Mesenchymal stem cell interaction with ultra-smooth nanostructured diamond for wear-resistant orthopaedic implants

Biocompatibility and interaction of porous alumina-zirconia scaffolds with adipose-derived mesenchymal stem cells for bone tissue regeneration

Replacement of bone defects with bone graft or implant is an important therapeutic strategy that has been used in routine practice. However, the identification of biomaterials that can mimic natural bone properties and serve as bone substitutes remains a major challenge. In this context, alumina-zirconia (Al2O3/ZrO2) nanocomposites emerge as potential alternatives for biomedical applications, owing to their high mechanical strength, wear resistance, and biocompatibility. In this sense, in this study, we prepared porous Al2O3/ZrO2 nanocomposites (scaffolds) using the gelcasting method and biomimetically coated them with calcium phosphate (CaP). We evaluated the biocompatibility of the scaffolds using the quantitative MTT cytotoxicity test in L929 cells. Moreover, rabbit adipose-derived mesenchymal stem cells (rADMSCs) were seeded with CaP-containing and CaP-free porous samples to evaluate cell proliferation and cell-scaffold interaction in vitro. Our results showed that the Al2O3/ZrO2 scaffolds were non-cytotoxic, and there were no significant differences between CaP-containing and CaP-free scaffolds in terms of cell growth and adhesion. In contrast, when co-cultured with rADMSCs, the scaffolds enhanced cell proliferation and cell adhesion. The rADMSCs adhered and migrated through the pores of the scaffold and anchored to different poles with differentiated elongated structures. These results suggest osteogenic differentiation of rADMSCs in response to mechanical loading of Al2O3/ZrO2 scaffolds. Therefore, we conclude that Al2O3/ZrO2 scaffolds have demonstrated significant implications in bone tissue engineering and are valuable biomaterials for bone replacement.

Diamond electrodes for controlling stem cells

Electrical stimulation is one of several methods for controlling differentiation and proliferation of stem cells. This work demonstrated the use of nitrogen-doped ultra-nanocrystalline diamond (N-UNCD) electrodes as a substrate for the growth of human mesenchymal stem cells (hMSCs). As well as exhibiting a high charge injection capacity, N-UNCD displays high cytocompatibility making it suitable electrode material for stem cell stimulation.Clinical Relevance-This work establishes that N-UNCD electrodes can support the growth of hMSCs.

Polycrystalline Diamond Coating on Orthopedic Implants: Realization and Role of Surface Topology and Chemistry in Adsorption of Proteins and Cell Proliferation

Polycrystalline diamond has the potential to improve the osseointegration of orthopedic implants compared to conventional materials such as titanium. However, despite the excellent biocompatibility and superior mechanical properties, the major challenge of using diamond for implants, such as those used for hip arthroplasty, is the limitation of microwave plasma chemical vapor deposition (CVD) techniques to synthesize diamond on complex-shaped objects. Here, for the first time, we demonstrate diamond growth on titanium acetabular shells using the surface wave plasma CVD method. Polycrystalline diamond coatings were synthesized at low temperatures (∼400 °C) on three types of acetabular shells with different surface structures and porosities. We achieved the growth of diamond on highly porous surfaces designed to mimic the structure of the trabecular bone and improve osseointegration. Biocompatibility was investigated on nanocrystalline diamond (NCD) and ultrananocrystalline diamond (UNCD) coatings terminated either with hydrogen or oxygen. To understand the role of diamond surface topology and chemistry in the attachment and proliferation of mammalian cells, we investigated the adsorption of extracellular matrix proteins and monitored the metabolic activity of fibroblasts, osteoblasts, and bone-marrow-derived mesenchymal stem cells (MSCs). The interaction of bovine serum albumin and type I collagen with the diamond surfaces was investigated by confocal fluorescence lifetime imaging microscopy (FLIM). We found that the proliferation of osteogenic cells was better on hydrogen-terminated UNCD than on the oxygen-terminated counterpart. These findings correlated with the behavior of collagen on diamond substrates observed by FLIM. Hydrogen-terminated UNCD provided better adhesion and proliferation of osteogenic cells, compared to titanium, while the growth of fibroblasts was poorest on hydrogen-terminated NCD and MSCs behaved similarly on all tested surfaces. These results open new opportunities for application of diamond coatings on orthopedic implants to further improve bone fixation and osseointegration.

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

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

Diamond in the Rough: Toward Improved Materials for the Bone-Implant Interface

The ability of an orthopedic implant to integrate successfully with the surrounding bone tissue is imperative for optimal patient outcomes. Here, the recent advances and future prospects for diamond-based coatings of conventional osteo-implant materials (primarily titanium) are explored. The ability of these diamond coatings to enhance integration into existing bone, improved implant mechanical properties, facilitate surface chemical functionalization, and provide anti-microbial properties are discussed in context of orthopedic implants. These diamond-based materials may have the additional benefit of providing an osteo-inductive effect, enabling better integration into existing bone via stem cell recruitment and bone regeneration. Current and timely research is highlighted to support the discussion and suggestions in further improving implant integration via an osseoinductive effect from the diamond composite materials.

3D-Printed Objects for Multipurpose Applications

3D printing is a popular nonconventional manufacturing technique used to print 3D objects by using conventional and nonconventional materials. The application and uses of 3D printing are rapidly increasing in each dimension of the engineering and medical sectors. This article overviews the multipurpose applications of 3D printing based on current research. In the beginning, various popular methods including fused deposition method, stereolithography 3D printing method, powder bed fusion method, digital light processing method, and metal transfer dynamic method used in 3D printing are discussed. Popular materials utilized randomly in printing techniques such as hydrogel, ABS, steel, silver, and epoxy are overviewed. Engineering applications under the current development of the printing technique which include electrode, 4D printing technique, twisting object, photosensitive polymer, and engines are focused. Printing of medical equipment including artificial tissues, scaffolds, bioprinted model, prostheses, surgical instruments, COVID-19, skull, and heart is of major focus. Characterization techniques of the printed 3D products are mentioned. In addition, potential challenges and future prospects are evaluated based on the current scenario. This review article will work as a masterpiece for the researchers interested to work in this field.

Human osteoblast-like SAOS-2 cells on submicron-scale fibers coated with nanocrystalline diamond films

A unique composite nanodiamond-based porous material with a hierarchically-organized submicron-nano-structure was constructed for potential bone tissue engineering. This material consisted of submicron fibers prepared by electrospinning of silicon oxide (SiO_x), which were oxygen-terminated (O-SiO_x) and were hermetically coated with nanocrystalline diamond (NCD) films. The NCD films were then terminated with hydrogen (H-NCD) or oxygen (O-NCD). The materials were tested as substrates for the adhesion, growth and osteogenic differentiation of human osteoblast-like Saos-2 cells. The number and the spreading area of the initially adhered cells, their growth rate during 7 days after seeding and the activity of alkaline phosphatase (ALP) were significantly higher on the NCD-coated samples than on the uncoated O-SiO_x samples. In addition, the concentration of type I collagen was significantly higher in the cells on the O-NCD-coated samples than on the bare O-SiO_x samples. The observed differences could be attributed to the tunable wettability of NCD and to the more appropriate surface morphology of the NCD-coated samples in contrast to the less stable, rapidly eroding bare SiO_x surface. The H-NCD coatings and the O-NCD coatings both promoted similar initial adhesion of Saos-2 cells, but the subsequent cell proliferation activity was higher on the O-NCD-coated samples. The concentration of beta-actin, vinculin, type I collagen and alkaline phosphatase (ALP), the ALP activity, and also the calcium deposition tended to be higher in the cells on the O-NCD-coated samples than on the H-NCD-coated samples, although these differences did not reach statistical significance. The improved cell performance on the O-NCD-coated samples could be attributed to higher wettability of these samples (water drop contact angle less than 10°), while the H-NCD-coated samples were hydrophobic (contact angle >70°). NCD-coated porous SiO_x meshes can therefore be considered as appropriate scaffolds for bone tissue engineering, particularly those with an O-terminated NCD coating.

Mixed oxide nanotubes in nanomedicine: A dead-end or a bridge to the future?

Nanomedicine has seen a significant rise in the development of new research tools and clinically functional devices. In this regard, significant advances and new commercial applications are expected in the pharmaceutical and orthopedic industries. For advanced orthopedic implant technologies, appropriate nanoscale surface modifications are highly effective strategies and are widely studied in the literature for improving implant performance. It is well-established that implants with nanotubular surfaces show a drastic improvement in new bone creation and gene expression compared to implants without nanotopography. Nevertheless, the scientific and clinical understanding of mixed oxide nanotubes (MONs) and their potential applications, especially in biomedical applications are still in the early stages of development. This review aims to establish a credible platform for the current and future roles of MONs in nanomedicine, particularly in advanced orthopedic implants. We first introduce the concept of MONs and then discuss the preparation strategies. This is followed by a review of the recent advancement of MONs in biomedical applications, including mineralization abilities, biocompatibility, antibacterial activity, cell culture, and animal testing, as well as clinical possibilities. To conclude, we propose that the combination of nanotubular surface modification with incorporating sensor allows clinicians to precisely record patient data as a critical contributor to evidence-based medicine.

Preparation of highly wettable coatings on Ti-6Al-4V ELI alloy for traumatological implants using micro-arc oxidation in an alkaline electrolyte

Pulsed micro-arc oxidation (MAO) in a strongly alkaline electrolyte (pH > 13), consisting of Na₂SiO₃⋅9H₂O and NaOH, was used to form a thin porous oxide coating consisting of two layers differing in chemical and phase composition. The unique procedure, combining MAO and removal of the outer layer by blasting, enables to prepare a coating suitable for application in temporary traumatological implants. A bilayer formed in an alkaline electrolyte environment during the application of MAO enables the formation of a wear-resistant layer with silicon incorporated in the oxide phase. Following the removal of the outer rutile-containing porous layer, the required coating properties for traumatological applications were determined. The prepared surfaces were characterized by scanning electron microscopy, X-ray diffraction patterns, X-ray photoelectron spectroscopy, atomic force microscopy and contact angle measurements. Cytocompatibility was evaluated using human osteoblast-like Saos-2 cells. The newly-developed surface modifications of Ti–6Al–4V ELI alloy performed satisfactorily in all cellular tests in comparison with MAO-untreated alloy and standard tissue culture plastic. High cell viability was supported, but the modifications allowed only relatively slow cell proliferation, and showed only moderate osseointegration potential without significant support for matrix mineralization. Materials with these properties are promising for utilization in temporary traumatological implants.

In vitro and in vivo biocompatibility and bio-tribological properties of the calcium/amorphous-C composite films for bone tissue engineering application

Carbon-and diamond-like-carbon coated Ti alloys hold great promise for tissue engineering applications. Unfortunately, their strong intrinsic stress leads to the adhesion failure of the films. Herein, a series of a-C films with different Ca content were prepared on Ti₆Al₄V via co-sputtering deposition technology. Homogeneous spherical Ca nanoclusters, with an inner diameter of 2-6 nm, were formed in an amorphous carbon matrix. The addition of Ca induced indistinctive variation in either phase composition or topography. However, the introduction of Ca not only improved the mechanical properties of a-C film but also significantly strengthened its adhesion to osteoblasts. The bio-tribological properties of Ca/a-C films were also assessed using a tribometer in FBS solution. The Ca/a-C films exhibited a low friction coefficient of 0.083 and a low wear rate of 1.02-1.24×10^-6 mm³/Nm. The low coefficient of friction (COF) of the Ca/a-C films indicates their superior mechanical properties, making them the promising target of nanocomposite films used in bio-tribological applications. Well-stretched cells and the developed actin filaments were distinctly observed on the Ca/a-C films in the osteoblast cell adhesion experiments. In addition, the Ca/a-C films promoted cell proliferation and showed high cell viability. After being implanted for 4 weeks, the Ca/a-C implant material still adhered well to the muscle tissue, without inducing hyperergic or inflammatory reactions. Collectively, our results suggest that the Ca/a-C film is an ideal mounting material for bone tissue engineering.

Enhanced osteogenesis of quasi-three-dimensional hierarchical topography

Natural extracellular matrices (ECMs) are three-dimensional (3D) and multi-scale hierarchical structure. However, coatings used as ECM-mimicking structures for osteogenesis are typically two-dimensional or single-scaled. Here, we design a distinct quasi-three-dimensional hierarchical topography integrated of density-controlled titania nanodots and nanorods. We find cellular pseudopods preferred to anchor deeply across the distinct 3D topography, dependently of the relative density of nanorods, which promote the osteogenic differentiation of osteoblast but not the viability of fibroblast. The in vivo experimental results further indicate that the new bone formation, the relative bone-implant contact as well as the push-put strength, are significantly enhanced on the 3D hierarchical topography. We also show that the exposures of HFN7.1 and mAb1937 critical functional motifs of fibronectin for cellular anchorage are up-regulated on the 3D hierarchical topography, which might synergistically promote the osteogenesis. Our findings suggest the multi-dimensions and multi-scales as vital characteristic of cell-ECM interactions and as an important design parameter for bone implant coatings.

Bioelectronics with nanocarbons

Characterizing the electrical activity of cardiomyocytes and neurons is crucial in understanding the complex processes in the heart and brain tissues, both in healthy and diseased states. Micro- and nanotechnologies have significantly improved the electrophysiological investigation of cellular networks. Carbon-based nanomaterials or nanocarbons, such as carbon nanotubes (CNTs), nanodiamonds (NDs) and graphene are promising building blocks for bioelectronics platforms owing to their outstanding chemical and physical properties. In this review, we discuss the various bioelectronics applications of nanocarbons and their derivatives. Furthermore, we touch upon the challenges that remain in the field and describe the emergence of carbon-based hybrid-nanomaterials that will potentially address those limitations, thus improving the capabilities to investigate the electrophysiology of excitable cells, both as a network and at the single cell level.

Diamond thin films: giving biomedical applications a new shine

Progress made in the last two decades in chemical vapour deposition technology has enabled the production of inexpensive, high-quality coatings made from diamond to become a scientific and commercial reality. Two properties of diamond make it a highly desirable candidate material for biomedical applications: first, it is bioinert, meaning that there is minimal immune response when diamond is implanted into the body, and second, its electrical conductivity can be altered in a controlled manner, from insulating to near-metallic. In vitro, diamond can be used as a substrate upon which a range of biological cells can be cultured. In vivo, diamond thin films have been proposed as coatings for implants and prostheses. Here, we review a large body of data regarding the use of diamond substrates for in vitro cell culture. We also detail more recent work exploring diamond-coated implants with the main targets being bone and neural tissue. We conclude that diamond emerges as one of the major new biomaterials of the twenty-first century that could shape the way medical treatment will be performed, especially when invasive procedures are required.

Osteoblast adhesion, migration, and proliferation variations on chemically patterned nanocrystalline diamond films evaluated by live-cell imaging

Cell fate modulation by adapting the surface of a biocompatible material is nowadays a challenge in implantology, tissue engineering as well as in construction of biosensors. Nanocrystalline diamond (NCD) thin films are considered promising in these fields due to their extraordinary physical and chemical properties and diverse ways in which they can be modified structurally and chemically. The initial cell distribution, the rate of cell adhesion, distance of cell migration and also the cell proliferation are influenced by the NCD surface termination. Here, we use real-time live-cell imaging to investigate the above-mentioned processes on oxidized NCD (NCD-O) and hydrogenated NCD (NCD-H) to elucidate cell preference to the NCD-O especially on surfaces with microscopic surface termination patterns. Cells adhere more slowly and migrate farther on NCD-H than on NCD-O. Cells seeded with a fetal bovine serum (FBS) supplement in the medium move across the surface prior to adhesion. In the absence of FBS, the cells adhere immediately, but still exhibit different migration and proliferation on NCD-O/H regions. We discuss the impact of these effects on the formation of cell arrays on micropatterned NCD. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1469-1478, 2017.

Investigation of silicon carbon nitride nanocomposite films as a wear resistant layer in vitro and in vivo for joint replacement applications

Silicon-contained CN_x nanocomposite films were prepared using the ion beam assisted magnetron sputtering under different nitrogen gas pressure. With increase of the nitrogen pressure, silicon and nitrogen content of the CN_x films drastically increase, and is saturated as the P_N2 reach about 40%. Surface roughness and the contact angle are increase, while the friction coefficient decreased. The CN_x film with 5.7at.% Si content possess the lowest friction coefficient of only 0.07, and exhibited the best tribological properties. The impact of CN_x films with different silicon content on the growth and the activation of osteoblasts were compared to that of Ti6Al4V. The incorporation of silicon in the CN_x film also showed an increase cell adhesion. Bonding structure and surface energy were determined to be the factors contributing to the improved biocompatibility. Macrophages attached to 5.7at.% Si contained CN_x films down regulated their production of cytokines and chemokines. Moreover, employed with Si contained CN_x coated joint replacements, which were implanted subcutaneously into Sprague-Dawley mice for up to 36days, the tissue reaction and capsule formation was significantly decreased compared to that of Ti6Al4V. A mouse implantation study demonstrated the excellent in vivo biocompatibility and functional reliability of wear resist layer for joint replacements with a Si doped a-CN_x coating for 36days.

Hidrogéis a base de ácido hialurônico e quitosana para engenharia de tecido cartilaginoso

Resumo A Engenharia de Tecidos envolve o desenvolvimento de novos materiais ou dispositivos capazes de interações específicas com os tecidos biológicos, buscando a utilização de materiais biocompatíveis que devem servir como arcabouço para o crescimento de células in vitro, organizando e desenvolvendo o tecido que posteriormente será implantado no paciente. Uma variedade de arcabouços como hidrogéis poliméricos, sintéticos e naturais, têm sido investigados para a expansão de condrócitos in vitro, visando o reparo da cartilagem lesionada. Um hidrogel de interesse particular na regeneração de cartilagem é o ácido hialurónico (AH). Trata-se de um biopolímero atraente para a fabricação de arcabouços artificiais para Engenharia de Tecidos por ser biocompatível e biodegradável. A biocompatibilidade do AH deve-se ao fato de estar presente na matriz extracelular nativa, deste modo, cria-se um ambiente propício que facilita a adesão, proliferação e diferenciação celular, além da existência de sinalização celular específica, o que contribui para a regeneração do tecido. O uso de hidrogel composto de ácido hialurónico e quitosana (QUI) também tem sido investigado em aplicações de Engenharia de Tecidos de cartilagem, com resultados promissores. Baseando-se nestas informações, o objetivo este trabalho foi investigar as alternativas disponíveis para regeneração tecidual da cartilagem e conhecer mais detalhadamente as relações entre células e biomateriais.

Biological evaluation of ultrananocrystalline and nanocrystalline diamond coatings

Nanostructured biomaterials have been investigated for achieving desirable tissue-material interactions in medical implants. Ultrananocrystalline diamond (UNCD) and nanocrystalline diamond (NCD) coatings are the two most studied classes of synthetic diamond coatings; these materials are grown using chemical vapor deposition and are classified based on their nanostructure, grain size, and sp³ content. UNCD and NCD are mechanically robust, chemically inert, biocompatible, and wear resistant, making them ideal implant coatings. UNCD and NCD have been recently investigated for ophthalmic, cardiovascular, dental, and orthopaedic device applications. The aim of this study was (a) to evaluate the in vitro biocompatibility of UNCD and NCD coatings and (b) to determine if variations in surface topography and sp³ content affect cellular response. Diamond coatings with various nanoscale topographies (grain sizes 5-400 nm) were deposited on silicon substrates using microwave plasma chemical vapor deposition. Scanning electron microscopy and atomic force microscopy revealed uniform coatings with different scales of surface topography; Raman spectroscopy confirmed the presence of carbon bonding typical of diamond coatings. Cell viability, proliferation, and morphology responses of human bone marrow-derived mesenchymal stem cells (hBMSCs) to UNCD and NCD surfaces were evaluated. The hBMSCs on UNCD and NCD coatings exhibited similar cell viability, proliferation, and morphology as those on the control material, tissue culture polystyrene. No significant differences in cellular response were observed on UNCD and NCD coatings with different nanoscale topographies. Our data shows that both UNCD and NCD coatings demonstrate in vitro biocompatibility irrespective of surface topography.

Corrosion resistance and biological activity of TiO2 implant coatings produced in oxygen-rich environments

The physical and chemical properties of bio-titanium alloy implant surfaces play an important role in their corrosion resistance and biological activity. New turning and turning-rolling processes are presented, employing an oxygen-rich environment in order to obtain titanium dioxide layers that can both protect implants from corrosion and also promote cell adhesion. The surface topographies, surface roughnesses and chemical compositions of the sample surfaces were obtained using scanning electron microscopy, a white light interferometer, and the Auger electron spectroscopy, respectively. The corrosion resistance of the samples in a simulated body fluid was determined using electrochemical testing. Biological activity on the samples was also analyzed, using a vitro cell culture system. The results show that compared with titanium oxide layers formed using a turning process in air, the thickness of the titanium oxide layers formed using turning and turning-rolling processes in an oxygen-rich environment increased by 4.6 and 7.3 times, respectively. Using an oxygen-rich atmosphere in the rolling process greatly improves the corrosion resistance of the resulting samples in a simulated body fluid. On samples produced using the turning-rolling process, cells spread quickly and exhibited the best adhesion characteristics.

Effects of nanotopography on the in vitro hemocompatibility of nanocrystalline diamond coatings

Nanocrystalline diamond (NCD) coatings have been investigated for improved wear resistance and enhanced hemocompatibility of cardiovascular devices. The goal of this study was to evaluate the effects of NCD surface nanotopography on in vitro hemocompatibility. NCD coatings with small (NCD-S) and large (NCD-L) grain sizes were deposited using microwave plasma chemical vapor deposition and characterized using scanning electron microscopy, atomic force microscopy, contact angle testing, and Raman spectroscopy. NCD-S coatings exhibited average grain sizes of 50-80 nm (RMS 5.8 nm), while NCD-L coatings exhibited average grain sizes of 200-280 nm (RMS 23.1 nm). In vitro hemocompatibility testing using human blood included protein adsorption, hemolysis, nonactivated partial thromboplastin time, platelet adhesion, and platelet activation. Both NCD coatings demonstrated low protein adsorption, a nonhemolytic response, and minimal activation of the plasma coagulation cascade. Furthermore, the NCD coatings exhibited low thrombogenicity with minimal platelet adhesion and aggregation, and similar morphological changes to surface-bound platelets (i.e., activation) in comparison to the HDPE negative control material. For all assays, there were no significant differences in the blood-material interactions of NCD-S versus NCD-L. The two tested NCD coatings, regardless of nanotopography, had similar hemocompatibility profiles compared to the negative control material (HDPE) and should be further evaluated for use in blood-contacting medical devices. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 253-264, 2017.

Resistance to protein adsorption and adhesion of fibroblasts on nanocrystalline diamond films: the role of topography and boron doping

Boron-doped nanocrystalline diamond (BNCD) films exhibit outstanding electrochemical properties that make them very attractive for the fabrication of electrodes for novel neural interfaces and prosthetics. In these devices, the physicochemical properties of the electrode materials are critical to ensure an efficient long-term performance. The aim of this study was to investigate the relative contribution of topography and doping to the biological performance of BNCD films. For this purpose, undoped and boron-doped NCD films were deposited on low roughness (LR) and high roughness (HR) substrates, which were studied in vitro by means of protein adsorption and fibroblast growth assays. Our results show that BNCD films significantly reduce the adsorption of serum proteins, mostly on the LR substrates. As compared to fibroblasts cultured on LR BNCD films, cells grown on the HR BNCD films showed significantly reduced adhesion and lower growth rates. The mean length of fibronectin fibrils deposited by the cells was significantly increased in the BNCD coated substrates, mainly in the LR surfaces. Overall, the largest influence on protein adsorption, cell adhesion, proliferation, and fibronectin deposition was due to the underlying sub-micron topography, with little or no influence of boron doping. In perspective, BNCD films displaying surface roughness in the submicron range may be used as a strategy to reduce the fibroblast growth on the surface of neural electrodes.

Noble Hybrid Nanostructures as Efficient Anti-Proliferative Platforms for Human Breast Cancer Cell

Nanomaterials have proven to possess great potential in biomaterials research. Recently, they have suggested considerable promise in cancer diagnosis and therapy. Among others, silicon (Si) nanomaterials have been extensively employed for various biomedical applications; however, the utilization of Si for cancer therapy has been limited to nanoparticles, and its potential as anticancer substrates has not been fully explored. Noble nanoparticles have also received considerable attention owing to unique anticancer properties to improve the efficiency of biomaterials for numerous biological applications. Nevertheless, immobilization and control over delivery of the nanoparticles have been challenge. Here, we develop hybrid nanoplatforms to efficiently hamper breast cancer cell adhesion and proliferation. Platforms are synthesized by femtosecond laser processing of Si into multiphase nanostructures, followed by sputter-coating with gold (Au)/gold-palladium (Au-Pd) nanoparticles. The performance of the developed platforms was then examined by exploring the response of normal fibroblast and metastatic breast cancer cells. Our results from the quantitative and qualitative analyses show a dramatic decrease in the number of breast cancer cells on the hybrid platform compared to untreated substrates. Whereas, fibroblast cells form stable adhesion with stretched and elongated cytoskeleton and actin filaments. The hybrid platforms perform as dual-acting cytophobic/cytostatic stages where Si nanostructures depress breast cancer cell adhesion while immobilized Au/Au-Pd nanoparticles are gradually released to affect any surviving cell on the nanostructures. The nanoparticles are believed to be taken up by breast cancer cells via endocytosis, which subsequently alter the cell nucleus and may cause cell death. The findings suggest that the density of nanostructures and concentration of coated nanoparticles play critical roles on cytophobic/cytostatic properties of the platforms on human breast cancer cells while having no or even cytophilic effects on fibroblast cells. Because of the remarkable contrary responses of normal and cancer cells to the proposed platform, we envision that it will provide novel applications in cancer research.

Development of a pneumatically driven active cover lid for multi-well microplates for use in perfusion three-dimensional cell culture

Before microfluidic-based cell culture models can be practically utilized for bioassays, there is a need for a transitional cell culture technique that can improve conventional cell culture models. To address this, a hybrid cell culture system integrating an active cover lid and a multi-well microplate was proposed to achieve perfusion 3-D cell culture. In this system, a microfluidic-based pneumatically-driven liquid transport mechanism was integrated into the active cover lid to realize 6-unit culture medium perfusion. Experimental results revealed that the flow of culture medium could be pneumatically driven in a flow-rate uniform manner. We used the system to successfully perform a perfusion 3-D cell culture of mesenchymal stem cells (MSCs) for up to 16 days. Moreover, we investigated the effects of various cell culture models on the physiology of MSCs. The physiological nature of MSCs can vary with respect to the cell culture model used. Using the perfusion 3-D cell culture format might affect the proliferation and osteogenic differentiation of MSCs. Overall, we have developed a cell culture system that can achieve multi-well microplate-based perfusion 3-D cell culture in an efficient, cost-effective, and user-friendly manner. These features could facilitate the widespread application of perfusion cell culture models for cell-based assays.

Nanocarbon-Coated Porous Anodic Alumina for Bionic Devices

A highly-stable and biocompatible nanoporous electrode is demonstrated herein. The electrode is based on a porous anodic alumina which is conformally coated with an ultra-thin layer of diamond-like carbon. The nanocarbon coating plays an essential role for the chemical stability and biocompatibility of the electrodes; thus, the coated electrodes are ideally suited for biomedical applications. The corrosion resistance of the proposed electrodes was tested under extreme chemical conditions, such as in boiling acidic/alkali environments. The nanostructured morphology and the surface chemistry of the electrodes were maintained after wet/dry chemical corrosion tests. The non-cytotoxicity of the electrodes was tested by standard toxicity tests using mouse fibroblasts and cortical neurons. Furthermore, the cell-electrode interaction of cortical neurons with nanocarbon coated nanoporous anodic alumina was studied in vitro. Cortical neurons were found to attach and spread to the nanocarbon coated electrodes without using additional biomolecules, whilst no cell attachment was observed on the surface of the bare anodic alumina. Neurite growth appeared to be sensitive to nanotopographical features of the electrodes. The proposed electrodes show a great promise for practical applications such as retinal prostheses and bionic implants in general.

Tuning cell adhesion by direct nanostructuring silicon into cell repulsive/adhesive patterns

Developing platforms that allow tuning cell functionality through incorporating physical, chemical, or mechanical cues onto the material surfaces is one of the key challenges in research in the field of biomaterials. In this respect, various approaches have been proposed and numerous structures have been developed on a variety of materials. Most of these approaches, however, demand a multistep process or post-chemical treatment. Therefore, a simple approach would be desirable to develop bio-functionalized platforms for effectively modulating cell adhesion and consequently programming cell functionality without requiring any chemical or biological surface treatment. This study introduces a versatile yet simple laser approach to structure silicon (Si) chips into cytophobic/cytophilic patterns in order to modulate cell adhesion and proliferation. These patterns are fabricated on platforms through direct laser processing of Si substrates, which renders a desired computer-generated configuration into patterns. We investigate the morphology, chemistry, and wettability of the platform surfaces. Subsequently, we study the functionality of the fabricated platforms on modulating cervical cancer cells (HeLa) behaviour. The results from in vitro studies suggest that the nanostructures efficiently repel HeLa cells and drive them to migrate onto untreated sites. The study of the morphology of the cells reveals that cells evade the cytophobic area by bending and changing direction. Additionally, cell patterning, cell directionality, cell channelling, and cell trapping are achieved by developing different platforms with specific patterns. The flexibility and controllability of this approach to effectively structure Si substrates to cell-repulsive and cell-adhesive patterns offer perceptible outlook for developing bio-functionalized platforms for a variety of biomedical devices. Moreover, this approach could pave the way for developing anti-cancer platforms that selectively repel cancer cells while favoring the adhesion of normal cells.

Osseointegration of Ti-6Al-4V alloy implants with a titanium nitride coating produced by a PIRAC nitriding technique: a long-term time course study in the rat

This study examined bone tissue responses to Ti-6Al-4V alloy implants with a hard TiN coating applied by an original powder immersion reaction-assisted coating (PIRAC) nitriding method. Progression of implant fixation in the distal epiphysis and within the medullary cavity of the rat femur was evaluated between 3 days and 6 months postimplantation by scanning electron microscopy, oxytetracycline incorporation, and histochemistry. After 6 months, successful osseointegration was achieved in both epiphyseal and diaphyseal sites. Throughout, implant portions located within the epiphysis remained in close contact with bone trabeculae that gradually engulfed the implant forming a bone collar continuous with the trabecular network of the epiphysis. In the diaphysis, woven bone was first formed within the marrow cavity around the implant and later was replaced by a shell of compact bone around the implant. In general, higher osseointegration rates were measured for TiN-coated versus the uncoated implants, both in the epiphysis and in the diaphysis. In conclusion, our findings indicate an excellent long-term biocompatibility of TiN coatings applied by the PIRAC nitriding technique and superior osteoinductive ability in comparison with uncoated Ti-6Al-4V alloy. Such coatings can, therefore, be considered for improving the corrosion and wear resistance of titanium-based orthopedic implants.

Immobilizing osteogenic growth peptide with and without fibronectin on a titanium surface: effects of loading methods on mesenchymal stem cell differentiation

In this study, to improve the osseointegration of implants, osteogenic growth peptide (OGP) and fibronectin (FN) were loaded within mineral, which was formed on titanium, through adsorption and coprecipitation methods. The release profiles of OGP loaded by either adsorption or coprecipitation and the effects of the loading methods to immobilize OGP with and without FN on rat mesenchymal stem cell (rMSC) osteogenic differentiation were studied. The coprecipitation approach slightly reduced the initial burst release, while the adsorption approach provided a more sustained release. Dual loading of OGP and FN further improved cell attachments compared with either OGP or FN alone. Dually loaded OGP and FN also had a positive impact on rMSC proliferation and osteogenic differentiation. The difference in methods of loading OGP with and without FN also had some effects on osteogenic differentiation. Compared with coprecipitated OGP alone, adsorbed OGP enhanced later differentiation, such as osteocalcin secretion and matrix mineralization. Simultaneously adsorbed OGP and FN led to higher proliferation and higher osteogenic differentiation in both early and late stages compared with sequentially loaded OGP and FN. rMSC culture clearly indicated that simultaneously adsorbed OGP and FN could improve osseointegration, and this treatment represents a potential method for effective surface modification of dental and orthopedic implants.

Cell response to nanocrystallized metallic substrates obtained through severe plastic deformation

Cell-substrate interface is known to control the cell response and subsequent cell functions. Among the various biophysical signals, grain structure, which indicates the repeating arrangement of atoms in the material, has also proved to play a role of significant importance in mediating the cell activities. Moreover, refining the grain size through severe plastic deformation is known to provide the processed material with novel mechanical properties. The potential application of such advanced materials as biomedical implants has recently been evaluated by investigating the effect of different substrate grain sizes on a wide variety of cell activities. In this review, recent advances in biomedical applications of severe plastic deformation techniques are highlighted with special attention to the effect of the obtained nano/ultra-fine-grain size on cell-substrate interactions. Various severe plastic deformation techniques used for this purpose are discussed presenting a brief description of the mechanism for each process. The results obtained for each treatment on cell morphology, adhesion, proliferation, and differentiation, as well as the in vivo studies, are discussed. Finally, the advantages and challenges regarding the application of these techniques to produce multifunctional bio-implant materials are addressed.

Influence of dexamethasone-loaded TNTs on the proliferation and osteogenic differentiation of rat mesenchymal stem cells

Schematic illustration of cellular responses of rMSCs to Dex-loaded TNT arrays.

Nanostructured diamond coatings for orthopaedic applications

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

Cell growth on different types of ultrananocrystalline diamond thin films

Unique functional materials provide a platform as scaffolds for cell/tissue regeneration. Investigation of cell-materials’ chemical and biological interactions will enable the application of more functional materials in the area of bioengineering, which provides a pathway to the novel treatment for patients who suffer from tissue/organ damage and face the limitation of donation sources. Many studies have been made into tissue/organ regeneration. Development of new substrate materials as platforms for cell/tissue regeneration is a key research area. Studies discussed in this paper focus on the investigation of novel ultrananocrystalline diamond (UNCD) films as substrate/scaffold materials for developmental biology. Specially designed quartz dishes have been coated with different types of UNCD films and cells were subsequently seeded on those films. Results showed the cells’ growth on UNCD-coated culture dishes are similar to cell culture dishes with little retardation, indicating that UNCD films have no or little inhibition on cell proliferation and are potentially appealing as substrate/scaffold materials. The mechanisms of cell adhesion on UNCD surfaces are proposed based on the experimental results. The comparisons of cell cultures on diamond-powder-seeded culture dishes and on UNCD-coated dishes with matrix-assisted laser desorption/ionization—time-of-flight mass spectroscopy (MALDI-TOF MS) and X-ray photoelectron spectroscopy (XPS) analyses provided valuable data to support the mechanisms proposed to explain the adhesion and proliferation of cells on the surface of the UNCD platform.

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

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

Osteointegration of titanium implant is sensitive to specific nanostructure morphology

An important aspect of orthopedic implant integration is the enhancement of functional activity of osteoblasts at the tissue-implant interface without any fibrous tissue intervention. Nanostructured implant surfaces are known to enhance osteoblast activity. Previously, we have reported a simple hydrothermal method for the fabrication of non-periodic nanostructures (nanoscaffold, nanoleaves and nanoneedles) on titanium implants showing good biocompatibility and a distinct osteoblast response in vitro in terms of osteoblast adhesion to the surface. In the present work, these nanostructures have been evaluated for their detailed in vitro cellular response as well as in vivo osteointegration. Our studies showed that a specific surface nanomorphology, viz. nanoleaves, which is a network of vertically aligned, non-periodic, leaf-like structures with thickness in the nanoscale, provided a distinct increase in osteoblast cell proliferation, alkaline phosphatase (ALP) activity and collagen synthesis compared to several other types of nanomorphology, such as nanotubes, nanoscaffold and nanoneedles (rods). Gene expression analysis of ALP, osteocalcin, collagen, decorin and Runx2 showed ~20- to 40-fold up-regulation on the leaf-like topography. Cytoskeletal arrangement studies on this substrate again revealed a unique response with favorable intracellular protein expressions of vinculin, FAK and src. In vivo osteointegration study over 12 weeks on rat model (Sprague-Dawley) showed early-stage bone formation (60% bone contact by week 2 and ~85% by week 8, p<0.01) in the leaf-like nanopattern, without any inflammatory cytokine production.

Regulation of the behaviors of mesenchymal stem cells by surface nanostructured titanium

The study describes the influence of surface nanostructured titanium substrates on the growth behaviors of mesenchymal stem cells. Surface nanostructures of titanium were produced with surface mechanical attrition treatment (SMAT) technique. The morphologies of native titanium and surface nanostructured titanium substrates were characterized by field emission scanning electron microscopy (FE-SEM), atomic force microscopy (AFM), transmission electron microscopy (TEM), X-ray diffraction (XRD) and contact-angle measurements, respectively. A thin nanostructured layer was formed onto the surfaces of titanium substrates after SMAT treatment. The effects of the surface nanostructured titanium substrates on the adhesion, spreading, proliferation and differentiation of mesenchymal stem cells (MSCs) was examined at cellular and molecular levels in vitro. The results suggest that the surface nanostructured substrates were beneficial for the growth of MSCs, including adhesion, filament orientation, proliferation and gene expression. This approach for the fabrication of surface nanostructured titanium may be exploited in the development of high performance titanium-based implants.

Carbon nanostructures for orthopedic medical applications

Carbon nanostructures (including carbon nanofibers, nanostructured diamond, fullerene materials and so forth) possess extraordinary physiochemical, mechanical and electrical properties attractive to bioengineers and medical researchers. In the past decade, numerous developments towards the fabrication and biological studies of carbon nanostructures have provided opportunities to improve orthopedic applications. Therefore, the aim of this article is to provide an up-to-date review on carbon nanostructure advances in orthopedic research. Orthopedic medical device applications of carbon nanotubes/carbon nanofibers and nanostructured diamond (including particulate nanodiamond and nanocrystalline diamond coatings) are emphasized here along with other carbon nanostructures that have promising potential. In addition, widely used fabrication techniques for producing carbon nanostructures in both the laboratory and in industry are briefly introduced. In conclusion, carbon nanostructures have demonstrated tremendous promise for orthopedic medical device applications to date, and although some safety, reliability and durability issues related to the manufacturing and implantation of carbon nanomaterials remain, their future is bright.

Enhanced growth and osteogenic differentiation of human osteoblast-like cells on boron-doped nanocrystalline diamond thin films

Intrinsic nanocrystalline diamond (NCD) films have been proven to be promising substrates for the adhesion, growth and osteogenic differentiation of bone-derived cells. To understand the role of various degrees of doping (semiconducting to metallic-like), the NCD films were deposited on silicon substrates by a microwave plasma-enhanced CVD process and their boron doping was achieved by adding trimethylboron to the CH₄:H₂ gas mixture, the B∶C ratio was 133, 1000 and 6700 ppm. The room temperature electrical resistivity of the films decreased from >10 MΩ (undoped films) to 55 kΩ, 0.6 kΩ, and 0.3 kΩ (doped films with 133, 1000 and 6700 ppm of B, respectively). The increase in the number of human osteoblast-like MG 63 cells in 7-day-old cultures on NCD films was most apparent on the NCD films doped with 133 and 1000 ppm of B (153,000±14,000 and 152,000±10,000 cells/cm², respectively, compared to 113,000±10,000 cells/cm² on undoped NCD films). As measured by ELISA per mg of total protein, the cells on NCD with 133 and 1000 ppm of B also contained the highest concentrations of collagen I and alkaline phosphatase, respectively. On the NCD films with 6700 ppm of B, the cells contained the highest concentration of focal adhesion protein vinculin, and the highest amount of collagen I was adsorbed. The concentration of osteocalcin also increased with increasing level of B doping. The cell viability on all tested NCD films was almost 100%. Measurements of the concentration of ICAM-1, i.e. an immunoglobuline adhesion molecule binding inflammatory cells, suggested that the cells on the NCD films did not undergo significant immune activation. Thus, the potential of NCD films for bone tissue regeneration can be further enhanced and tailored by B doping and that B doping up to metallic-like levels is not detrimental for cells.

Synthesis and Characterization of Multilayered Diamond Coatings for Biomedical Implants

With incredible hardness and excellent wear-resistance, nanocrystalline diamond (NCD) coatings are gaining interest in the biomedical community as articulating surfaces of structural implant devices. The focus of this study was to deposit multilayered diamond coatings of alternating NCD and microcrystalline diamond (MCD) layers on Ti-6Al-4V alloy surfaces using microwave plasma chemical vapor deposition (MPCVD) and validate the multilayer coating’s effect on toughness and adhesion. Multilayer samples were designed with varying NCD to MCD thickness ratios and layer numbers. The surface morphology and structural characteristics of the coatings were studied with X-ray diffraction (XRD), Raman spectroscopy, and atomic force microscopy (AFM). Coating adhesion was assessed by Rockwell indentation and progressive load scratch adhesion tests. Multilayered coatings shown to exhibit the greatest adhesion, comparable to single-layered NCD coatings, were the multilayer samples having the lowest average grain sizes and the highest titanium carbide to diamond ratios.

Biocompatibility and bioactivity enhancement of Ce stabilized ZrO(2) doped HA coatings by controlled porosity change of Al(2) O(3) substrates

Al(2) O(3) substrates with controlled porosity were manufactured from nanosized powders obtained by plasma processing. It was observed that when increasing the sintering temperature the overall porosity was decreasing, but the pores got larger. In a second step, Ce stabilized ZrO(2) doped hydroxyapatite coatings were pulsed laser deposited onto the Al(2) O(3) substrates. It was shown that the surface morphology, consisting of aggregates and particulates in micrometric range, was altered by the substrate porosity and interface properties, respectively. TEM studies evidenced that Ce stabilized ZrO(2) doped HA particulates ranged from 10 to 50 nm, strongly depending on the Al(2) O(3) porosity. The coatings consisted of HA nanocrystals embedded in an amorphous matrix quite similar to the bone structure. These findings were congruent with the increased biocompatibility and bioactivity of these layers confirmed by enhanced growing and proliferation of human mesenchymal stem cells.

Induction and regulation of differentiation in neural stem cells on ultra-nanocrystalline diamond films

The interaction of ultra-nanocrystalline diamond (UNCD) with neural stem cells (NSCs) has been studied in order to evaluate its potential as a biomaterial. Hydrogen-terminated UNCD (H-UNCD) films were compared with standard grade polystyrene in terms of their impact on the differentiation of NSCs. When NSCs were cultured on these substrates in medium supplemented with low concentration of serum and without any differentiating factors, H-UNCD films spontaneously induced neuronal differentiation on NSCs. By direct suppression of mitogen-activated protein kinase/extracellular signaling-regulated kinase1/2 (MAPK/Erk1/2) signaling pathway in NSCs using U0126, known to inhibit the activation of Erk1/2, we demonstrated that the enhancement of Erk1/2 pathway is one of the effects of H-UNCD-induced NSCs differentiation. Moreover, functional-blocking antibody directed against integrin beta1 subunit inhibited neuronal differentiation on H-UNCD films. This result demonstrated the involvement of integrin beta1 in H-UNCD-mediated neuronal differentiation. Mechanistic studies revealed the cell adhesion to H-UNCD films associated with focal adhesion kinase (Fak) and initiated MAPK/Erk1/2 signaling. Our study demonstrated that H-UNCD films-mediated NSCs differentiation involves fibronectin-integrin beta1 and Fak-MAPK/Erk signaling pathways in the absence of differentiation factors. These observations raise the potential for the use of UNCD as a biomaterial for central nervous system transplantation and tissue engineering.