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Li YB, Zhang HQ, Lu YP, Yang XJ, Wang GD, Wang YY, Tang KL, Huang SY, Xiao GY. Construction of Magnesium Phosphate Chemical Conversion Coatings with Different Microstructures on Titanium to Enhance Osteogenesis and Angiogenesis. ACS Appl Mater Interfaces 2024; 16:21672-21688. [PMID: 38637290 DOI: 10.1021/acsami.4c03024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Titanium (Ti) and its alloys are widely used as hard tissue substitutes in dentistry and orthopedics, but their low bioactivity leads to undesirable osseointegration defects in the early osteogenic phase. Surface modification is an important approach to overcome these problems. In the present study, novel magnesium phosphate (MgP) coatings with controllable structures were fabricated on the surface of Ti using the phosphate chemical conversion (PCC) method. The effects of the microstructure on the physicochemical and biological properties of the coatings on Ti were researched. The results indicated that accelerators in PCC solution were important factors affecting the microstructure and properties of the MgP coatings. In addition, the coated Ti exhibited excellent hydrophilicity, high bonding strength, and good corrosion resistance. Moreover, the biological results showed that the MgP coatings could improve the spread, proliferation, and osteogenic differentiation of mouse osteoblast cells (MC3T3-E1) and vascular differentiation of human umbilical vein endothelial cells (HUVECs), indicating that the coated Ti samples had a great effect on promoting osteogenesis and angiogenesis. Overall, this study provided a new research idea for the surface modification of conventional Ti to enhance osteogenesis and angiogenesis in different bone types for potential biomedical applications.
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Affiliation(s)
- Yi-Bo Li
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China
- School of Materials Science and Engineering, Shandong University, Jinan 250061, China
| | - Huan-Qing Zhang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
| | - Yu-Peng Lu
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China
- School of Materials Science and Engineering, Shandong University, Jinan 250061, China
| | - Xiao-Juan Yang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
| | - Guan-Duo Wang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
| | - Yu-Ying Wang
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China
- School of Materials Science and Engineering, Shandong University, Jinan 250061, China
| | - Kang-le Tang
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China
- School of Materials Science and Engineering, Shandong University, Jinan 250061, China
| | - Sheng-Yun Huang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Gui-Yong Xiao
- Key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials, Ministry of Education, Shandong University, Jinan 250061, China
- School of Materials Science and Engineering, Shandong University, Jinan 250061, China
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Yu Z, Wang H, Ying B, Mei X, Zeng D, Liu S, Qu W, Pan X, Pu S, Li R, Qin Y. Mild photothermal therapy assist in promoting bone repair: Related mechanism and materials. Mater Today Bio 2023; 23:100834. [PMID: 38024841 PMCID: PMC10643361 DOI: 10.1016/j.mtbio.2023.100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/21/2023] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
Achieving precision treatment in bone tissue engineering (BTE) remains a challenge. Photothermal therapy (PTT), as a form of precision therapy, has been extensively investigated for its safety and efficacy. It has demonstrated significant potential in the treatment of orthopedic diseases such as bone tumors, postoperative infections and osteoarthritis. However, the high temperatures associated with PTT can lead to certain limitations and drawbacks. In recent years, researchers have explored the use of biomaterials for mild photothermal therapy (MPT), which offers a promising approach for addressing these limitations. This review provides a comprehensive overview of the mechanisms underlying MPT and presents a compilation of photothermal agents and their utilization strategies for bone tissue repair. Additionally, the paper discusses the future prospects of MPT-assisted bone tissue regeneration, aiming to provide insights and recommendations for optimizing material design in this field.
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Affiliation(s)
- Zehao Yu
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Hao Wang
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Boda Ying
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Xiaohan Mei
- National & Local Joint Engineering Laboratory for Synthesis Technology of High-Performance Polymer, College of Chemistry, Jilin University, Changchun, 130012, People’s Republic of China
| | - Dapeng Zeng
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Shibo Liu
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Wenrui Qu
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Xiangjun Pan
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Si Pu
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Ruiyan Li
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
| | - Yanguo Qin
- Department of Joint Surgery of Orthopaedic Center, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China
- Jilin Provincial Key Laboratory of Orhtopeadics, Changchun, Jilin 130041 People’s Republic of China
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Jayasree A, Liu C, Salomon C, Ivanovski S, Gulati K, Han P. Microvesicle-eluting nano-engineered implants influence inflammatory response of keratinocytes. Drug Deliv Transl Res 2023:10.1007/s13346-023-01457-x. [PMID: 37985540 DOI: 10.1007/s13346-023-01457-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/22/2023]
Abstract
Besides enhancing osseo- and soft tissue integration, modulating inflammation at the implant site is also crucial for dental implant success. Uncontrolled peri-implant inflammation can cause significant loss of surrounding tissue and implant failure. It was recently shown that microvesicles (MVs), a less-studied type of extracellular vesicles, play a crucial role in cell-to-cell communication and may modulate angiogenesis and inflammatory response. The effect of MVs on regulating inflammation at an implant site, however, remains unexplored. In the current study, MVs were isolated and characterised from human primary gingival fibroblasts (hGFs) and loaded within titania nanotubes (TNTs, fabricated via anodisation on 3D Ti wire implants) towards their local release. The modified implants were characterised using SEM and confocal imaging to confirm the loading and local release of MVs from TNTs. In vitro studies demonstrated the internalisation of hGFs-MVs by human gingival keratinocytes (OKF6/TERT2 cell line), which caused a significant reduction in the production of pro-inflammatory cytokines. The results support MVs-releasing TNTs as a promising implant surface modification strategy to reduce inflammation, paving the way for further advancements in therapeutic dental implants.
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Affiliation(s)
- Anjana Jayasree
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia
- Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, 4006, Australia
| | - Chun Liu
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia
- Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, 4006, Australia
| | - Carlos Salomon
- Translational Extracellular Vesicles in Obstetrics and Gynae-Oncology Group, University of Queensland Centre for Clinical Research, Faculty of Medicine, Royal Brisbane and Women's Hospital, The University of Queensland, Brisbane, QLD, 4029, Australia
| | - Sašo Ivanovski
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia.
- Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, 4006, Australia.
| | - Karan Gulati
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia.
- Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, 4006, Australia.
| | - Pingping Han
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia.
- Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, 4006, Australia.
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Gulati K, Adachi T. Profiling to Probing: Atomic force microscopy to characterize nano-engineered implants. Acta Biomater 2023; 170:15-38. [PMID: 37562516 DOI: 10.1016/j.actbio.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
Surface modification of implants in the nanoscale or implant nano-engineering has been recognized as a strategy for augmenting implant bioactivity and achieving long-term implant success. Characterizing and optimizing implant characteristics is crucial to achieving desirable effects post-implantation. Modified implant enables tailored, guided and accelerated tissue integration; however, our understanding is limited to multicellular (bulk) interactions. Finding the nanoscale forces experienced by a single cell on nano-engineered implants will aid in predicting implants' bioactivity and engineering the next generation of bioactive implants. Atomic force microscope (AFM) is a unique tool that enables surface characterization and understanding of the interactions between implant surface and biological tissues. The characterization of surface topography using AFM to gauge nano-engineered implants' characteristics (topographical, mechanical, chemical, electrical and magnetic) and bioactivity (adhesion of cells) is presented. A special focus of the review is to discuss the use of single-cell force spectroscopy (SCFS) employing AFM to investigate the minute forces involved with the adhesion of a single cell (resident tissue cell or bacterium) to the surface of nano-engineered implants. Finally, the research gaps and future perspectives relating to AFM-characterized current and emerging nano-engineered implants are discussed towards achieving desirable bioactivity performances. This review highlights the use of advanced AFM-based characterization of nano-engineered implant surfaces via profiling (investigating implant topography) or probing (using a single cell as a probe to study precise adhesive forces with the implant surface). STATEMENT OF SIGNIFICANCE: Nano-engineering is emerging as a surface modification platform for implants to augment their bioactivity and achieve favourable treatment outcomes. In this extensive review, we closely examine the use of Atomic Force Microscopy (AFM) to characterize the properties of nano-engineered implant surfaces (topography, mechanical, chemical, electrical and magnetic). Next, we discuss Single-Cell Force Spectroscopy (SCFS) via AFM towards precise force quantification encompassing a single cell's interaction with the implant surface. This interdisciplinary review will appeal to researchers from the broader scientific community interested in implants and cell adhesion to implants and provide an improved understanding of the surface characterization of nano-engineered implants.
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Affiliation(s)
- Karan Gulati
- Institute for Life and Medical Sciences, Kyoto University, Sakyo, Kyoto 606-8507, Japan; The University of Queensland, School of Dentistry, Herston QLD 4006, Australia.
| | - Taiji Adachi
- Institute for Life and Medical Sciences, Kyoto University, Sakyo, Kyoto 606-8507, Japan
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Jiang P, Zhang Y, Hu R, Shi B, Zhang L, Huang Q, Yang Y, Tang P, Lin C. Advanced surface engineering of titanium materials for biomedical applications: From static modification to dynamic responsive regulation. Bioact Mater 2023; 27:15-57. [PMID: 37035422 PMCID: PMC10074421 DOI: 10.1016/j.bioactmat.2023.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
Titanium (Ti) and its alloys have been widely used as orthopedic implants, because of their favorable mechanical properties, corrosion resistance and biocompatibility. Despite their significant success in various clinical applications, the probability of failure, degradation and revision is undesirably high, especially for the patients with low bone density, insufficient quantity of bone or osteoporosis, which renders the studies on surface modification of Ti still active to further improve clinical results. It is discerned that surface physicochemical properties directly influence and even control the dynamic interaction that subsequently determines the success or rejection of orthopedic implants. Therefore, it is crucial to endow bulk materials with specific surface properties of high bioactivity that can be performed by surface modification to realize the osseointegration. This article first reviews surface characteristics of Ti materials and various conventional surface modification techniques involving mechanical, physical and chemical treatments based on the formation mechanism of the modified coatings. Such conventional methods are able to improve bioactivity of Ti implants, but the surfaces with static state cannot respond to the dynamic biological cascades from the living cells and tissues. Hence, beyond traditional static design, dynamic responsive avenues are then emerging. The dynamic stimuli sources for surface functionalization can originate from environmental triggers or physiological triggers. In short, this review surveys recent developments in the surface engineering of Ti materials, with a specific emphasis on advances in static to dynamic functionality, which provides perspectives for improving bioactivity and biocompatibility of Ti implants.
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Han J, Ma Q, An Y, Wu F, Zhao Y, Wu G, Wang J. The current status of stimuli-responsive nanotechnologies on orthopedic titanium implant surfaces. J Nanobiotechnology 2023; 21:277. [PMID: 37596638 PMCID: PMC10439657 DOI: 10.1186/s12951-023-02017-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/21/2023] [Indexed: 08/20/2023] Open
Abstract
With the continuous innovation and breakthrough of nanomedical technology, stimuli-responsive nanotechnology has been gradually applied to the surface modification of titanium implants to achieve brilliant antibacterial activity and promoted osteogenesis. Regarding to the different physiological and pathological microenvironment around implants before and after surgery, these surface nanomodifications are designed to respond to different stimuli and environmental changes in a timely, efficient, and specific way/manner. Here, we focus on the materials related to stimuli-responsive nanotechnology on titanium implant surface modification, including metals and their compounds, polymer materials and other materials. In addition, the mechanism of different response types is introduced according to different activation stimuli, including magnetic, electrical, photic, radio frequency and ultrasonic stimuli, pH and enzymatic stimuli (the internal stimuli). Meanwhile, the associated functions, potential applications and developing prospect were discussion.
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Affiliation(s)
- Jingyuan Han
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Qianli Ma
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Geitmyrsveien, Oslo, 710455 Norway
| | - Yanxin An
- Department of General Surgery, The First Affiliated Hospital of Xi’an Medical University, Xi’an, China
| | - Fan Wu
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Yuqing Zhao
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Gaoyi Wu
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Jing Wang
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
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Gulati K, Chopra D, Kocak-Oztug NA, Verron E. Fit and forget: The future of dental implant therapy via nanotechnology. Adv Drug Deliv Rev 2023; 199:114900. [PMID: 37263543 DOI: 10.1016/j.addr.2023.114900] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia.
| | - Divya Chopra
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Necla Asli Kocak-Oztug
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Istanbul University, Faculty of Dentistry, Department of Periodontology, 34116 Istanbul, Turkey
| | - Elise Verron
- Nantes Université, CNRS, CEISAM, UMR 6230, 44000 Nantes, France
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Chan WS, Gulati K, Peters OA. Advancing Nitinol: From heat treatment to surface functionalization for nickel–titanium (NiTi) instruments in endodontics. Bioact Mater 2023; 22:91-111. [PMID: 36203965 PMCID: PMC9520078 DOI: 10.1016/j.bioactmat.2022.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022] Open
Abstract
Nickel-titanium (NiTi) alloy has been extensively researched in endodontics, particularly in cleaning and shaping the root canal system. Research advances have primarily focused on the design, shape, and geometry of the NiTi files as well as metallurgy and mechanical properties. So far, extensive investigations have been made surrounding surface and thermomechanical treatments, however, limited work has been done in the realm of surface functionalization to augment its performance in endodontics. This review summarizes the unique characteristics, current use, and latest developments in thermomechanically treated NiTi endodontic files. It discusses recent improvements in nano-engineering and the possibility of customizing the NiTi file surface for added functionalization. Whilst clinical translation of this technology has yet to be fully realized, future research direction will lie in the use of nanotechnology. Nitinol (Nickel Titanium alloy) is widely used to clean/shape root canal system in endodontics. To enhance its performance, various thermo-mechanical and nano-engineering modifications have been performed. This comprehensive review summarizes the latest advances and future trends relating to functionalized NiTi endodontic files.
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Gulati K, Ding C, Guo T, Guo H, Yu H, Liu Y. Craniofacial therapy: advanced local therapies from nano-engineered titanium implants to treat craniofacial conditions. Int J Oral Sci 2023; 15:15. [PMID: 36977679 PMCID: PMC10050545 DOI: 10.1038/s41368-023-00220-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/05/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
Nano-engineering-based tissue regeneration and local therapeutic delivery strategies show significant potential to reduce the health and economic burden associated with craniofacial defects, including traumas and tumours. Critical to the success of such nano-engineered non-resorbable craniofacial implants include load-bearing functioning and survival in complex local trauma conditions. Further, race to invade between multiple cells and pathogens is an important criterion that dictates the fate of the implant. In this pioneering review, we compare the therapeutic efficacy of nano-engineered titanium-based craniofacial implants towards maximised local therapy addressing bone formation/resorption, soft-tissue integration, bacterial infection and cancers/tumours. We present the various strategies to engineer titanium-based craniofacial implants in the macro-, micro- and nano-scales, using topographical, chemical, electrochemical, biological and therapeutic modifications. A particular focus is electrochemically anodised titanium implants with controlled nanotopographies that enable tailored and enhanced bioactivity and local therapeutic release. Next, we review the clinical translation challenges associated with such implants. This review will inform the readers of the latest developments and challenges related to therapeutic nano-engineered craniofacial implants.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD, Australia
| | - Chengye Ding
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Tianqi Guo
- The University of Queensland, School of Dentistry, Herston, QLD, Australia
| | - Houzuo Guo
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huajie Yu
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
- Fourth Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
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Guo T, Scimeca JC, Ivanovski S, Verron E, Gulati K. Enhanced Corrosion Resistance and Local Therapy from Nano-Engineered Titanium Dental Implants. Pharmaceutics 2023; 15. [PMID: 36839638 DOI: 10.3390/pharmaceutics15020315] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Titanium is the ideal material for fabricating dental implants with favorable biocompatibility and biomechanics. However, the chemical corrosions arising from interaction with the surrounding tissues and fluids in oral cavity can challenge the integrity of Ti implants and leach Ti ions/nanoparticles, thereby causing cytotoxicity. Various nanoscale surface modifications have been performed to augment the chemical and electrochemical stability of Ti-based dental implants, and this review discusses and details these advances. For instance, depositing nanowires/nanoparticles via alkali-heat treatment and plasma spraying results in the fabrication of a nanostructured layer to reduce chemical corrosion. Further, refining the grain size to nanoscale could enhance Ti implants' mechanical and chemical stability by alleviating the internal strain and establishing a uniform TiO2 layer. More recently, electrochemical anodization (EA) has emerged as a promising method to fabricate controlled TiO2 nanostructures on Ti dental implants. These anodized implants enhance Ti implants' corrosion resistance and bioactivity. A particular focus of this review is to highlight critical advances in anodized Ti implants with nanotubes/nanopores for local drug delivery of potent therapeutics to augment osseo- and soft-tissue integration. This review aims to improve the understanding of novel nano-engineered Ti dental implant modifications, focusing on anodized nanostructures to fabricate the next generation of therapeutic and corrosion-resistant dental implants. The review explores the latest developments, clinical translation challenges, and future directions to assist in developing the next generation of dental implants that will survive long-term in the complex corrosive oral microenvironment.
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Wang C, Gao S, Lu R, Wang X, Chen S. In Vitro and In Vivo Studies of Hydrogenated Titanium Dioxide Nanotubes with Superhydrophilic Surfaces during Early Osseointegration. Cells 2022; 11:3417. [DOI: 10.3390/cells11213417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Titanium-based implants are often utilized in oral implantology and craniofacial reconstructions. However, the biological inertness of machined titanium commonly results in unsatisfactory osseointegration. To improve the osseointegration properties, we modified the titanium implants with nanotubular/superhydrophilic surfaces through anodic oxidation and thermal hydrogenation and evaluated the effects of the machined surfaces (M), nanotubular surfaces (Nano), and hydrogenated nanotubes (H-Nano) on osteogenesis and osseointegration in vitro and in vivo. After incubation of mouse bone marrow mesenchymal stem cells on the samples, we observed improved cell adhesion, alkaline phosphatase activity, osteogenesis-related gene expression, and extracellular matrix mineralization in the H-Nano group compared to the other groups. Subsequent in vivo studies indicated that H-Nano implants promoted rapid new bone regeneration and osseointegration at 4 weeks, which may be attributed to the active osteoblasts adhering to the nanotubular/superhydrophilic surfaces. Additionally, the Nano group displayed enhanced osteogenesis in vitro and in vivo at later stages, especially at 8 weeks. Therefore, we report that hydrogenated superhydrophilic nanotubes can significantly accelerate osteogenesis and osseointegration at an early stage, revealing the considerable potential of this implant modification for clinical applications.
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Prosolov KA, Komarova EG, Kazantseva EA, Lozhkomoev AS, Kazantsev SO, Bakina OV, Mishina MV, Zima AP, Krivoshchekov SV, Khlusov IA, Sharkeev YP. UMAOH Calcium Phosphate Coatings Designed for Drug Delivery: Vancomycin, 5-Fluorouracil, Interferon α-2b Case. Materials 2022; 15:4643. [PMID: 35806777 PMCID: PMC9267872 DOI: 10.3390/ma15134643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 12/10/2022]
Abstract
Drug delivery systems based on calcium phosphate (CaP) coatings have been recently recognized as beneficial drug delivery systems in complex cases of bone diseases for admission of drugs in the localized area, simultaneously inducing osteoinduction because of the bioavailable Ca and P ions. However, micro-arc oxidation (MAO) deposition of CaP does not allow for the formation of a coating with sufficient interconnected porosity for drug delivery purposes. Here, we report on the method to deposit CaP-based coatings using a new hybrid ultrasound-assisted MAO (UMAOH) method for deposition of coatings for drug delivery that could carry various types of drugs, such as cytostatic, antibacterial, or immunomodulatory compositions. Application of UMAOH resulted in coatings with an Ra roughness equal to 3.5 µm, a thickness of 50–55 µm, and a combination of high values of internal and surface porosity, 39 and 28%, respectively. The coating is represented by the monetite phase that is distributed in the matrix of amorphous CaP. Optimal conditions of coating deposition have been determined and used for drug delivery by impregnation with Vancomycin, 5-Fluorouracil, and Interferon-α-2b. Cytotoxicity and antimicrobial activity of the manufactured drug-carrying coatings have been studied using the three different cell lines and methicillin-resistant S. aureus.
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Chopra D, Jayasree A, Guo T, Gulati K, Ivanovski S. Advancing dental implants: Bioactive and therapeutic modifications of zirconia. Bioact Mater 2022; 13:161-178. [PMID: 35224299 PMCID: PMC8843948 DOI: 10.1016/j.bioactmat.2021.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/22/2021] [Accepted: 10/06/2021] [Indexed: 12/16/2022] Open
Abstract
Zirconium-based implants have gained popularity in the dental implant field owing to their corrosion resistance and biocompatibility, attributed to the formation of a native zirconia (ZrO2) film. However, enhanced bioactivity and local therapy from such implants are desirable to enable the earlier establishment and improved long-term maintenance of implant integration, especially in compromised patient conditions. As a result, surface modification of zirconium-based implants have been performed using various physical, chemical and biological techniques at the macro-, micro-, and nano-scales. In this extensive review, we discuss and detail the development of Zr implants covering the spectrum from past and present advancements to future perspectives, arriving at the next generation of highly bioactive and therapeutic nano-engineered Zr-based implants. The review provides in-depth knowledge of the bioactive/therapeutic value of surface modification of Zr implants in dental implant applications focusing on clinical translation.
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Affiliation(s)
| | | | | | - Karan Gulati
- Corresponding authors. School of Dentistry, University of Queensland, 288 Herston Road, Herston QLD, 4006, Australia.
| | - Sašo Ivanovski
- Corresponding authors. School of Dentistry, University of Queensland, 288 Herston Road, Herston QLD, 4006, Australia.
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Liu H, Xu D, Ma Y, Qian J, Yang Y, Yu B, Ren L, Yang K. Mechanisms of Hierarchical Topographies Tuning Bacteria and Cell Biological Responses to the Surfaces of Pure Titanium and Cu-Bearing Titanium Alloy. ACS Appl Mater Interfaces 2022; 14:19226-19240. [PMID: 35446537 DOI: 10.1021/acsami.2c02802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The competition between cells integration and bacterial colonization determines the fate of implantations. To reveal the effects of clinical implant topographies on osteoblast differentiation and bacterial biofilm formation, a series of micron/submicron/nano-hierarchical structures were created at pure titanium surfaces (Ti-I, Ti-II, Ti-III). It was found that the hierarchical structures promoted MC3T3-E1 cell differentiation through contact guidance and Ti-II processed the best osteogenic ability. Undesirably, hierarchical surfaces further accelerated the biofilm formation due to submicron structures with low interaction. To reduce the risk of bacterial infections, hierarchical structures were prepared on the antibacterial Cu-bearing titanium alloy surfaces (TiCu-I, TiCu-II, TiCu-III). Hierarchical topographies not only endowed TiCu surfaces with antibacterial trapping characteristics due to CuO doped in the outermost oxides layer but also shifted the corrosion behavior of TiCu alloy into activation-passivation, increasing the Cu-ion release rate and further promoting the osteogenic differentiation. TiCu-III possessed excellent antibacterial trapping ability and optimal osteogenic action. Finally, in the osteomyelitis-modeled mice, hierarchical topographies aggravated the bacterial infection around Ti implants, which entirely lost the osseointegration, while all of the TiCu surfaces significantly inhibited the infection and accelerated the formation of new bone tunnels around the implants. In vivo studies successfully confirmed the tuning mechanism of hierarchical topographies on the biological responses of bacteria and cells to the Ti and TiCu alloys, which would pave the way to develop novel biofunctionalized metal implants.
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Affiliation(s)
- Hui Liu
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, 72 Wenhua Road, Shenyang 110016, China
| | - Daorong Xu
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yuan Ma
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Jikun Qian
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | | | - Bin Yu
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Ling Ren
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, China
| | - Ke Yang
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, China
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Abstract
Objectives P4 Medicine is based on a proactive approach for clinical patient care incorporating the four “pillars” of prediction, prevention, personalization, and participation for patient management. The purpose of this review is to demonstrate how the concepts of P4 medicine can be incorporated into the management of periodontal diseases (particularly periodontitis) termed P4 periodontics. Methods This is a narrative review that used current literature to explore how P4 periodontics can be aligned with the 2018 Classification of Periodontal Diseases, current periodontal treatment paradigms, and periodontal regenerative technologies. Results The proposed model of P4 periodontics is highly aligned with the 2018 Classification of Periodontal Diseases and represents a logical extension of this classification into treatment paradigms. Each stage of periodontitis can be related to a holistic approach to clinical management. The role of “big data” in future P4 periodontics is discussed and the concepts of a treat-to-target focus for treatment outcomes are proposed as part of personalized periodontics. Personalized regenerative and rejuvenative periodontal therapies will refocus our thinking from risk management to regenerative solutions to manage the effects of disease and aging. Conclusions P4 Periodontics allows us to focus not only on early prevention and intervention but also allow for personalized late-stage reversal of the disease trajectory and the use of personalized regenerative procedures to reconstruct damaged tissues and restore them to health. Clinical Significance P4 Periodontics is a novel means of viewing a holistic, integrative, and proactive approach to periodontal treatment.
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Affiliation(s)
- P Mark Bartold
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia.
| | - Sašo Ivanovski
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia
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Gulati K. Nano-Engineering Solutions for Dental Implant Applications. Nanomaterials (Basel) 2022; 12:272. [PMID: 35055289 PMCID: PMC8779811 DOI: 10.3390/nano12020272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/13/2022] [Indexed: 02/05/2023]
Abstract
This Special Issue of Nanomaterials explores the recent advances and trends with respect to nano-engineered strategies towards dental implant applications [...].
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Affiliation(s)
- Karan Gulati
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia
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17
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Rempel AA, Valeeva AA, Vokhmintsev AS, Weinstein IA. Titanium dioxide nanotubes: synthesis, structure, properties and applications. Russ Chem Rev 2021. [DOI: 10.1070/rcr4991] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract
Methods of synthesis of nanotubular structures based on titania of various phase and chemical compositions are described. A systematic account is given of known data about the influence of synthesis and subsequent treatment conditions on the amorphous and crystal structures, specific surface area, morphology and optical, luminescence and electro-physical properties of titania-based nanotubular oxide materials. The photocatalytic properties in the oxidation reactions of organic compounds and the performance characteristics of the memristive behaviour of TiO2-based nanotubular structures are considered in details. Their applications are discussed.
The bibliography includes 238 references.
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Guo T, Oztug NAK, Han P, Ivanovski S, Gulati K. Influence of sterilization on the performance of anodized nanoporous titanium implants. Mater Sci Eng C Mater Biol Appl 2021; 130:112429. [PMID: 34702514 DOI: 10.1016/j.msec.2021.112429] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/22/2021] [Accepted: 09/06/2021] [Indexed: 12/27/2022]
Abstract
Towards clinical translation of bioactive nano-engineered titanium implants, achieving appropriate sterilization and understanding its influence on the modified implant characteristics is essential. With limited studies exploring the influence of sterilization techniques on electrochemically anodized titanium with TiO2 nanostructures, we aimed to advance this domain by performing an in-depth evaluation of the influence of common sterilization techniques (ethanol immersion, various UV irradiation times, gamma irradiation, and dry/wet autoclaving) on TiO2 nanopores fabricated on micro-rough Ti surfaces (dual micro-nano) via single step anodization. Various sterilized surfaces were systematically compared in terms of topographical, chemical, crystalline, wettability and mechanical characteristics. Next, we investigated the protein adhesion capacity and functions of primary gingival fibroblasts (proliferation, adhesion/alignment and spreading morphology) to compare the bioactivity of the sterilized nanopores. Ethanol immersion, gamma irradiation and UV irradiation conserved the topography of the fabricated nanopores, while autoclave sterilization (both dry and wet) compromised the nanoporous structures. Various duration of UV-sterilization resulted in no significant changes in the surface topography and chemistry of the fabricated TNPs. Our findings revealed that UV irradiation is the most appropriate technique to sterilize nano-engineered titanium implants for appropriate wettability, protein adhesion capacity and enhanced metabolism and proliferation of human gingival fibroblasts (hGFs). This study systematically investigated the influence of sterilization on anodized nano-engineered titanium implants towards achieving reproducible outcomes (in terms of topography, chemistry and bioactivity), and found that UV irradiation holds great promise for application across different nano-engineered metal surfaces.
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Affiliation(s)
- Tianqi Guo
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Necla Asli Kocak Oztug
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Istanbul University, Faculty of Dentistry, Department of Periodontology, Istanbul 34116, Turkey
| | - Pingping Han
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Sašo Ivanovski
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia.
| | - Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia.
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Zhang Y, Gulati K, Li Z, Di P, Liu Y. Dental Implant Nano-Engineering: Advances, Limitations and Future Directions. Nanomaterials (Basel) 2021; 11:2489. [PMID: 34684930 PMCID: PMC8538755 DOI: 10.3390/nano11102489] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/08/2021] [Accepted: 09/18/2021] [Indexed: 12/27/2022]
Abstract
Titanium (Ti) and its alloys offer favorable biocompatibility, mechanical properties and corrosion resistance, which makes them an ideal material choice for dental implants. However, the long-term success of Ti-based dental implants may be challenged due to implant-related infections and inadequate osseointegration. With the development of nanotechnology, nanoscale modifications and the application of nanomaterials have become key areas of focus for research on dental implants. Surface modifications and the use of various coatings, as well as the development of the controlled release of antibiotics or proteins, have improved the osseointegration and soft-tissue integration of dental implants, as well as their antibacterial and immunomodulatory functions. This review introduces recent nano-engineering technologies and materials used in topographical modifications and surface coatings of Ti-based dental implants. These advances are discussed and detailed, including an evaluation of the evidence of their biocompatibility, toxicity, antimicrobial activities and in-vivo performances. The comparison between these attempts at nano-engineering reveals that there are still research gaps that must be addressed towards their clinical translation. For instance, customized three-dimensional printing technology and stimuli-responsive, multi-functional and time-programmable implant surfaces holds great promise to advance this field. Furthermore, long-term in vivo studies under physiological conditions are required to ensure the clinical application of nanomaterial-modified dental implants.
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Affiliation(s)
- Yifan Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China;
| | - Karan Gulati
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia;
| | - Ze Li
- School of Stomatology, Chongqing Medical University, Chongqing 400016, China;
| | - Ping Di
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia;
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Gulati K, Zhang Y, Di P, Liu Y, Ivanovski S. Research to Clinics: Clinical Translation Considerations for Anodized Nano-Engineered Titanium Implants. ACS Biomater Sci Eng 2021; 8:4077-4091. [PMID: 34313123 DOI: 10.1021/acsbiomaterials.1c00529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Titania nanotubes (TNTs) fabricated on titanium orthopedic and dental implants have shown significant potential in "proof of concept" in vitro, ex vivo, and short-term in vivo studies. However, most studies do not focus on a clear direction for future research towards clinical translation, and there exists a knowledge gap in identifying key research challenges that must be addressed to progress to the clinical setting. This review focuses on such challenges with respect to anodized titanium implants modified with TNTs, including optimized fabrication on clinically utilized microrough surfaces, clinically relevant bioactivity assessments, and controlled/tailored local release of therapeutics. Further, long-term in vivo investigations in compromised animal models under loading conditions are needed. We also discuss and detail challenges and progress related to the mechanical stability of TNT-based implants, corrosion resistance/electrochemical stability, optimized cleaning/sterilization, packaging/aging, and nanotoxicity concerns. This extensive, clinical translation focused review of TNTs modified Ti implants aims to foster improved understanding of key research gaps and advances, informing future research in this domain.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
| | - Yifan Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology and National Clinical Research Centre for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology and National Clinical Research Centre for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Sašo Ivanovski
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
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