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Gomes AM, da Silva DF, Bezerra FJ, Zambuzzi WF. Nanohydroxyapatite-Coated Titanium Surface Increases Vascular Endothelial Cells Distinct Signaling Responding to High Glucose Concentration. J Funct Biomater 2023; 14:jfb14040188. [PMID: 37103278 PMCID: PMC10142760 DOI: 10.3390/jfb14040188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Aim: The success of dental implants depends on osseointegration can be compromised by well-known related adverse biological processes, such as infection and diabetes. Previously, nanohydroxyapatite-coated titanium surfaces (nHA_DAE) have been shown to contain properties that promote osteogenesis by enhancing osteoblast differentiation. In addition, it was hypothesized to drive angiogenesis in high-glucose microenvironments, mimicking diabetes mellitus (DM). On the other hand, the null hypothesis would be confirmed if no effect was observed in endothelial cells (ECs). Materials and methods: Titanium discs presenting the differential surfaces were previously incubated in an FBS-free cell culture medium for up to 24 h, which was, thereafter, supplemented with 30.5 mM of glucose to expose human umbilical vein endothelial cells (HUVECs, ECs) for 72 h. They were then harvested, and the sample was processed to provide molecular activity of specific genes related to EC survival and activity by using qPCR, and the conditioned medium by ECs was used to evaluate the activity of matrix metalloproteinases (MMPs). Results: Our data guaranteed better performance of this nanotechnology-involved titanium surface to this end once the adhesion and survival characteristics were ameliorated by promoting a higher involvement of β1-Integrin (~1.5-fold changes), Focal Adhesion Kinases (FAK; ~1.5-fold changes) and SRC (~2-fold changes) genes. This signaling pathway culminated with the cofilin involvement (~1.5-fold changes), which guaranteed cytoskeleton rearrangement. Furthermore, nHA_DAE triggered signaling that was able to drive the proliferation of endothelial cells once the cyclin-dependent kinase gene was higher in response to it, while the P15 gene was significantly down-regulated with an impact on the statement of angiogenesis. Conclusions: Altogether, our data show that a nanohydroxyapatite-coated titanium surface ameliorates the EC performance in a high-glucose model in vitro, suggesting its potential application in DM patients.
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High-resolution ex vivo analysis of the degradation and osseointegration of Mg-xGd implant screws in 3D. Bioact Mater 2022; 13:37-52. [PMID: 35224290 PMCID: PMC8844220 DOI: 10.1016/j.bioactmat.2021.10.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 11/24/2022] Open
Abstract
Biodegradable magnesium (Mg) alloys can revolutionize osteosynthesis, because they have mechanical properties similar to those of the bone, and degrade over time, avoiding the need of removal surgery. However, they are not yet routinely applied because their degradation behavior is not fully understood. In this study we have investigated and quantified the degradation and osseointegration behavior of two biodegradable Mg alloys based on gadolinium (Gd) at high resolution. Mg-5Gd and Mg-10Gd screws were inserted in rat tibia for 4, 8 and 12 weeks. Afterward, the degradation rate and degradation homogeneity, as well as bone-to-implant interface, were studied with synchrotron radiation micro computed tomography and histology. Titanium (Ti) and polyether ether ketone (PEEK) were used as controls material to evaluate osseointegration. Our results showed that Mg-5Gd degraded faster and less homogeneously than Mg-10Gd. Both alloys gradually form a stable degradation layer at the interface and were surrounded by new bone tissue. The results were correlated to in vitro data obtained from the same material and shape. The average bone-to-implant contact of the Mg-xGd implants was comparable to that of Ti and higher than for PEEK. The results suggest that both Mg-xGd alloys are suitable as materials for bone implants. High-resolution non-destructive synchrotron micro computed tomography of biodegradable Mg alloys ex vivo. Mg-xGd implants exhibit a high bone-to-implant contact, similar to titanium implants. Initially Mg-xGd implants are surrounded by a lesser bone volume fraction but reach similar levels as reference materials. Mg-xGd implants degrade at rates lower than 1 mm a−1 in vivo, decreasing to less than 0.4 mm a−1 after 12 weeks.
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ABSTRACTS (BY NUMBER). Tissue Eng Part A 2022. [DOI: 10.1089/ten.tea.2022.29025.abstracts] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Zhu C, He M, Mao L, Yang H, Hu B, Zhang L, Feng G, Liu L, Song Y. Titanium interlayer-mediated hydroxyapatite-coated polyetheretherketone cage in transforaminal lumbar interbody fusion surgery. BMC Musculoskelet Disord 2021; 22:918. [PMID: 34724952 PMCID: PMC8561990 DOI: 10.1186/s12891-021-04803-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/19/2021] [Indexed: 02/08/2023] Open
Abstract
Background The variance in clinical responses to polyetheretherketone (PEEK) cages with titanium (Ti) and hydroxyapatite (HA) coatings (PEEK-Ti-HA cages) is still not clear. In this study, we aimed to evaluate the radiographic and clinical outcomes of patients undergoing TLIF using PEEK-Ti-HA cages with a particular focus on fusion rate. Methods A prospective and nonrandomized study was conducted to compare the outcomes of PEEK-Ti-HA cages (group A, n = 32) and uncoated PEEK cages (group B, n = 32). The follow up time was at least 2 years. The radiographic assessments included the regional lordosis (RL), disc height (DH), and fusion rate. The clinical indexes included the Japanese Orthopedic Association (JOA) scores and visual analog scale (VAS) scores (back and leg). Results No significant differences were found in the pre- and postoperative RL and DH between Group A and Group B. And RL and DH, even if there were any variance initially, were restored not long after surgery in both groups. Though Group A had a significantly higher fusion rate than group B at 3 months post-surgery (93.7% vs. 75.0%), the fusion rates for the two groups reached the same level (100%) when it comes to the final follow-up. Additionally, differences of VAS and JOA scores for the two groups in general approximate. Conclusions PEEK-Ti-HA cages, in contrast with uncoated PEEK cages, produced a better fusion rate at 3 months after single-level TLIF. The fusion rates of both groups could get 100% at the final follow-up. PEEK-Ti-HA cages could achieve similar RL, DH, JOA scores and VAS scores in comparison with uncoated PEEK cages post-surgery.
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Affiliation(s)
- Ce Zhu
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China.,Department of Spine Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Miaomiao He
- Analytical & Testing Center, Sichuan University, Chengdu, China
| | - Lili Mao
- Department of Ultrasound, Hospital of Traditional Chinese Medicine Affiliated to Southwest Medical University, Luzhou, China
| | - Huiliang Yang
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China
| | - Bowen Hu
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China
| | - Li Zhang
- Analytical & Testing Center, Sichuan University, Chengdu, China
| | - Ganjun Feng
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China
| | - Limin Liu
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China.
| | - Yueming Song
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China.
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Zhu C, He M, Mao L, Li T, Zhang L, Liu L, Feng G, Song Y. Titanium-interlayer mediated hydroxyapatite coating on polyetheretherketone: a prospective study in patients with single-level cervical degenerative disc disease. J Transl Med 2021; 19:14. [PMID: 33407627 PMCID: PMC7788895 DOI: 10.1186/s12967-020-02688-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/22/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). METHODS Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle (C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. RESULTS There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. CONCLUSIONS In patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.
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Affiliation(s)
- Ce Zhu
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China.,Department of Spine Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Miaomiao He
- Analytical & Testing Center, Sichuan University, Chengdu, China
| | - Lili Mao
- Department of Ultrasound, Hospital of Traditional Chinese Medicine Affiliated to Southwest Medical University, Luzhou, China
| | - Tao Li
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China
| | - Li Zhang
- Analytical & Testing Center, Sichuan University, Chengdu, China
| | - Limin Liu
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China.
| | - Ganjun Feng
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China.
| | - Yueming Song
- Department of Orthopedics Surgery and Orthopedics Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, China
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Ferreira MR, Milani R, Rangel EC, Peppelenbosch M, Zambuzzi W. OsteoBLAST: Computational Routine of Global Molecular Analysis Applied to Biomaterials Development. Front Bioeng Biotechnol 2020; 8:565901. [PMID: 33117780 PMCID: PMC7578266 DOI: 10.3389/fbioe.2020.565901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/20/2020] [Indexed: 11/13/2022] Open
Abstract
For bone purposes, surface modifications are a common trend in biomaterials research aiming to reduce the time necessary for osteointegration, culminating in faster recovery of patients. In this scenario, analysis of intracellular signaling pathways have emerged as an important and reliable strategy to predict biological responses from in vitro approaches. We have combined global analysis of intracellular protein phosphorylation, systems biology and bioinformatics into an early biomaterial analysis routine called OsteoBLAST. We employed the routine as follows: the PamChip tyrosine kinase assay was applied to mesenchymal stem cells grown on three distinct titanium surfaces: machined, dual acid-etched and nanoHA. Then, OsteoBLAST was able to identify the most reliable spots to further obtain the differential kinome profile and finally to allow a comparison among the different surfaces. Thereafter, NetworKIN, STRING, and Cytoscape were used to build and analyze a supramolecular protein-protein interaction network, and DAVID tools identified biological signatures in the differential kinome for each surface.
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Affiliation(s)
- Marcel Rodrigues Ferreira
- Department of Chemistry and Biochemistry, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - Renato Milani
- Bioquímica e Biologia Tecidual, Biology Institute, Universidade de Campinas (UNICAMP), São Paulo, Brazil
| | - Elidiane C Rangel
- Institute of Science and Technology, São Paulo State University (UNESP), São Paulo, Brazil
| | - Maikel Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Willian Zambuzzi
- Department of Chemistry and Biochemistry, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil
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Bunz O, Benz CI, Arnold WH, Piwowarczyk A. Shear bond strength of veneering composite to high performance polymers. Dent Mater J 2020; 40:304-311. [PMID: 33087631 DOI: 10.4012/dmj.2019-300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
High performance polymers like PEEK (polyetheretherketone) and FRC (fiberreinforced composite) could substitute metallic alloys for removable partial dentures. However, these polymers require aesthetic veneering. This study was to determine the bond strength to direct composite. Specimens made of PEEK and FRC were produced and air-abraded (50 μm aluminum-oxide). Specimens were allocated to four experimental groups: Luxatemp Glaze & Bond, Scotchbond Universal, SR Nexco Connect and iBond Universal. Specimens were divided into three subgroups for short-term, long-term and no artificial aging and shear bond strength (SBS) was evaluated. SBS of specimens made of PEEK with no artificial aging showed values between 10.79-14.00 MPa, short-term artificial aging resulted in values between 3.78-13.85 MPa and after long-term artificial aging SBS decreased to 0-8.75 MPa. SBS measurement of FRC specimens resulted in values between 9.83-12.1 MPa without aging, after short-term artificial aging values decreased to 8.36-11.98 MPa and after long-term aging SBS showed a degradation to 4.52-7.82 MPa.
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Affiliation(s)
- Oskar Bunz
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University
| | - Carla I Benz
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University
| | - Wolfgang H Arnold
- Department of Biological and Material Sciences in Dentistry, School of Dentistry, Faculty of Health, Witten/Herdecke University
| | - Andree Piwowarczyk
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University
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McEntire BJ, Maslin G, Bal BS. Two-year results of a double-blind multicenter randomized controlled non-inferiority trial of polyetheretherketone (PEEK) versus silicon nitride spinal fusion cages in patients with symptomatic degenerative lumbar disc disorders. JOURNAL OF SPINE SURGERY 2020; 6:523-540. [PMID: 33102889 DOI: 10.21037/jss-20-588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background During lumbar spinal fusion, spacer cages are implanted to provide vertebral stability, restore sagittal alignment, and maintain disc and foraminal height. Polyetheretherketone (PEEK) is commonly used by most spine surgeons. Silicon nitride (Si3N4) is a less well-known alternative although it was first used as a spacer in lumbar fusion over 30 years ago. The present study was designed to see if Si3N4 cages would perform similarly to PEEK in a randomized controlled trial. Methods A non-inferiority multicenter 100-patient study was designed where both the observer and patient were blinded. Single- or double-level transforaminal lumbar interbody fusion with pedicle screw fixation using an oblique PEEK or Si3N4 cage was performed. The primary non-inferiority outcome was the Roland-Morris Disability Questionnaire (RMDQ). Secondary measures included the Oswestry Disability Questionnaire, Visual Analogue Scales (VAS) for back and leg pain, SF-36 Physical and Mental Function indices, patient and surgeon Likert scores on perceived recovery, and X-ray and CT radiological evaluations for subsidence, segmental motion, and fusion. Follow-up evaluations occurred at 3, 6, 12, and 24 months. Results After exclusions for protocol violations and canceled surgeries, 92 patients were randomized (i.e., 48 for PEEK and 44 for Si3N4). There were no differences in baseline demographics, pre-operative disabilities, or pain scores between the groups. Both treatment arms showed significant improvements in disability, pain, and recovery scores. No significant differences were observed for subsidence, segmental motion, or fusion. For the primary outcome (i.e., RMDQ scores), the non-inferiority of Si3N4 compared to PEEK could not be established using the original protocol criteria. However, the comparison was undermined by larger than anticipated patient fallout coupled with higher than expected RMDQ score standard deviations. A post hoc analysis coupled with a more extensive review of the literature was conducted which resulted in the selection of a revised clinically justified non-inferiority margin; and using this method, the non-inferiority of Si3N4 was affirmed. Conclusions This study demonstrated that the use of either PEEK or Si3N4 cages is safe and effective for patients undergoing lumbar spine fusion for chronic degenerative disc disease.
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Affiliation(s)
| | - Greg Maslin
- Biomedical Statistical Consulting, Wynnewood, PA, USA
| | - B Sonny Bal
- SINTX Technologies, Inc., Salt Lake City, UT, USA
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Smith KA, Russo GS, Vaccaro AR, Arnold PM. Scientific, Clinical, Regulatory, and Economic Aspects of Choosing Bone Graft/Biological Options in Spine Surgery. Neurosurgery 2020; 84:827-835. [PMID: 30032187 DOI: 10.1093/neuros/nyy322] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/17/2018] [Indexed: 01/07/2023] Open
Abstract
Spinal arthrodesis is a major element of the spinal surgeon's practice. To attain successful fusion rates, attention must be paid to spinal segment immobilization and proper selection of bone graft. Autogenous bone graft (ie, ICBG), the "gold standard," with or without graft extenders and enhancers provides the foundation for most spinal fusions. ABG is the only graft option containing all 3 factors of new bone growth: osteoconductivity, osteoinductivity, and osteogenicity. While many bone graft alternatives function well as bone graft extenders, only growth factors proteins (ie, rhBMP-2 or OP-2) function as bone graft enhancers and substitutes. The search for optimal hybrid interbody cages, bone graft substitutes, autogenous or allogenic stem cells, and nanostructure scaffolds for release of growth factors continues.
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Affiliation(s)
- Kyle A Smith
- Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Glenn S Russo
- Department of Orthopedics, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Alexander R Vaccaro
- Department of Orthopedics, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Paul M Arnold
- Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas
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Jiang X, Yao Y, Tang W, Han D, Zhang L, Zhao K, Wang S, Meng Y. Design of dental implants at materials level: An overview. J Biomed Mater Res A 2020; 108:1634-1661. [PMID: 32196913 DOI: 10.1002/jbm.a.36931] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/17/2022]
Abstract
Due to the excellent restoration of masticatory function, satisfaction on aesthetics and other superiorities, dental implants represent an effective method to resolve tooth losing and damaging. Current dental implant systems still have problems waiting to be addressed, and problems are centralized on the materials of implant bodies. This review aims to summarize major developments in the field of dental implant materials, starting with an overview on structures, procedures of dental implants and challenges of implant materials. Next, implant materials are examined in three categories, that is, metals, ceramics, and polymers, their mechanical properties, biocompatibility, and bioactivity are summarized. And as an important aspect, strategies of surface modification are also reviewed, along with some finite element analysis to guiding the research direction of implant materials. Finally, the conclusive remarks are outlined to provide an outlook on the future research directions and prospects of dental implants.
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Affiliation(s)
- Xunyuan Jiang
- The Key Laboratory of Low-Carbon Chemistry and Energy Conservation of Guangdong Province, State Key Laboratory of Optoelectronic Materials Technologies, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yitong Yao
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Weiming Tang
- The Key Laboratory of Low-Carbon Chemistry and Energy Conservation of Guangdong Province, State Key Laboratory of Optoelectronic Materials Technologies, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Dongmei Han
- The Key Laboratory of Low-Carbon Chemistry and Energy Conservation of Guangdong Province, State Key Laboratory of Optoelectronic Materials Technologies, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Li Zhang
- Analytical and Testing Center, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Ke Zhao
- Department of Prosthodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Shuanjin Wang
- The Key Laboratory of Low-Carbon Chemistry and Energy Conservation of Guangdong Province, State Key Laboratory of Optoelectronic Materials Technologies, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yuezhong Meng
- The Key Laboratory of Low-Carbon Chemistry and Energy Conservation of Guangdong Province, State Key Laboratory of Optoelectronic Materials Technologies, Sun Yat-Sen University, Guangzhou, People's Republic of China
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11
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Pobloth AM, Mersiowsky MJ, Kliemt L, Schell H, Dienelt A, Pfitzner BM, Burgkart R, Detsch R, Wulsten D, Boccaccini AR, Duda GN. Bioactive coating of zirconia toughened alumina ceramic implants improves cancellous osseointegration. Sci Rep 2019; 9:16692. [PMID: 31723174 PMCID: PMC6853946 DOI: 10.1038/s41598-019-53094-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 10/27/2019] [Indexed: 01/16/2023] Open
Abstract
Bioactive coatings have the potential to improve the bony integration of mechanically loaded orthopedic ceramic implants. Using the concept of mimicking the natural bone surface, four different coatings of varying thickness on a zirconia toughened alumina (ZTA) ceramic implant were investigated regarding their osseointegration in a drill-hole model in sheep. The hypothesis that a bioactive coating of ZTA ceramics would facilitate cancellous bone integration was investigated. The bioactive coatings consisted of either a layer of covalently bound multi phosphonate molecules (chemical modification = CM), a nano hydoxyapatite coating (HA), or two different bioactive glass (BG) coatings in micrometer thickness, forming a hydroxyl-carbonate apatite layer on the implant surface in vivo (dip-coated 45S5 = DipBG; sol-gel 70S30C = SGBG). Coated surfaces were characterized by scanning electron microscopy and X-ray photoelectron spectroscopy. After 12 weeks, osseointegration was evaluated via mechanical push-out testing and histology. HA enhanced the maximum push-out force (HA: mean 3573.85 ± 1119.91 N; SGBG: mean 1691.57 ± 986.76 N; p = 0.046), adhesive shear strength (HA: mean 9.82 ± 2.89 MPA; SGBG: mean 4.57 ± 2.65 MPA; p = 0.025), and energy release rate (HA: mean 3821.95 ± 1474.13 J/mm2; SGBG: mean 1558.47 ± 923.47 J/mm2; p = 0.032) compared to SGBG. The implant-bone interfacial stiffness increased by CM compared to SGBG coating (CM: mean 6258.06 ± 603.80 N/mm; SGBG: mean 3565.57 ± 1705.31 n/mm; p = 0.038). Reduced mechanical osseointegration of SGBG coated implants could be explained histologically by a foreign body reaction surrounding the implants.
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Affiliation(s)
- Anne-Marie Pobloth
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Max J Mersiowsky
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Luisa Kliemt
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Hanna Schell
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Anke Dienelt
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Berit M Pfitzner
- Institut für Pathologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Rainer Burgkart
- Clinic of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675, München, Germany
| | - Rainer Detsch
- Institute of Biomaterials, University of Erlangen-Nuremberg, Cauerstr. 6, 91058, Erlangen, Germany
| | - Dag Wulsten
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Aldo R Boccaccini
- Institute of Biomaterials, University of Erlangen-Nuremberg, Cauerstr. 6, 91058, Erlangen, Germany
| | - Georg N Duda
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Benz K, Schöbel A, Dietz M, Maurer P, Jackowski J. Adhesion Behaviour of Primary Human Osteoblasts and Fibroblasts on Polyether Ether Ketone Compared with Titanium under In Vitro Lipopolysaccharide Incubation. MATERIALS 2019; 12:ma12172739. [PMID: 31461861 PMCID: PMC6747843 DOI: 10.3390/ma12172739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/21/2022]
Abstract
The aim of this in vitro pilot study was to analyse the adhesion behaviour of human osteoblasts and fibroblasts on polyether ether ketone (PEEK) when compared with titanium surfaces in an inflammatory environment under lipopolysaccharide (LPS) incubation. Scanning electron microscopy (SEM) images of primary human osteoblasts/fibroblasts on titanium/PEEK samples were created. The gene expression of the LPS-binding protein (LBP) and the LPS receptor (toll-like receptor 4; TLR4) was measured by real-time polymerase chain reaction (PCR). Immunocytochemistry was used to obtain evidence for the distribution of LBP/TLR4 at the protein level of the extra-cellular-matrix-binding protein vinculin and the actin cytoskeleton. SEM images revealed that the osteoblasts and fibroblasts on the PEEK surfaces had adhesion characteristics comparable to those of titanium. The osteoblasts contracted under LPS incubation and a significantly increased LBP gene expression were detected. This was discernible at the protein level on all the materials. Whereas no increase of TLR4 was detected with regard to mRNA concentrations, a considerable increase in the antibody reaction was detected on all the materials. As is the case with titanium, the colonisation of human osteoblasts and fibroblasts on PEEK samples is possible under pro-inflammatory environmental conditions and the cellular inflammation behaviour towards PEEK is lower than that of titanium.
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Affiliation(s)
- Korbinian Benz
- Department of Oral Surgery and Dental Emergency Care, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany.
| | - Andreas Schöbel
- Department of Oral Surgery and Dental Emergency Care, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Marisa Dietz
- Department of Oral and Maxillofacial Surgery, Hospital North Dortmund, 44145 Dortmund, Germany
| | - Peter Maurer
- Private Practice Clinic for Oral Surgery, 66606 St. Wendel, Germany
| | - Jochen Jackowski
- Department of Oral Surgery and Dental Emergency Care, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
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Regeneration of large bone defects using mesoporous silica coated magnetic nanoparticles during distraction osteogenesis. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2019; 21:102040. [PMID: 31228602 DOI: 10.1016/j.nano.2019.102040] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 06/05/2019] [Accepted: 06/11/2019] [Indexed: 02/04/2023]
Abstract
Distraction osteogenesis (DO) represents an effective but undesirably lengthy treatment for large bone defects. Both magnetic nanoparticles and silicon have been shown to induce osteogenic differentiation of mesenchymal stem cells (MSCs), the key participant in bone regeneration. We herein synthesized mesoporous silica coated magnetic (Fe3O4) nanoparticles (M-MSNs) and evaluated its potential for acceleration of bone regeneration in a rat DO model. The M-MSNs exhibited good biocompatibility and remarkable capability in promoting the osteogenic differentiation of MSCs via the canonical Wnt/β-catenin pathway in vitro. More importantly, local injection of M-MSNs dramatically accelerated bone regeneration in a rat DO model according to the results of X-ray imaging, micro-CT, mechanical testing, histological examination, and immunochemical analysis. This study demonstrates the notable potential of M-MSNs in promoting bone regeneration during DO by enhancing the osteogenic differentiation of MSCs, paving the way for clinical translation of M-MSNs in DO to repair large bone defects.
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da S Feltran G, Bezerra F, da Costa Fernandes CJ, Ferreira MR, Zambuzzi WF. Differential inflammatory landscape stimulus during titanium surfaces obtained osteogenic phenotype. J Biomed Mater Res A 2019; 107:1597-1604. [PMID: 30884166 DOI: 10.1002/jbm.a.36673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/26/2018] [Indexed: 01/04/2023]
Abstract
Molecular mechanism governing inflammatory scenario in response to titanium (Ti)-nanotexturing surfaces needs to be better addressed. Thus, we subjected pre-osteoblast to different Ti-texturing surfaces, as follows: machined (Mac), double acid-etching (DAE), and nanoscaled hydroxyapatite-blasted titanium surface (nHA), considering the cells chronically responding either directly (when the cells were cultured onto the surfaces) or indirectly (when the cells were challenged with the conditioned medium by the surfaces), up to 10 days. Our results showed that there is a dynamic requirement of inflammatory-related genes activation in response to nHA by up expressing IL1ß, IL6, IL10, and IL33 (direct condition) and IL6, IL10, IL18 (indirect condition). Importantly, our data show that there is inflammasome involvement, once NLRP3, ASC1, and CASP1 genes were also required. As we found a strong signal of IL10, an anti-inflammatory cytokine, we further investigated Sonic Hedgehog (Shh) signaling cascade. Surprisingly, Shh ligand and Smoothened (Smo) genes were up-modulated in response to nHA, while Patched (Ptc) was down-modulated. Finally, an interactome was built using bioinformatics reinforcing Shh signaling cascade on modulating IL10 transcripts by Src mediating this process and this prevalence of anti-inflammatory picture might explain the low profile of RANKL transcripts in response to nHA, compromising the osteoclastogenesis surrounding the implants. Taking our results into account, our data show that the inflammatory landscape promoted by nHA is strictly modulated by Shh signaling promoted anti-inflammatory pathways. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1597-1604, 2019.
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Affiliation(s)
- Georgia da S Feltran
- Department of Chemistry and Biochemistry, Bioscience Institute, State University of São Paulo - UNESP, campus Botucatu, Botucatu, São Paulo, Brazil
| | - Fábio Bezerra
- Department of Chemistry and Biochemistry, Bioscience Institute, State University of São Paulo - UNESP, campus Botucatu, Botucatu, São Paulo, Brazil
| | - Célio Júnior da Costa Fernandes
- Department of Chemistry and Biochemistry, Bioscience Institute, State University of São Paulo - UNESP, campus Botucatu, Botucatu, São Paulo, Brazil
| | - Marcel Rodrigues Ferreira
- Department of Chemistry and Biochemistry, Bioscience Institute, State University of São Paulo - UNESP, campus Botucatu, Botucatu, São Paulo, Brazil
| | - Willian F Zambuzzi
- Department of Chemistry and Biochemistry, Bioscience Institute, State University of São Paulo - UNESP, campus Botucatu, Botucatu, São Paulo, Brazil.,Electron Microscopy Center, IBB, UNESP, Botucatu, São Paulo, Brazil
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Bathala L, Majeti V, Rachuri N, Singh N, Gedela S. The Role of Polyether Ether Ketone (Peek) in Dentistry - A Review. J Med Life 2019; 12:5-9. [PMID: 31123518 PMCID: PMC6527406 DOI: 10.25122/jml-2019-0003] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/21/2019] [Indexed: 11/17/2022] Open
Abstract
This study is aimed to review the applications of Polyether Ether Ketone (PEEK) in dentistry. The increased demand for aesthetics, legislation in some developed countries, few drawbacks with existing materials and clinicians shifting their paradigms towards metal free restorations led space for the metal-free restorations in today's dental practice. An electronic literature search was conducted through Medline via PubMed, Wiley Online library, EBSCOhost, Science Direct, as well as the Google Scholar between January 2010 and March 2018 using the keywords: PEEK, modified PEEK, PEEK and Dental, advantages of PEEK, applications of PEEK in dentistry and PEEK Implants. A total of 103 articles were found in the literature search and out of these, 18 were not related to our study and hence were excluded. Finally, 85 articles were found to be relevant. PEEK has been explained for a number of applications in dental practice. The literature showed that the PEEK material has superior mechanical properties with different uses in various specialties of dentistry.
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Affiliation(s)
- Lakshmana Bathala
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, India
| | - Vaishnavi Majeti
- Department of Oral & Maxillofacial Surgery, Lenora Institute of Dental Sciences, Rajahmundry, India
| | - Narendra Rachuri
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, India
| | - Nibha Singh
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, India
| | - Sirisha Gedela
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, India
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Barkarmo S, Östberg AK, Johansson CB, Franco-Tabares S, Johansson PH, Dahlgren U, Stenport V. Inflammatory cytokine release from human peripheral blood mononuclear cells exposed to polyetheretherketone and titanium-6 aluminum-4 vanadium in vitro. J Biomater Appl 2018; 33:245-258. [PMID: 30001662 DOI: 10.1177/0885328218786005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective To investigate the cytokine expression profiles of blood cells exposed to polyetheretherketone and titanium-6 aluminum-4 vanadium materials in vitro. Materials and methods Coin-shaped samples composed of titanium-6 aluminum-4 vanadium, polyetheretherketone, and blasted polyetheretherketone were manufactured. The surfaces of the coins were characterized using optical interferometry, scanning electron microscopy, and contact angle measurements. Peripheral blood mononuclear cells collected from 10 blood donors were cultured for one, three, and six days in the presence or absence of the coins, and then assayed for cytokine production. Quantification of the peripheral blood mononuclear cells attached to the coins was performed using confocal microscopy after immunofluorescence staining. Results The machined titanium-6 aluminum-4 vanadium coins had a smoother surface topography compared to the machined polyetheretherketone and blasted polyetheretherketone. The highest mean contact angle was noted for the blasted polyetheretherketone, followed by the machined polyetheretherketone and titanium-6 aluminum-4 vanadium. The peripheral blood mononuclear cells produced significantly more proinflammatory cytokines when exposed to the polyetheretherketone surface compared to the titanium-6 aluminum-4 vanadium surface, while the blasted polyetheretherketone induced the highest level of proinflammatory cytokine release from the peripheral blood mononuclear cells. Significantly more cells attached to both polyetheretherketone surfaces, as compared to the titanium-6 aluminum-4 vanadium surface. Conclusion Polyetheretherketone induces a stronger inflammatory response from peripheral blood mononuclear cells than does titanium-6 aluminum-4 vanadium. Surface topography has an impact on cytokine release from peripheral blood mononuclear cells.
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Affiliation(s)
- Sargon Barkarmo
- The Sahlgrenska Academy, Institute of Odontology, Göteborg, Sweden
| | | | | | | | | | - Ulf Dahlgren
- The Sahlgrenska Academy, Institute of Odontology, Göteborg, Sweden
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Hughes EAB, Parkes A, Williams RL, Jenkins MJ, Grover LM. Formulation of a covalently bonded hydroxyapatite and poly(ether ether ketone) composite. J Tissue Eng 2018; 9:2041731418815570. [PMID: 30574291 PMCID: PMC6299303 DOI: 10.1177/2041731418815570] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/31/2018] [Indexed: 01/21/2023] Open
Abstract
Spinal fusion devices can be fabricated from composites based on combining hydroxyapatite and poly(ether ether ketone) phases. These implants serve as load-bearing scaffolds for the formation of new bone tissue between adjacent vertebrae. In this work, we report a novel approach to covalently bond hydroxyapatite and poly(ether ether ketone) to produce a novel composite formulation with enhanced interfacial adhesion between phases. Compared to non-linked composites (HA_PEEK), covalently linked composites (HA_L_PEEK), loaded with 1.25 vol% hydroxyapatite, possessed a greater mean flexural strength (170 ± 5.4 vs 171.7 ± 14.8 MPa (mean ± SD)) and modulus (4.8 ± 0.2 vs 5.0 ± 0.3 GPa (mean ± SD)). Although the mechanical properties were not found to be significantly different (p > 0.05), PEEK_L_HA contained substantially larger hydroxyapatite inclusions (100-1000 µm) compared to HA_PEEK (50-200 µm), due to the inherently agglomerative nature of the covalently bonded hydroxyapatite and poly(ether ether ketone) additive. Larger inclusions would expectedly weaken the HA_L_PEEK composite; however, there is no significant difference between the flexural modulus of poly(ether ether ketone) with respect to HA_L_PEEK (p = 0.13). In addition, the flexural modulus of HA_PEEK is significantly lower compared to poly(ether ether ketone) (p = 0.03). Ultimately, covalent linking reduces hydroxyapatite particulate de-bonding from the polymeric matrix and inhibits micro-crack development, culminating in enhanced transfer of stiffness between hydroxyapatite and poly(ether ether ketone) under loading.
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Affiliation(s)
- Erik AB Hughes
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK
| | - Andrew Parkes
- School of Metallurgy and Materials, University of Birmingham, Birmingham, UK
| | - Richard L Williams
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Mike J Jenkins
- School of Metallurgy and Materials, University of Birmingham, Birmingham, UK
| | - Liam M Grover
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
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Mounir M, Atef M, Abou-Elfetouh A, Hakam MM. Titanium and polyether ether ketone (PEEK) patient-specific sub-periosteal implants: two novel approaches for rehabilitation of the severely atrophic anterior maxillary ridge. Int J Oral Maxillofac Surg 2017; 47:658-664. [PMID: 29183698 DOI: 10.1016/j.ijom.2017.11.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to assess two new protocols for single-stage rehabilitation of the severely atrophic maxillary ridge using customized porous titanium or polyether ether ketone (PEEK) sub-periosteal implants. Ten patients with a severely atrophic anterior maxillary alveolar ridge were divided randomly into two groups (five patients in each) to receive customized sub-periosteal implants fabricated via CAD/CAM technology: group 1, porous titanium implants; group 2, PEEK implants. Prosthetic loading with fixed acrylic bridges was performed 1 month postoperative. The implants were followed-up for 12 months and evaluated for the presence of any sign of radiographic bone resorption, mobility, infection, prosthetic fracture, or implant exposure. The immediate postoperative period was uneventful except for one case complicated by wound dehiscence in group 1. At 12 months, all implants were functionally stable and the patients were comfortable with the prostheses. No signs of radiographic bone resorption, mobility, infection, or prosthetic fracture were observed. Within the limitations of this study, the application of customized porous titanium and PEEK sub-periosteal implants produced through CAD/CAM technology appears to be an acceptable method for single-stage prosthetic rehabilitation of the severely atrophic edentulous anterior maxilla. This study was awarded the best case study at the academy of osseintegration annual meeting 2017, Orlando, Florida.
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Affiliation(s)
- M Mounir
- Oral and Maxillofacial Surgery department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - M Atef
- Oral and Maxillofacial Surgery department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - A Abou-Elfetouh
- Oral and Maxillofacial Surgery department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - M M Hakam
- Oral and Maxillofacial Surgery department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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19
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Bhatt A, Anbarasu A. Rapid and economic synthesis of bone like apatite using simulated body fluid (SBF). ACTA ACUST UNITED AC 2017. [DOI: 10.1080/14328917.2017.1404203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Akshay Bhatt
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Anand Anbarasu
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
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20
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Hsu WK, Goldstein CL, Shamji MF, Cho SK, Arnold PM, Fehlings MG, Mroz TE. Novel Osteobiologics and Biomaterials in the Treatment of Spinal Disorders. Neurosurgery 2017; 80:S100-S107. [PMID: 28350951 DOI: 10.1093/neuros/nyw085] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/11/2017] [Indexed: 12/12/2022] Open
Abstract
Spinal osteobiologics have evolved substantially in this century after the development of many product categories such as growth factors, allograft, and stem cells. The indications for the use of novel biologics within spine surgery are rapidly expanding as the mechanism of each is elucidated. While the knowledge base of bone morphogenetic protein increases with each subsequent year, the application of new nanotechnology and cell-based strategies are being reported. This review will discuss the most recent data in novel osteobiologics, and where we could use future study.
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Affiliation(s)
- Wellington K Hsu
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Mohammed F Shamji
- Department of Orthopaedic Surgery, University of Toronto, Toronto, Canada
| | - Sam K Cho
- Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, New York
| | - Paul M Arnold
- Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Missouri
| | - Michael G Fehlings
- Department of Orthopaedic Surgery, University of Toronto, Toronto, Canada
| | - Tom E Mroz
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
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21
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Bezerra F, Ferreira MR, Fontes GN, da Costa Fernandes CJ, Andia DC, Cruz NC, da Silva RA, Zambuzzi WF. Nano hydroxyapatite-blasted titanium surface affects pre-osteoblast morphology by modulating critical intracellular pathways. Biotechnol Bioeng 2017; 114:1888-1898. [DOI: 10.1002/bit.26310] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/16/2017] [Accepted: 04/03/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Fábio Bezerra
- Department of Chemistry and Biochemistry, Bioscience Institute; State University of São Paulo-UNESP; P.O. Box: 510, 18618-970, Rubião Jr, campus Botucatu, São Paulo Botucatu Brazil
| | - Marcel R. Ferreira
- Department of Chemistry and Biochemistry, Bioscience Institute; State University of São Paulo-UNESP; P.O. Box: 510, 18618-970, Rubião Jr, campus Botucatu, São Paulo Botucatu Brazil
| | - Giselle N. Fontes
- Laboratory of Microscopy Applied to Life Science-LAMAV, Directory of Metrology Applied to Life Science-Dimav; National Institute of Metrology Quality and Technology-INMETRO; Duque de Caxias Rio de Janeiro Brazil
| | - Célio Jr da Costa Fernandes
- Department of Chemistry and Biochemistry, Bioscience Institute; State University of São Paulo-UNESP; P.O. Box: 510, 18618-970, Rubião Jr, campus Botucatu, São Paulo Botucatu Brazil
| | - Denise C. Andia
- Health Science Institute, Dental Research Division, Department of Epigenetics; Paulista University - UNIP; São Paulo, SP Brazil
| | - Nilson C. Cruz
- Laboratório de Plasmas Tecnológicos; Instituto de Ciência e Tecnologia; Universidade Estadual Paulista; Sorocaba-SP Brazil
| | - Rodrigo A. da Silva
- Department of Chemistry and Biochemistry, Bioscience Institute; State University of São Paulo-UNESP; P.O. Box: 510, 18618-970, Rubião Jr, campus Botucatu, São Paulo Botucatu Brazil
| | - Willian F. Zambuzzi
- Department of Chemistry and Biochemistry, Bioscience Institute; State University of São Paulo-UNESP; P.O. Box: 510, 18618-970, Rubião Jr, campus Botucatu, São Paulo Botucatu Brazil
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Weigand A, Beier JP, Schmid R, Knorr T, Kilian D, Götzl R, Gerber T, Horch RE, Boos AM. Bone Tissue Engineering Under Xenogeneic-Free Conditions in a Large Animal Model as a Basis for Early Clinical Applicability. Tissue Eng Part A 2017; 23:208-222. [PMID: 27998239 DOI: 10.1089/ten.tea.2016.0176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
For decades, researchers have been developing a range of promising strategies in bone tissue engineering with the aim of producing a significant clinical benefit over existing therapies. However, a major problem concerns the traditional use of xenogeneic substances for the expansion of cells, which complicates direct clinical transfer. The study's aim was to establish a totally autologous sheep model as a basis for further preclinical studies and future clinical application. Ovine mesenchymal stromal cells (MSC) were cultivated in different concentrations (0%, 2%, 5%, 10%, and 25%) of either autologous serum (AS) or fetal calf serum (FCS). With an increase of serum concentration, enhanced metabolic activity and proliferation could be observed. There were minor differences between MSC cultivated in AS or FCS, comparing gene and protein expression of osteogenic and stem cell markers, morphology, and osteogenic differentiation. MSC implanted subcutaneously in the sheep model, together with a nanostructured bone substitute, either in stable block or moldable putty form, induced similar vascularization and remodeling of the bone substitute irrespective of cultivation of MSC in AS or FCS and osteogenic differentiation. The bone substitute in block form together with MSC proved particularly advantageous in the induction of ectopic bone formation compared to the cell-free control and putty form. It could be demonstrated that AS is suitable for replacement of FCS for cultivation of ovine MSC for bone tissue engineering purposes. Substantial progress has been made in the development of a strictly xenogeneic-free preclinical animal model to bring future clinical application of bone tissue engineering strategies within reach.
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Affiliation(s)
- Annika Weigand
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Justus P Beier
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Rafael Schmid
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Tobias Knorr
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - David Kilian
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Rebekka Götzl
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Thomas Gerber
- 2 Institute of Physics, University of Rostock , Rostock, Germany
| | - Raymund E Horch
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Anja M Boos
- 1 Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU) , Erlangen, Germany
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Mahjoubi H, Buck E, Manimunda P, Farivar R, Chromik R, Murshed M, Cerruti M. Surface phosphonation enhances hydroxyapatite coating adhesion on polyetheretherketone and its osseointegration potential. Acta Biomater 2017; 47:149-158. [PMID: 27717913 DOI: 10.1016/j.actbio.2016.10.004] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/28/2016] [Accepted: 10/03/2016] [Indexed: 12/19/2022]
Abstract
Polyetheretherketone (PEEK) has excellent mechanical properties, biocompatibility, chemical resistance and radiolucency, making it suitable for use as orthopedic implants. However, its surface is hydrophobic and bioinert, and surface modification is required to improve its bioactivity. In this work, we showed that grafting phosphonate groups via diazonium chemistry enhances the bioactivity of PEEK. Decreased contact angle indicated reduced hydrophobicity as a result of the treatment and X-ray photoelectron spectroscopy (XPS) confirmed the attachment of phosphonate groups to the surface. The surface treatment not only accelerated hydroxyapatite (HA) deposition after immersion in simulated body fluid but also significantly increased the adhesion strength of HA particles on PEEK. MC3T3-E1 cell viability, metabolic activity and deposition of calcium-containing minerals were also enhanced by the phosphonation. After three months of implantation in a critical size calvarial defect model, a fibrous capsule surrounded untreated PEEK while no fibrous capsule was observed around the treated PEEK. Instead, mineral deposition was observed in the region between the treated PEEK implant and underlying bone. This work introduces a simple method to improve the potential of PEEK-based orthopedic implants. STATEMENT OF SIGNIFICANCE We have introduced phosphonate groups on the surface of PEEK substrates using diazonium chemistry. Our results show that the treatment not only increased the adhesion strength of hydroxyapatite particles deposited on PEEK in vitro by approximately 40% compared to unmodified PEEK, but also improved the metabolic activity and mineralization of MC3T3-E1 cells. When implanted in cranial defects in rats, the phosphonate coating enhanced the osseointegration of PEEK by successfully preventing the formation of a fibrous capsule and favoring mineral deposition between the implant and the surrounding bone. This work introduces a simple method to improve the potential of PEEK-based orthopedic implants, particularly those with complex shapes.
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Najeeb S, Zafar MS, Khurshid Z, Siddiqui F. Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics. J Prosthodont Res 2016; 60:12-9. [PMID: 26520679 DOI: 10.1016/j.jpor.2015.10.001] [Citation(s) in RCA: 392] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/15/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Polyetheretherketone (PEEK) is a polymer that has many potential uses in dentistry. The aim of this review was to summarize the outcome of research conducted on the material for dental applications. In addition, future prospects of PEEK in the field of clinical dentistry have been highlighted. STUDY SELECTION An electronic search was carried out via the PubMed (Medline) database using keywords 'polyetheretherketone', 'dental' and 'dentistry' in combination. Original research papers published in English language in last fifteen year were considered. The studies relevant to our review were critically analyzed and summarized. RESULTS PEEK has been explored for a number of applications for clinical dentistry. For example, PEEK dental implants have exhibited lesser stress shielding compared to titanium dental implants due to closer match of mechanical properties of PEEK and bone. PEEK is a promising material for a number of removable and fixed prosthesis. Furthermore, recent studies have focused improving the bioactivity of PEEK implants at the nanoscale. CONCLUSION Considering mechanical and physical properties similar to bone, PEEK can be used in many areas of dentistry. Improving the bioactivity of PEEK dental implants without compromising their mechanical properties is a major challenge. Further modifications and improving the material properties may increase its applications in clinical dentistry.
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Affiliation(s)
- Shariq Najeeb
- School of Clinical Dentistry, University of Sheffield, United Kingdom
| | - Muhammad S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Al Munawwarah, Saudi Arabia.
| | - Zohaib Khurshid
- School of Metallurgy and Materials, University of Birmingham, Edgbaston, Birmingham, UK; Department of Biomedical Engineering, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Fahad Siddiqui
- Division of Oral Health & Society, Faculty of Dentistry, McGill University, Montreal, Canada
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Wen J, Lu T, Wang X, Xu L, Wu Q, Pan H, Wang D, Liu X, Jiang X. In Vitro and in Vivo Evaluation of Silicate-Coated Polyetheretherketone Fabricated by Electron Beam Evaporation. ACS APPLIED MATERIALS & INTERFACES 2016; 8:13197-13206. [PMID: 27124890 DOI: 10.1021/acsami.5b10229] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Intrinsic bioinertness severely hampers the application of polyetheretherketone (PEEK), although in the field of dentistry it is considered to be an ideal titanium substitute implanting material. In this study, a bioactive silicate coating was successfully introduced onto PEEK surface by using electron beam evaporation (EBE) technology to improve its bioactivity and osseointegration of PEEK. Through controlling the duration of EBE, the incorporated amounts of silicon (Si) could be exquisitely adjusted to obtain proper biofunctionality, as assessed by cell adhesion, proliferation, osteogenic gene expression, and protein detection. In vivo, the samples were then tested in a femur implantation model to assay osseointegration effects in ovariectomized (OVX) rats. Remarkable enhancement of adhesion, spreading, osteogenesis, and differentiation of bone marrow stem cells (rBMSCs-OVX) were noted on silicate-coated samples. In particular, the group that was processed for 5 min with EBE (EBE-5 min) showed the most improvements in ALP activity and osteogenic-related gene expression compared to the remaining groups. Better osseointegration of the group that was processed for 8 min with EBE (EBE-8 min) was observed in vivo, as indicated by micro-CT test, fluorescent labeling, and histological and histomorphometric analyses. Collectively, the outcomes of the above experiments demonstrate that the present work is a meaningful attempt to promote osseointegration under osteoporotic conditions with only Si element incorporated to PEEK surface by the application of EBE technique. To the best of our knowledge, this work is the first demonstration of tuning the surface properties of PEEK via the adoption of an EBE-fabricated silicate coating to address an osteoporotic problem both in vitro and in vivo.
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Affiliation(s)
- Jin Wen
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine , 639 Zhizaoju Road, Shanghai 200011, China
- Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology , 639 Zhizaoju Road, Shanghai 200011, China
| | - Tao Lu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences , Shanghai 200050, China
| | - Xiao Wang
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine , 639 Zhizaoju Road, Shanghai 200011, China
- Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology , 639 Zhizaoju Road, Shanghai 200011, China
| | - Lianyi Xu
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine , 639 Zhizaoju Road, Shanghai 200011, China
- Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology , 639 Zhizaoju Road, Shanghai 200011, China
| | - Qianju Wu
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine , 639 Zhizaoju Road, Shanghai 200011, China
- Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology , 639 Zhizaoju Road, Shanghai 200011, China
| | - Hongya Pan
- Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology , 639 Zhizaoju Road, Shanghai 200011, China
| | - Donghui Wang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences , Shanghai 200050, China
| | - Xuanyong Liu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences , Shanghai 200050, China
| | - Xinquan Jiang
- Department of Prosthodontics, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine , 639 Zhizaoju Road, Shanghai 200011, China
- Oral Bioengineering Lab, Shanghai Research Institute of Stomatology, Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology , 639 Zhizaoju Road, Shanghai 200011, China
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Johansson P, Jimbo R, Naito Y, Kjellin P, Currie F, Wennerberg A. Polyether ether ketone implants achieve increased bone fusion when coated with nano-sized hydroxyapatite: a histomorphometric study in rabbit bone. Int J Nanomedicine 2016; 11:1435-42. [PMID: 27103801 PMCID: PMC4827897 DOI: 10.2147/ijn.s100424] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Polyether ether ketone (PEEK) possesses excellent mechanical properties similar to those of human bone and is considered the best alternative material other than titanium for orthopedic spine and trauma implants. However, the deficient osteogenic properties and the bioinertness of PEEK limit its fields of application. The aim of this study was to limit these drawbacks by coating the surface of PEEK with nano-scaled hydroxyapatite (HA) minerals. In the study, the biological response to PEEK, with and without HA coating, was investigated. Twenty-four screw-like and apically perforated implants in the rabbit femur were histologically evaluated at 3 weeks and 12 weeks after surgery. Twelve of the 24 implants were HA coated (test), and the remaining 12 served as uncoated PEEK controls. At 3 weeks and 12 weeks, the mean bone–implant contact was higher for test compared to control (P<0.05). The bone area inside the threads was comparable in the two groups, but the perforating hole showed more bone area for the HA-coated implants at both healing points (P<0.01). With these results, we conclude that nano-sized HA coating on PEEK implants significantly improved the osteogenic properties, and in a clinical situation this material composition may serve as an implant where a rapid bone fusion is essential.
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Affiliation(s)
- Pär Johansson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ryo Jimbo
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Yoshihito Naito
- Oral Implant Center, Tokushima University Hospital, Tokushima, Japan
| | | | | | - Ann Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Nanomodified Peek Dental Implants: Bioactive Composites and Surface Modification-A Review. Int J Dent 2015; 2015:381759. [PMID: 26495000 PMCID: PMC4606406 DOI: 10.1155/2015/381759] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/30/2015] [Indexed: 12/21/2022] Open
Abstract
Purpose. The aim of this review is to summarize and evaluate the relevant literature regarding the different ways how polyetheretherketone (PEEK) can be modified to overcome its limited bioactivity, and thereby making it suitable as a dental implant material. Study Selection. An electronic literature search was conducted via the PubMed and Google Scholar databases using the keywords “PEEK dental implants,” “nano,” “osseointegration,” “surface treatment,” and “modification.” A total of 16 in vivo and in vitro studies were found suitable to be included in this review. Results. There are many viable methods to increase the bioactivity of PEEK. Most methods focus on increasing the surface roughness, increasing the hydrophilicity and coating osseoconductive materials. Conclusion. There are many ways in which PEEK can be modified at a nanometer level to overcome its limited bioactivity. Melt-blending with bioactive nanoparticles can be used to produce bioactive nanocomposites, while spin-coating, gas plasma etching, electron beam, and plasma-ion immersion implantation can be used to modify the surface of PEEK implants in order to make them more bioactive. However, more animal studies are needed before these implants can be deemed suitable to be used as dental implants.
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Calcium orthophosphate deposits: Preparation, properties and biomedical applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 55:272-326. [PMID: 26117762 DOI: 10.1016/j.msec.2015.05.033] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/21/2015] [Accepted: 05/08/2015] [Indexed: 01/12/2023]
Abstract
Since various interactions among cells, surrounding tissues and implanted biomaterials always occur at their interfaces, the surface properties of potential implants appear to be of paramount importance for the clinical success. In view of the fact that a limited amount of materials appear to be tolerated by living organisms, a special discipline called surface engineering was developed to initiate the desirable changes to the exterior properties of various materials but still maintaining their useful bulk performances. In 1975, this approach resulted in the introduction of a special class of artificial bone grafts, composed of various mechanically stable (consequently, suitable for load bearing applications) implantable biomaterials and/or bio-devices covered by calcium orthophosphates (CaPO4) to both improve biocompatibility and provide an adequate bonding to the adjacent bones. Over 5000 publications on this topic were published since then. Therefore, a thorough analysis of the available literature has been performed and about 50 (this number is doubled, if all possible modifications are counted) deposition techniques of CaPO4 have been revealed, systematized and described. These CaPO4 deposits (coatings, films and layers) used to improve the surface properties of various types of artificial implants are the topic of this review.
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