New Zr-Ti-Nb Alloy for Medical Application: Development, Chemical and Mechanical Properties, and Biocompatibility

PEEK stress-shielding with artificial bone for dental implants

Dental titanium implants and their surface modifications markedly improve implant biocompatibility. However, studies evaluating the mechanical biocompatibility of implants are scarce. In particular, the analysis of mechanical biocompatibility deficiencies leading to stress shield-induced bone resorption. Recently, we focused on using PEEK as a dental material. This study explored the hypothesis that PEEK implants improve the stress shielding of titanium. In this study, artificial bone surfaces were examined to measure strains on the artificial bone surface under compressive loading with the implants in place. Additionally, 3D image analysis of the fracture state inside the bone tissue was performed using micro-CT (µCT). This hypothesis was supported by µCT imaging analysis of bone tissue changes under stress, which revealed that PEEK implants transfer greater loads than titanium implants. µCT imaging and statistical analysis showed that bone porosity had little effect on stress shielding.

Microstructure and Micro-Mechanical Properties of Thermally Sprayed HA-TiO2 Coating on Beta-Titanium Substrate

Metallic biomaterials in a solid form cause stress-shielding in orthopedic applications. Such implants also suffer from limited tissue attachment to become a part of the living system. In view of that, hydroxyapatite (HA) coating reinforced with titanium oxide (TiO2) was deposited in a beta (β)-Titanium (Ti-35Nb-7Ta-5Zr) substrate by plasma spray. This allows us to exploit the best of the two materials, namely the relatively low modulus of β-Ti, together with the porous and bone-like structure/composition of the HA to facilitate cell growth. This is foreseen to be used as an implant, particularly for musculoskeletal-related disability. Detailed scanning electron microscopy (SEM) investigation shows the lamellar structure of the coating that is composed of different phases and some porosities. Transmission electron microscopy (TEM) confirms the co-existence of both the amorphous and crystalline phases that build up the coating structure. In situ micro-mechanical tests revealed that the HA-TiO2 coating was low in strength and modules compared to that of the substrate material, together with lower ductility. The yield stress and modulus of elasticity of the coating were about 877 ± 174 MPa and 447 ± 24 MPa, respectively. In contrast, the beta (β)-Ti substrate possesses about 990 ± 85 MPa of yield stress and 259 ± 19 MPa modulus of elasticity. The deformation mechanism was also quite different, where the coating crumbled under compressive loading, featuring limited ductility with cleavage (brittle)-type fracture, and the substrate showed plastic flow of materials in the form of slip/shear planes with extended ductility.

Recent Advances and Prospects in β-type Titanium Alloys for Dental Implants Applications

Titanium and its alloys, especially Ti-6Al-4V, are widely studied in implantology for their favorable characteristics. However, challenges remain, such as the high modulus of elasticity and concerns about cytotoxicity. To resolve these issues, research focuses on β-type titanium alloys that incorporate elements such as Mo, Nb, Sn, and Ta to improve corrosion resistance and obtain a lower modulus of elasticity compatible with bone. This review comprehensively examines current β titanium alloys, evaluating their mechanical properties, in particular the modulus of elasticity, and corrosion resistance. To this end, a systematic literature search was carried out, where 81 articles were found to evaluate these outcomes. In addition, this review also covers the formation of the alloy, processing methods such as arc melting, and its physical, mechanical, electrochemical, tribological, and biological characteristics. Because β-Ti alloys have a modulus of elasticity closer to that of human bone compared to other metal alloys, they help reduce stress shielding. This is important because the alloy allows for a more even distribution of forces by having a modulus of elasticity more similar to that of bone. In addition, these alloys show good corrosion resistance due to the formation of a noble titanium oxide layer, facilitated by the incorporation of β stabilizers. These alloys also show significant improvements in mechanical strength and hardness. Finally, they also have lower cytotoxicity and bacterial adhesion, depending on the β stabilizer used. However, there are persistent challenges that require detailed research in critical areas, such as optimizing the composition of the alloy to achieve optimal properties in different clinical applications. In addition, it is crucial to study the long-term effects of implants on the human body and to advance the development of cutting-edge manufacturing techniques to guarantee the quality and biocompatibility of implants.

Biomechanical Analysis of Axial Gradient Porous Dental Implants: A Finite Element Analysis

The porous structure can reduce the elastic modulus of a dental implant and better approximate the elastic characteristics of the material to the alveolar bone. Therefore, it has the potential to alleviate bone stress shielding around the implant. However, natural bone is heterogeneous, and, thus, introducing a porous structure may produce pathological bone stress. Herein, we designed a porous implant with axial gradient variation in porosity to alleviate stress shielding in the cancellous bone while controlling the peak stress value in the cortical bone margin region. The biomechanical distribution characteristics of axial gradient porous implants were studied using a finite element method. The analysis showed that a porous implant with an axial gradient variation in porosity ranging from 55% to 75% was the best structure. Under vertical and oblique loads, the proportion of the area with a stress value within the optimal stress interval at the bone-implant interface (BII) was 40.34% and 34.57%, respectively, which was 99% and 65% higher compared with that of the non-porous implant in the control group. Moreover, the maximum equivalent stress value in the implant with this pore parameter was 64.4 MPa, which was less than 1/7 of its theoretical yield strength. Axial gradient porous implants meet the strength requirements for bone implant applications. They can alleviate stress shielding in cancellous bone without increasing the stress concentration in the cortical bone margin, thereby optimizing the stress distribution pattern at the BII.

Solid-State Processing of CoCrMoNbTi High-Entropy Alloy for Biomedical Applications

High-entropy alloys (HEAs) gained interest in the field of biomedical applications due to their unique effects and to the combination of the properties of the constituent elements. In addition to the required property of biocompatibility, other requirements include properties such as mechanical resistance, bioactivity, sterility, stability, cost effectiveness, etc. For this paper, a biocompatible high-entropy alloy, defined as bio-HEA by the literature, can be considered as an alternative to the market-available materials due to their superior properties. According to the calculation of the valence electron concentration, a majority of body-centered cubic (BCC) phases were expected, resulting in properties such as high strength and plasticity for the studied alloy, confirmed by the XRD analysis. The tetragonal (TVC) phase was also identified, indicating that the presence of face-centered cubic (FCC) phases in the alloyed materials resulted in high ductility. Microstructural and compositional analyses revealed refined and uniform metallic powder particles, with a homogeneous distribution of the elemental particles observed from the mapping analyses, indicating that alloying had occurred. The technological characterization of the high-entropy alloy-elaborated powder revealed the particle dimension reduction due to the welding and fracturing process that occurs during mechanical alloying, with a calculated average particle size of 45.12 µm.

Microstructural, Biomechanical, and In Vitro Studies of Ti-Nb-Zr Alloys Fabricated by Powder Metallurgy

This study investigated the microstructures, mechanical performances, corrosion resistances, and in vitro studies of porous Ti-xNb-10Zr (x: 10 and 20; at. %) alloys. The alloys were fabricated by powder metallurgy with two categories of porosities, i.e., 21-25% and 50-56%, respectively. The space holder technique was employed to generate the high porosities. Microstructural analysis was performed by using various methods including scanning electron microscopy, energy dispersive spectroscopy, electron backscatter diffraction, and x-ray diffraction. Corrosion resistance was assessed via electrochemical polarisation tests, while mechanical behavior was determined by uniaxial compressive tests. In vitro studies, such as cell viability and proliferation, adhesion potential, and genotoxicity, were examined by performing an MTT assay, fibronectin adsorption, and plasmid-DNA interaction assay. Experimental results showed that the alloys had a dual-phase microstructure composed of finely dispersed acicular hcp α-Ti needles in the bcc β-Ti matrix. The ultimate compressive strength ranged from 1019 MPa to 767 MPa for alloys with 21-25% porosities and from 173 MPa to 78 MPa for alloys with 50-56% porosities. Noted that adding a space holder agent played a more critical role in the mechanical behaviors of the alloys compared to adding niobium. The pores were largely open and exhibited irregular shapes, with uniform size distribution, allowing for cell ingrowth. Histological analysis showed that the alloys studied met the biocompatibility criteria required for orthopaedic biomaterial use.

Optimization of stress distribution of bone-implant interface (BII)

Many studies have found that the threshold of occlusal force tolerated by titanium-based implants is significantly lower than that of natural teeth due to differences in biomechanical mechanisms. Therefore, implants are considered to be susceptible to occlusal trauma. In clinical practice, many implants have shown satisfactory biocompatibility, but the balance between biomechanics and biofunction remains a huge clinical challenge. This paper comprehensively analyzes and summarizes various stress distribution optimization methods to explore strategies for improving the resistance of the implants to adverse stress. Improving stress resistance reduces occlusal trauma and shortens the gap between implants and natural teeth in occlusal function. The study found that: 1) specific implant-abutment connection design can change the force transfer efficiency and force conduction direction of the load at the BII; 2) reasonable implant surface structure and morphological character design can promote osseointegration, maintain alveolar bone height, and reduce the maximum effective stress at the BII; and 3) the elastic modulus of implants matched to surrounding bone tissue can reduce the stress shielding, resulting in a more uniform stress distribution at the BII. This study concluded that the core BII stress distribution optimization lies in increasing the stress distribution area and reducing the local stress peak value at the BII. This improves the biomechanical adaptability of the implants, increasing their long-term survival rate.

Alloy Design and Fabrication of Duplex Titanium-Based Alloys by Spark Plasma Sintering for Biomedical Implant Applications

Very often, pure Ti and (α + β) Ti-6Al-4V alloys have been used commercially for implant applications, but ensuring their chemical, mechanical, and biological biocompatibility is always a serious concern for sustaining the long-term efficacy of implants. Therefore, there has always been a great quest to explore new biomedical alloying systems that can offer substantial beneficial effects in tailoring a balance between the mechanical properties and biocompatibility of implantable medical devices. With a view to the mechanical performance, this study focused on designing a Ti-15Zr-2Ta-xSn (where x = 4, 6, 8) alloying system with high strength and low Young's modulus prepared by a powder metallurgy method. The experimental results showed that mechanical alloying, followed by spark plasma sintering, produced a fully consolidated (α + β) Ti-Zr-Ta-Sn-based alloy with a fine grain size and a relative density greater than 99%. Nevertheless, the shape, size, and distribution of α-phase precipitations were found to be sensitive to Sn contents. The addition of Sn also increased the α/β transus temperature of the alloy. For example, as the Sn content was increased from 4 wt.% to 8 wt.%, the β grains transformed into diverse morphological characteristics, namely, a thin-grain-boundary α phase (α_GB), lamellar α colonies, and acicular α_s precipitates and very low residual porosity during subsequent cooling after the spark plasma sintering procedure, which is consistent with the relative density results. Among the prepared alloys, Ti-15Zr-2Ta-8Sn exhibited the highest hardness (s340 HV), compressive yield strength (~1056 MPa), and maximum compressive strength (~1470). The formation of intriguing precipitate-matrix interfaces (α/β) acting as dislocation barriers is proposed to be the main reason for the high strength of the Ti-15Zr-2Ta-8Sn alloy. Finally, based on mechanical and structural properties, it is envisaged that our developed alloys will be promising for indwelling implant applications.

Approaches to Biofunctionalize Polyetheretherketone for Antibacterial: A Review

Due to excellent mechanical properties and similar elastic modulus compared with human cortical bone, polyetheretherketone (PEEK) has become one of the most promising orthopedic implant materials. However, implant-associated infections (IAIs) remain a challenging issue since PEEK is bio-inert. In order to fabricate an antibacterial bio-functional surface, modifications of PEEK had been widely investigated. This review summarizes the modification strategies to biofunctionalize PEEK for antibacterial. We will begin with reviewing different approaches, such as surface-coating modifications and controlled release of antimicrobials. Furthermore, blending modifications and 3D printing technology were discussed. Finally, we compare the effects among different approaches. We aimed to provide an in-depth understanding of the antibacterial modification and optimize the design of the PEEK orthopedic implant.

Study of Electrochemical and Biological Characteristics of As-Cast Ti-Nb-Zr-Ta System Based on Its Microstructure

The quaternary Ti-Nb-Zr-Ta (TNZT) alloy was successfully cast-fabricated with the objective to be used in the medical field. Samples’ microstructure was compared to CP-Ti and Ti-6Al-4V (control samples) and related to corrosion, ion release and biological properties. As-cast TNZT was formed with large β grain sizes (285 µm) compared to the ultrafine α grain sizes of CP-Ti (11 µm) and the α + β ultrafine grain sizes of 1.45 µm and 0.74 µm. Hardness and flexural elastic moduli (94 HV and 43 GPa) came close to the biological structures, such as dentin and enamel values. The ion release mechanism of as-cast TNZT was significantly lesser than CP-Ti and Ti-6Al-4V, which can be related to the difference in samples’ grain sizes and chemical compositions. However, the corrosion rate was higher than for the control samples; this way offers corrosion properties inferior with respect to the properties obtained in the reference materials. Biological assays demonstrated that the two-cell (hDPSCs and MG-63) lineage studied presented good adhesion and capability to differentiate in bone cells on the as-cast TNZT surface, and no cytotoxicity effects were found. Details and reasons based on samples’ microstructure are discussed.

Characterization of Titanium Alloy Obtained by Powder Metallurgy

Ti-based alloys are an important class of materials suitable especially for medical applications, but they are also used in the industrial sector. Due to their low tribological properties it is necessary to find optimal technologies and alloying elements in order to develop new alloys with improved properties. In this paper, a study on the influence of sintering treatments on the final properties of a titanium alloy is presented. The alloy of interest was obtained using the powders in following weight ratio: 80% wt Ti, 8% wt Mn, 3% wt Sn, 6% wt Aluminix123, 2% wt Zr and 1% wt graphite. Two sintering methods were used, namely two-step sintering (TSS) and multiple-step sintering (MSS), as alternatives to conventional sintering which uses a single sintering dwell time. Evolution of sample morphology, composition and crystalline structure with sintering method was evidenced. The lower values for the friction coefficient and for the wear rate was attained in the case of the sample obtained by TSS.

Icariin-loaded Sulfonated Polyetheretherketone with Osteogenesis Promotion and Osteoclastogenesis Inhibition Properties via Immunomodulation for Advanced Osseointegration

Preventing prosthesis loosening due to insufficient osseointegration is critical for patients with osteoporosis. Endowing implants with immunomodulatory function can effectively enhance osseointegration. In this work, we loaded icariin (ICA) onto...

Synthesis and Characterization of a Novel Biocompatible Alloy, Ti-Nb-Zr-Ta-Sn

Many current-generation biomedical implants are fabricated from the Ti-6Al-4V alloy because it has many attractive properties, such as low density and biocompatibility. However, the elastic modulus of this alloy is much larger than that of the surrounding bone, leading to bone resorption and, eventually, implant failure. In the present study, we synthesized and performed a detailed analysis of a novel low elastic modulus Ti-based alloy (Ti-28Nb-5Zr-2Ta-2Sn (TNZTS alloy)) using a variety of methods, including scanning electron microscopy, transmission electron microscopy, X-ray diffraction, and tensile test. Additionally, the in vitro biocompatibility of the TNZTS alloy was evaluated using SCP-1, SaOs-2, and THP-1 cell lines and primary human osteoblasts. Compared to Ti-6Al-4V, the elastic modulus of TNZTS alloy was significantly lower, while measures of its in vitro biocompatibility are comparable. O2 plasma treatment of the surface of the alloy significantly increased its hydrophilicity and, hence, its in vitro biocompatibility. TNZTS alloy specimens did not induce the release of cytokines by macrophages, indicating that such scaffolds would not trigger inflammatory responses. The present results suggest that the TNZTS alloy may have potential as an alternative to Ti-6Al-4V.

Modification of polyetheretherketone implants: From enhancing bone integration to enabling multi-modal therapeutics

Polyetheretherketone (PEEK) is a popular thermoplastic material widely used in engineering applications due to its favorable mechanical properties and stability at high temperatures. With the first implantable grade PEEK being commercialized in 1990s, the use of PEEK has since grown exponentially in the biomedical field and has rapidly transformed a large section of the medical devices landscape. Nowadays, PEEK is a standard biomaterial used across a wide range of implant applications, however, its bioinertness remains a limitation for bone repair applications. The increasing demand for enhanced treatment efficacy/improved patient quality of life, calls for next-generation implants that can offer fast bone integration as well as other desirable therapeutic functions. As such, modification of PEEK implants has progressively shifted from offering desirable mechanical properties, enhancing bioactivity/fast osteointegration, to more recently, tackling post-surgery bacterial infection/biofilm formation, modulation of inflammation and management of bone cancers. Such progress is also accompanied by the evolution of the PEEK manufacturing technologies, to meet the ever increasing demand for more patient specific devices. However, no review has comprehensively covered the recently engaged application areas to date. This paper provides an up-to-date review on the development of PEEK-based biomedical devices in the past 10 years, with particularly focus on modifying PEEK for multi-modal therapeutics. The aim is to provide the peers with a timely update, which may guide and inspire the research and development of next generation PEEK-based healthcare products. STATEMENT OF SIGNIFICANCE: Significant progress has been made in PEEK processing and modification techniques in the past decades, which greatly contributed to its wide applications in the biomedical field. Despite the high volume of published literature on PEEK implant related research, there is a lack of review on its emerging applications in multi-modal therapeutics, which involve bone regeneration, anti-bacteria/anti-inflammation, and cancer inhibition, etc. This timely review covers the state-of-the-art in these exciting areas and provides the important guidance for next generation PEEK based biomedical device research and development.

Evaluation of biocompatibility and osseointegration of Nb-xTi-Zr alloys for use as dental implant materials

The aim of this study was to evaluate the biocompatibility and osteogenic potential of 50%Nb-xTi-Zr (NTZ, x=20%, 30%, 40% by weight) alloys as compared with dental commercial pure titanium (cpTi). Cell cytotoxity assay, fluorescence microscopy and electron microscopy were used to measure the in vitro biocompatibility of NTZ. The expression of alkaline phosphatase (ALP), integrin β1, osteocalcin (OC), Ki67 and collagen-I (Col-I) at the mRNA level was measured by real-time reverse transcription-polymerase chain reaction (RT-PCR). Osseointegration ability was determined using X-ray evaluation and histological analysis in vivo. Compared with the MG63 cells grown on cpTi on day 3, the viability, adherence and proliferation rates of cells cultured on NTZ alloys were significantly improved (p < 0.05). Furthermore, similar expression levels of Ki67, Col-Ⅰ, OC and ALP were found in the MG63 cells grown on NTZ alloys and those grown on cpTi. The Cbf α1 level was significantly higher for the 50%Nb-30%Ti-Zr (NTZ3) than for the cpTi group on day 6 (p < 0.01), indicating that NTZ alloys can induce osteogenesis. A considerable amount of new bone formation and osseointegration was observed around NTZ3 implants compared with cpTi implants in vivo. Collectively, NTZ3 showed superior biocompatibility and osteogenic activity; therefore, NTZ3 may be an excellent replacement for dental Ti implants.

Biological Response to Nanosurface Modification on Metallic Biomaterials

PURPOSE OF REVIEW

New biomaterials for biomedical applications have been developed over the past few years. This work summarizes the current cell lines investigations regarding nanosurface modifications to improve biocompatibility and osseointegration.

RECENT FINDINGS

Material surfaces presenting biomimetic morphology that provides nanoscale architectures have been shown to alter cell/biomaterial interactions. Topographical and biofunctional surface modifications present a positive effect between material and host response. Nanoscale surfaces on titanium have the potential to provide a successful interface for implantable biomedical devices. Future studies need to directly evaluate how the titanium nanoscale materials will perform in in vivo experiments. Biocompatibility should be determined to identify titanium nanoscale as an excellent option for implant procedures.

Biocompatibility and Antibacterial Properties of ZnO-Incorporated Anodic Oxide Coatings on TiZrNb Alloy

In a present paper, we demonstrate novel approach to form ceramic coatings with incorporated ZnO nanoparticles (NPs) on low modulus TiZrNb alloy with enhanced biocompatibility and antibacterial parameters. Plasma Electrolytic Oxidation (PEO) was used to integrate ZnO nanoparticles (average size 12-27 nm), mixed with Ca(H2PO2)2 aqueous solution into low modulus TiZrNb alloy surface. The TiZrNb alloys with integrated ZnO NPs successfully showed higher surface porosity and contact angle. XPS investigations showed presence of Ca ions and absence of phosphate ions in the PEO modified layer, what explains higher values of contact angle. Cell culture experiment (U2OS type) confirmed that the surface of as formed oxide-ZnO NPs demonstrated hydrophobic properties, what can affect primary cell attachment. Further investigations showed that Ca ions in the PEO coating stimulated proliferative activity of attached cells, resulting in competitive adhesion between cells and bacteria in clinical situation. Thus, high contact angle and integrated ZnO NPs prevent bacterial adhesion and considerably enhance the antibacterial property of TiZrNb alloys. A new anodic oxide coating with ZnO NPs could be successfully used for modification of low modulus alloys to decrease post-implantation complications.

Effects of the sources of calcium and phosphorus on the structural and functional properties of ceramic coatings on titanium dental implants produced by plasma electrolytic oxidation

Plasma Electrolytic Oxidation (PEO) is as a promising technique to modify metal surfaces by application of oxide ceramic coatings with appropriate physical, chemical and biological characteristics. Therefore, objective of this research was to find the simplest settings, yet able to produce relevant bioactive implant surfaces layers on Ti implants by means of PEO. We show that an electrolyte containing potassium dihydrogen phosphate as a source of P and either calcium hydroxide or calcium formate as a source of Ca in combination with a chelating agent, ethylenediamine tetraacetic acid (EDTA), is suitable for PEO to deliver coatings with desired properties. We determined surface morphology, roughness, wettability, chemical and phase composition of titanium after the PEO process. To investigate biocompatibility and bacterial properties of the PEO oxide coatings we used microbial and cell culture tests. The electrolyte based on Ca(OH)₂ and EDTA promotes active crystallization of apatites after PEO processing of the Ti implants. The PEO layers can increase electrochemical corrosion resistance. The PEO can be potentially used for development of bioactive surfaces with increased support of eukaryotic cells while inhibiting attachment and growth of bacteria without use of antibacterial agents.

Formation of a Bacteriostatic Surface on ZrNb Alloy via Anodization in a Solution Containing Cu Nanoparticles

High strength, excellent corrosion resistance, high biocompatibility, osseointegration ability, and low bacteria adhesion are critical properties of metal implants. Additionally, the implant surface plays a critical role as the cell and bacteria host, and the development of a simultaneously antibacterial and biocompatible implant is still a crucial challenge. Copper nanoparticles (CuNPs) could be a promising alternative to silver in antibacterial surface engineering due to low cell toxicity. In our study, we assessed the biocompatibility and antibacterial properties of a PEO (plasma electrolytic oxidation) coating incorporated with CuNPs (Cu nanoparticles). The structural and chemical parameters of the CuNP and PEO coating were studied with TEM/SEM (Transmission Electron Microscopy/Scanning Electron Microscopy), EDX (Energy-Dispersive X-ray Dpectroscopy), and XRD (X-ray Diffraction) methods. Cell toxicity and bacteria adhesion tests were used to prove the surface safety and antibacterial properties. We can conclude that PEO on a ZrNb alloy in Ca-P solution with CuNPs formed a stable ceramic layer incorporated with Cu nanoparticles. The new surface provided better osteoblast adhesion in all time-points compared with the nontreated metal and showed medium grade antibacterial activities. PEO at 450 V provided better antibacterial properties that are recommended for further investigation.