coll/sHya. After healing periods of 4 and 8 weeks, bone implant contact (BIC), bone volume density (BVD) as well as osteoid related parameters were measured. After 4 weeks, control implants showed a BIC of 44% which was comparable to coll/CS coated implants (48%) and significantly higher compared to coll/sHya coatings (37%, p = 0.012). This difference leveled out after 8 weeks. No significant differences could be detected for BVD values after 4 weeks and all surfaces showed reduced BVD values after 8 weeks. However, at that time, BVD around both, coll/CS (30%, p = 0.029), and coll/sHya (32%, p = 0.015), coatings was significantly higher compared to controls (22%). The osteoid implant contact (OIC) showed no significant differences after 4 weeks. After 8 weeks OIC for controls was comparable to coll/CS, the latter being significantly higher compared to coll/sHya (0.9% vs. 0.4%, p = 0.012). There were no significant differences in osteoid volume density. In summary, implant surface coatings by the chosen organic components of the extracellular matrix showed a certain potential to influence osseointegration in vivo.

Nanomaterials and synergistic low-intensity direct current (LIDC) stimulation technology for orthopedic implantable medical devices

Nanomaterials play a significant role in biomedical research and applications because of their unique biological, mechanical, and electrical properties. In recent years, they have been utilized to improve the functionality and reliability of a wide range of implantable medical devices ranging from well-established orthopedic residual hardware devices (e.g., hip implants) that can repair defects in skeletal systems to emerging tissue engineering scaffolds that can repair or replace organ functions. This review summarizes the applications and efficacies of these nanomaterials that include synthetic or naturally occurring metals, polymers, ceramics, and composites in orthopedic implants, the largest market segment of implantable medical devices. The importance of synergistic engineering techniques that can augment or enhance the performance of nanomaterial applications in orthopedic implants is also discussed, the focus being on a low-intensity direct electric current (LIDC) stimulation technology to promote the long-term antibacterial efficacy of oligodynamic metal-based surfaces by ionization, while potentially accelerating tissue growth and osseointegration. While many nanomaterials have clearly demonstrated their ability to provide more effective implantable medical surfaces, further decisive investigations are necessary before they can translate into medically safe and commercially viable clinical applications. The article concludes with a discussion about some of the critical impending issues with the application of nanomaterials-based technologies in implantable medical devices, and potential directions to address these.

The nano era in dentistry

Nanotechnology is a new transnational and transcultural development that is growing rapidly and pervasively. The potential impact of novel Nanodentistry Applications in disease diagnosis, therapy and prevention is foreseen to change oral health care in a fundamental way. This review presents a general overview of the novel nanomaterial and relevant advances of nanotechnology, focusing on promising dental applications. In particular, relevant applications are reported in Restorative dentistry, minimally invasive dental procedures, cancer diagnosis and treatment, molecular imaging and implant dentistry. Many applications are still in their infancy. An increasing number of products are currently under clinical investigation while some are commercially available.

Nanostructured diamond coatings for orthopaedic applications

With increasing numbers of orthopaedic devices being implanted, greater emphasis is being placed on ceramic coating technology to reduce friction and wear in mating total joint replacement components, in order to improve implant function and increase device lifespan. In this chapter, we consider ultra-hard carbon coatings, with emphasis on nanostructured diamond, as alternative bearing surfaces for metallic components. Such coatings have great potential for use in biomedical implants as a result of their extreme hardness, wear resistance, low friction and biocompatibility. These ultra-hard carbon coatings can be deposited by several techniques resulting in a wide variety of structures and properties.

Nanotechnology for surgeons

Surgeons are constantly looking for minimally invasive ways to treat their patients, as recovery is faster when a lesser trauma is inflicted upon a patient, scarring is lessened and there are usually fewer complications in the aftermath of the operation. Through nanotechnology, tiny biosensors could be constructed which could take these factors into account, thus shortening a patients recovery period and saving hospitals money, reducing infection rates within the hospital, reducing the waiting lists for operation and allowing doctors to treat more patients in the same period of time. One of the greatest achievements of nanotechnology in surgery will be what we call the "ideal graft"; that is, biocompatible and durable "repairs" of parts of the body like arteries, joints or even organs. At first, these repairs will be used for healing, but soon afterwards, they will be used for transcendence: to enhance current human abilities.

Nano-regenerative medicine towards clinical outcome of stem cell and tissue engineering in humans

Nanotechnology is a fast growing area of research that aims to create nanomaterials or nanostructures development in stem cell and tissue-based therapies. Concepts and discoveries from the fields of bio nano research provide exciting opportunities of using stem cells for regeneration of tissues and organs. The application of nanotechnology to stem-cell biology would be able to address the challenges of disease therapeutics. This review covers the potential of nanotechnology approaches towards regenerative medicine. Furthermore, it focuses on current aspects of stem- and tissue-cell engineering. The magnetic nanoparticles-based applications in stem-cell research open new frontiers in cell and tissue engineering.

Effects of barium titanate nanoparticles on proliferation and differentiation of rat mesenchymal stem cells

Nanomaterials hold great promise in the manipulation and treatments of mesenchymal stem cells, since they allow the modulation of their properties and differentiation. However, systematic studies have to be carried out in order to assess their potential toxicological effects. The present study reports on biocompatibility evaluation of glycol-chitosan coated barium titanate nanoparticles (BTNPs) on rat mesenchymal stem cells (MSCs). BTNPs are a class of ceramic systems which possess interesting features for biological applications thanks to their peculiar dielectric and piezoelectric properties. Viability was evaluated up to 5 days of incubation (concentrations in the range 0-100 μg/ml) both quantitatively and qualitatively with specific assays. Interactions cells/nanoparticles were further investigated with analysis of the cytoskeleton conformation, with SEM and TEM imaging, and with AFM analysis. Finally, differentiation in adipocytes and osteocytes was achieved in the presence of high doses of BTNPs, thus highlighting the safety of these nanostructures towards mesenchymal stem cells.

In vitro studies on the effect of particle size on macrophage responses to nanodiamond wear debris

Nanostructured diamond coatings improve the smoothness and wear characteristics of the metallic component of total hip replacements and increase the longevity of these implants, but the effect of nanodiamond wear debris on macrophages needs to be determined to estimate the long-term inflammatory effects of wear debris. The objective was to investigate the effect of the size of synthetic nanodiamond particles on macrophage proliferation (BrdU incorporation), apoptosis (Annexin-V flow cytometry), metabolic activity (WST-1 assay) and inflammatory cytokine production (qPCR). RAW 264.7 macrophages were exposed to varying sizes (6, 60, 100, 250 and 500 nm) and concentrations (0, 10, 50, 100 and 200 μg ml(-1)) of synthetic nanodiamonds. We observed that cell proliferation but not metabolic activity was decreased with nanoparticle sizes of 6-100 nm at lower concentrations (50 μg ml(-1)), and both cell proliferation and metabolic activity were significantly reduced with nanodiamond concentrations of 200 μg ml(-1). Flow cytometry indicated a significant reduction in cell viability due to necrosis irrespective of particle size. Nanodiamond exposure significantly reduced gene expression of tumor necrosis factor-α, interleukin-1β, chemokine Ccl2 and platelet-derived growth factor compared to serum-only controls or titanium oxide (anatase 8 nm) nanoparticles, with variable effects on chemokine Cxcl2 and vascular endothelial growth factor. In general, our study demonstrates a size and concentration dependence of macrophage responses in vitro to nanodiamond particles as possible wear debris from diamond-coated orthopedic joint implants.

Synthesis and Characterization of Sol-Gel Derived Hydroxyapatite-Bioglass Composite Nanopowders for Biomedical Applications

The main purpose of this study is to prepare and characterize hydroxyapatite (HA)–10%wt bioglass (BG) composite nanopowders and its bioactivity. Composites of hydroxyapatite with synthesized bioglass are prepared at various temperatures. Suitable calcination temperature is chosen by evaluating of the phase composition. X-ray diffraction (XRD), Transmission electron microscopy (TEM) and Scanning electron microscopy (SEM) techniques are utilized to characterize the prepared nanopowders. The bioactivity of the prepared composite samples is evaluated in an in vitro study by immersion of samples in simulated body fluid (SBF) for predicted time. Fourier transformed infrared (FTIR) spectroscopy and inductively coupled plasma (ICP) are used for evaluation of apatite formation and the bioactivity properties. Results show that HA-BG composite nanopowders are successfully prepared without any decomposition of hydroxyapatite. The suitable temperature for calcination is 600°C and the particle size of hydroxyapatite is about 40-70 nm. The apatite phase forms after 14 days immersing of the samples in SBF. It could be concluded that this process can be used to synthesize HA-BG composite nanopowders with improved bioactivity which is much needed for hard tissue repair and biomedical applications.

Improved interaction of osteoblast-like cells with apatite-nanodiamond coatings depends on fibronectin

New apatite (AP)/nanodiamond (ND) coating has been developed to improve physical and biological properties of stainless steel (SS) versus single AP coating. Homogeneously electrodeposited AP-ND layer demonstrates increased mechanical strength, interlayer cohesion and ductility. In the absence of serum, osteoblast-like MG63 cells attach well but poorly spread on both AP and AP-ND substrata. Pre-adsorption with serum or fibronectin (FN) improves the cellular interaction-an effect that is better pronounced on the AP-ND coating. In single protein adsorption study fluorescein isothiocyanate-labeled FN (FITC-FN) shows enhanced deposition on the AP-ND layer consistent with the significantly improved cell adhesion, spreading and focal adhesions formation (in comparison to SS and AP), particularly at low FN adsorption concentrations (1 μg/ml). Higher FN concentrations (20 μg/ml) abolish this difference suggesting that the promoted cellular interaction of serum (where FN is low) is caused by the greater affinity for FN. Moreover, it is found that MG63 cells tend to rearrange both adsorbed and secreted FN on the AP-ND layer suggesting facilitated FN matrix formation.

Nanotechnology applications in medicine and dentistry

Nanotechnology, or nanoscience, refers to the research and development of an applied science at the atomic, molecular, or macromolecular levels (i.e. molecular engineering, manufacturing). The prefix "nano" is defined as a unit of measurement in which the characteristic dimension is one billionth of a unit. Although the nanoscale is small in size, its potential is vast. As nanotechnology expands in other fields, clinicians, scientists, and manufacturers are working to discover the uses and advances in biomedical sciences. Applications of nanotechnology in medical and dental fields have only approached the horizon with opportunities and possibilities for the future that can only be limited by our imagination. This paper provides an early glimpse of nanotechnology applications in medicine and dentistry to illustrate their potentially far-reaching impacts on clinical practice. It also narrates the safety issues concerning nanotechnology applications.

Bioengineered periodontal tissue formed on titanium dental implants

The ability to use autologous dental progenitor cells (DPCs) to form organized periodontal tissues on titanium implants would be a significant improvement over current implant therapies. Based on prior experimental results, we hypothesized that rat periodontal ligament (PDL)-derived DPCs can be used to bioengineer PDL tissues on titanium implants in a novel, in vivo rat maxillary molar implant model. Analyses of recovered implants revealed organized PDL tissues surrounding titanium implant surfaces in PDL-cell-seeded, and not in unseeded control, implants. Rat PDL DPCs also exhibited differentiative potential characteristic of stem cells. These proof-of-principle findings suggest that PDL DPCs can organize periodontal tissues in the jaw, at the site of previously lost teeth, indicating that this method holds potential as an alternative approach to osseointegrated dental implants. Further refinement of this approach will facilitate the development of clinically relevant methods for autologous PDL regeneration on titanium implants in humans.

Thickness and surface structure of a ceramic layer created on three indirect resin composites with aerosol deposition

PURPOSE

Aerosol deposition is a technology for coating ceramics with impact consolidation at room temperature. The aim of the present study was to investigate the thickness and the microstructure of the aluminium oxide layer on different three dental resin composite materials created by means of aerosol deposition.

METHODS

Disk-shaped specimens were fabricated with three resin composites (Estenia C&B, Targis, and Gradia). The specimens were ground flat, and then subjected to aerosol deposition using aluminium oxide submicron particles without inducing a localized temperature rise. The average thickness (AVH) and maximum thickness (Hmax) of the aluminium oxide layer deposited on the resin composite material were measured using a profilometer. Data were analyzed by ANOVA and post hoc Tukey compromise test at α=0.05. The specimen surfaces were also observed using a scanning electron microscope.

RESULTS

The aluminium oxide layer formed on Estenia C&B (AVH 8.1 μm, Hmax 9.1 μm) and Targis (AVH 7.7 μm, Hmax 8.9 μm) were significantly thicker than that on Gradia (AVH 4.2 μm, Hmax 5.4 μm). The micrograph showed that the aluminium oxide layer on Estenia C&B was similar to that on Targis. However, the aerosol deposition area of Gradia was seen relatively rough and partly caved.

CONCLUSIONS

The type of resin composite affected the microstructure of the deposited aluminium oxide layer. The highly filled light- and heat-cured resin composites are advantageous as a target material rather than the lower filled light-cured resin composite.

Orthopedic nano diamond coatings: control of surface properties and their impact on osteoblast adhesion and proliferation

The superior mechanical and tribological properties of diamond coatings suggest their promise for improving current orthopedic implants. Therefore, understanding and controlling biological responses on diamond coatings are important and necessary for their advancement in orthopedics. For this reason, the objective of the present study was to correlate surface properties of diamond coatings with osteoblast (OB) adhesion and proliferation. Diamond coatings on silicon of variable surface features (specifically, grain size, surface roughness and surface chemistry) were fabricated by microwave plasma enhanced chemical-vapor-deposition (MPCVD). Scanning electron microscopy (SEM) as well as atomic force microscopy (AFM) was applied for topographical characterization and contact angles were measured to assess surface wettability. Results revealed that the grain size, surface roughness and wettability of diamond coatings can be controlled by adjusting H(2) plasma in the MPCVD process. Further, results showed enhanced OB adhesion on nanocrystalline diamond (ND) with grain sizes less than 100 nm whereas nanostructured diamond/amorphous carbon coatings (NDp) and microcrystalline diamond (MD) inhibited OB adhesion. H(2) plasma treated ND (NDH) also promoted OB adhesion. Similarly, OB proliferated to a greater extent on ND and NDH compared with MD and uncoated silicon controls. In summary, surface properties (including topography and chemistry) of diamond coatings can be controlled to either promote or inhibit OB functions, which implies that various forms of diamond coatings can be used to either support or inhibit bone growth in different regions of an orthopedic implant.

Nanodimensional and Nanocrystalline Apatites and Other Calcium Orthophosphates in Biomedical Engineering, Biology and Medicine

Recent developments in biomineralization have already demonstrated that nanosized particles play an important role in the formation of hard tissues of animals. Namely, the basic inorganic building blocks of bones and teeth of mammals are nanodimensional and nanocrystalline calcium orthophosphates (in the form of apatites) of a biological origin. In mammals, tens to hundreds nanocrystals of a biological apatite were found to be combined into self-assembled structures under the control of various bioorganic matrixes. In addition, the structures of both dental enamel and bones could be mimicked by an oriented aggregation of nanosized calcium orthophosphates, determined by the biomolecules. The application and prospective use of nanodimensional and nanocrystalline calcium orthophosphates for a clinical repair of damaged bones and teeth are also known. For example, a greater viability and a better proliferation of various types of cells were detected on smaller crystals of calcium orthophosphates. Thus, the nanodimensional and nanocrystalline forms of calcium orthophosphates have a great potential to revolutionize the field of hard tissue engineering starting from bone repair and augmentation to the controlled drug delivery devices. This paper reviews current state of knowledge and recent developments of this subject starting from the synthesis and characterization to biomedical and clinical applications. More to the point, this review provides possible directions of future research and development.

Physico/chemical characterization and in vivo evaluation of nanothickness bioceramic depositions on alumina-blasted/acid-etched Ti-6Al-4V implant surfaces

The objective of this study was to physico/chemically characterize and evaluate the in vivo performance of two nanothickness ion beam assisted depositions (IBAD) of bioceramic coatings on implants in a beagle model. Alumina-blasted/acid-etched (AB/AE) Ti-6Al-4V implants were subjected to two different IBAD depositions (IBAD I and IBAD II), which were physico/chemically characterized by SEM, EDS, XPS, XPS + ion-beam milling (depth profiling), XRD, AFM, and ToF-SIMS. A beagle dog tibia model was utilized for histomorphometric and biomechanical (torque) comparison between AB/AE, IBAD I, IBAD II, and plasma-sprayed hydroxyapatite (PSHA) coated implants that remained in vivo for 3 and 5 weeks. The coatings were characterized as amorphous Ca-P with high Ca/P stoichiometries with thicknesses of an order of magnitude difference (IBAD I = 30-50 nm and IBAD II = 300-500 nm). The histomorphometric and biomechanical testing results showed that the 300-500 nm thickness deposition (IBAD II) and PSHA positively modulated bone healing at early implantation times.

Applying Nanotechnology to Human Health: Revolution in Biomedical Sciences

Recent research on biosystems at the nanoscale has created one of the most dynamic science and technology domains at the confluence of physical sciences, molecular engineering, biology, biotechnology, and medicine. This domain includes better understanding of living and thinking systems, revolutionary biotechnology processes, synthesis of new drugs and their targeted delivery, regenerative medicine, neuromorphic engineering, and developing a sustainable environment. Nanobiosystems research is a priority in many countries and its relevance within nanotechnology is expected to increase in the future. The realisation that the nanoscale has certain properties needed to solve important medical challenges and cater to unmet medical needs is driving nanomedical research. The present review explores the significance of nanoscience and latest nanotechnologies for human health. Addressing the associated opportunities, the review also suggests how to manage far-reaching developments in these areas.

Templating route for mesostructured calcium phosphates with carboxylic acid- and amine-type surfactants

Mesostructured calcium phosphates constructed by ionic frameworks were synthesized using carboxylic acid- and amine-type surfactants in mixed solvent systems of ethanol and water. A lamellar mesostructured calcium phosphate was prepared using palmitic acid as an anionic surfactant, as in the case using n-alkylamines. A wormhole-like mesostructured calcium phosphate can be obtained using dicarboxyl N-lauroyl- l-glutamic acid, whose headgroup is larger than that of palmitic acid. Similar mesostructured product was obtained using 4-dodecyldiethylenetriamine with a large headgroup containing two primary amine groups. Interactions of carboxyl and primary amino groups in the surfactant molecules with inorganic species are quite important for the formation of mesostructured calcium phosphates. The Ca/P molar ratio of mesostructured calcium phosphates was strongly affected by the molecular structure of surfactants containing carboxyl and primary amino groups. Ca-rich materials can be obtained using carboxylic acid-type surfactants (Ca/P approximately 1.7) rather than amine-type surfactants (Ca/P approximately 1.0).

A comparison of different nanostructured biomaterials in subcutaneous tissue

The nanostructured surface of a material can improve its interaction with cells and its acceptance as an implant. We compared two novel biomaterials with different nanostructures: Bioverit II with a coating of nanoporous silica and chitosan-hydroxyapatite composite materials. Pure Bioverit II served as a control. Platelets of these materials were implanted for 28, 85 and 300 days in the subcutaneous tissue in the neck of 38 rabbits. After excising the specimens they were fixed, embedded in epoxy resin and analyzed histologically. All coated Bioverit II implants showed a thin capsule of connective tissue. After 300 days, these capsules tended to be thicker than in pure Bioverit II. No signs of inflammation were observed and the materials appeared unaltered by visual inspection. In case of chitosan-hydroxyapatite composites, massive capsules consisting of dense connective tissue were found, and the material showed signs of biodegradation in form of fissures and cavities. In conclusion, the nanoporous coating showed no obvious positive effect with regard to capsule formation; the chitosan-hydroxyapatite implants provoked a stronger interaction between cells and material. However, most Bioverit II implants showed no alterations optically, whereas chitosan-hydroxyapatite was partly degraded in all cases.

Nanostructured bioceramics for maxillofacial applications

Biomaterials science and technology have been expanding tremendously the recent years. The results of this evolution are obvious in maxillofacial applications especially with the contemporary development of Nanotechnology. Among biomaterials, bioceramics possess a specific field due to various interactions with the biological tissues. The combination of bioceramics and nanotechnology has resulted in enhanced skeletal interactions in maxillofacial applications. Nanotechnology secures better mechanical properties and more effective biological interactions with jaws. The main production methods for the synthesis of nanostructured materials include plasma arcing, chemical vapour deposition, sol-gel and precipitation. The bioceramics in Dentistry comprise inert, bioactive, resorbable and composite systems. The purpose of the present article is to describe the available nanotechnology methods and how these could be addressed to synthesise maxillofacial bioceramics with advanced properties for better biological applications. Additionally, it describes specific clinical applications in maxillofacial surgery of these biomaterials--either by themselves or in combination with others--that can be promising candidates for bone tissue engineering. Such applications include replacement of lost teeth, filling of jaws defects or reconstruction of mandible and temporomandibular joint.

Histological evaluation of novel ossicular chain replacement prostheses: an animal study in rabbits

CONCLUSION

The improved biocompatibility of Bioverit II coated with a nanostructured surface shows promising qualities for use in human reconstructive middle ear surgery. In the case of chitosan-hydroxyapatite composite prostheses, further investigations regarding composition of the material, degree of purity and design are necessary before clinical application.

OBJECTIVE

The selection of optimal materials for reconstructive middle ear surgery continues to be a problem. In the present study novel materials were tested as total ossicular replacement prostheses (TORPs) in an animal model.

MATERIALS AND METHODS

Bioverit II coated with a nanostructured surface and chitosan-hydroxyapatite composites were placed in the middle ear of 40 rabbits. Uncoated Bioverit II was used as control. After an implantation period of 28, 84 or 300 days petrous bones were extracted, embedded in epoxy resin and examined by light microscopy.

RESULTS

Uncoated and coated Bioverit prostheses revealed a mucosal coverage and a little osseogenic response after 28 days. The results of the coated Bioverit prostheses slightly surpassed those of the plain prostheses. Chitosan-hydroxyapatite composite prostheses were mostly found to be dislocated after 28 days. Formations of granulation tissue and fibrotic capsules were observed around these implants. This reaction could be caused by the instability of the composite material or may be due to impurities present in the chitosan.

Applications of nanotechnology in orthopaedics

Nanotechnology is the application of science and engineering at the nanoscale. A diverse range of applications are beginning to emerge in all areas of medicine. We performed a survey from November 2005 to March 2006 using the Internet search engines PubMed, ScienceDirect, ISI Web of Knowledge, and Google Scholar. We report on the role of nanotechnology in orthopaedics, exploring current and potential applications. Nanostructured materials have been proposed as the next generation of orthopaedic implant properties by creating a surface environment more conducive for osteoblast function. Bone substitute materials, whose nanoscale composition emulates the hierarchic organization of natural bone, shows initiation of the desirable formation of an apatite layer. Nanotechnology also has been harnessed to improve the cutting performance and quality of surgical blades. Postoperative infection rates may be reduced by using nanofibrous membrane wound dressings containing antibacterial properties. The most notable application of nanotechnology in orthopaedics may be drug delivery, including nanotherapeutics for treating bone cancer and arthritis. Nanotechnology is being used in orthopaedics, and likely will play a valuable role in future developments.