Gradient surface porosity in titanium dental implants: relation between processing parameters and microstructure

The effect of porous compliance bushings in a dental implant on the distribution of occlusal loads

Porous dental implants are clinically used, but the mechanism of load distribution for stepped implant shaft surrounded by compliance bushings is still not known, especially for different bone conditions. The aim of the study was to assess the impact of the design of a dental implant with compliance bushings (CBs) on the occlusal load distribution during primary and secondary stability using finite element simulation (FEA), with a distinction between low and high quality cervical support under primary stability. The FEA of the oblique occlusal load transfer (250 N; 45°) was carried out for implants under variable bone conditions. The stepped shaft in the intermediate part of the dental implant was surrounded by CBs with an increasing modulus of elasticity of 2, 10 and 50 GPa. With a smaller Young's modulus of the bushings the increase of stress in the trabecular bone indicated that more bone tissue can be protected against disuse. The beneficial effect for the trabecular bone derived from the reduction of the stiffness of the bushings in relation to the loss of the implant's load bearing ability can be assessed using the FEM method.

Surface Functionalization of Orthopedic Titanium Implants with Bone Sialoprotein

Orthopedic implant failure due to aseptic loosening and mechanical instability remains a major problem in total joint replacement. Improving osseointegration at the bone-implant interface may reduce micromotion and loosening. Bone sialoprotein (BSP) has been shown to enhance bone formation when coated onto titanium femoral implants and in rat calvarial defect models. However, the most appropriate method of BSP coating, the necessary level of BSP coating, and the effect of BSP coating on cell behavior remain largely unknown. In this study, BSP was covalently coupled to titanium surfaces via an aminosilane linker (APTES), and its properties were compared to BSP applied to titanium via physisorption and untreated titanium. Cell functions were examined using primary human osteoblasts (hOBs) and L929 mouse fibroblasts. Gene expression of specific bone turnover markers at the RNA level was detected at different intervals. Cell adhesion to titanium surfaces treated with BSP via physisorption was not significantly different from that of untreated titanium at any time point, whereas BSP application via covalent coupling caused reduced cell adhesion during the first few hours in culture. Cell migration was increased on titanium disks that were treated with higher concentrations of BSP solution, independent of the coating method. During the early phases of hOB proliferation, a suppressive effect of BSP was observed independent of its concentration, particularly when BSP was applied to the titanium surface via physisorption. Although alkaline phosphatase activity was reduced in the BSP-coated titanium groups after 4 days in culture, increased calcium deposition was observed after 21 days. In particular, the gene expression level of RUNX2 was upregulated by BSP. The increase in calcium deposition and the stimulation of cell differentiation induced by BSP highlight its potential as a surface modifier that could enhance the osseointegration of orthopedic implants. Both physisorption and covalent coupling of BSP are similarly effective, feasible methods, although a higher BSP concentration is recommended.

In vitro and in vivo performance of bioactive Ti6Al4V/TiC/HA implants fabricated by a rapid microwave sintering technique

Failure of the bone-implant interface in a joint prosthesis is a main cause of implant loosening. The introduction of a bioactive substance, hydroxyapatite (HA), to a metallic bone-implant may enhance its fixation on human bone by encouraging direct bone bonding. Ti6Al4V/TiC/HA composites with a reproducible porous structure (porosity of 27% and pore size of 6-89 μm) were successfully fabricated by a rapid microwave sintering technique. This method allows the biocomposites to be fabricated in a short period of time under ambient conditions. Ti6Al4V/TiC/HA composites exhibited a compressive strength of 93 MPa, compressive modulus of 2.9 GPa and microhardness of 556 HV which are close to those of the human cortical bone. The in vitro preosteoblast MC3T3-E1 cells cultured on the Ti6Al4V/TiC/HA composite showed that the composite surface could provide a biocompatible environment for cell adhesion, proliferation and differentiation without any cytotoxic effects. This is among the first attempts to study the in vivo performance of load-bearing Ti6Al4V/TiC and Ti6Al4V/TiC/HA composites in a live rabbit. The results indicated that the Ti6Al4V/TiC/HA composite had a better bone-implant interface compared with the Ti6Al4V/TiC implant. Based on the microstructural features, the mechanical properties, and the in vitro and in vivo test results from this study, the Ti6Al4V/TiC/HA composites have the potential to be employed in load-bearing orthopedic applications.

New Developments of Ti-Based Alloys for Biomedical Applications

Ti-based alloys are finding ever-increasing applications in biomaterials due to their excellent mechanical, physical and biological performance. Nowdays, low modulus β-type Ti-based alloys are still being developed. Meanwhile, porous Ti-based alloys are being developed as an alternative orthopedic implant material, as they can provide good biological fixation through bone tissue ingrowth into the porous network. This paper focuses on recent developments of biomedical Ti-based alloys. It can be divided into four main sections. The first section focuses on the fundamental requirements titanium biomaterial should fulfill and its market and application prospects. This section is followed by discussing basic phases, alloying elements and mechanical properties of low modulus β-type Ti-based alloys. Thermal treatment, grain size, texture and properties in Ti-based alloys and their limitations are dicussed in the third section. Finally, the fourth section reviews the influence of microstructural configurations on mechanical properties of porous Ti-based alloys and all known methods for fabricating porous Ti-based alloys. This section also reviews prospects and challenges of porous Ti-based alloys, emphasizing their current status, future opportunities and obstacles for expanded applications. Overall, efforts have been made to reveal the latest scenario of bulk and porous Ti-based materials for biomedical applications.

Dental implants from functionally graded materials

Functionally graded material (FGM) is a heterogeneous composite material including a number of constituents that exhibit a compositional gradient from one surface of the material to the other subsequently, resulting in a material with continuously varying properties in the thickness direction. FGMs are gaining attention for biomedical applications, especially for implants, owing to their reported superior composition. Dental implants can be functionally graded to create an optimized mechanical behavior and achieve the intended biocompatibility and osseointegration improvement. This review presents a comprehensive summary of biomaterials and manufacturing techniques researchers employ throughout the world. Generally, FGM and FGM porous biomaterials are more difficult to fabricate than uniform or homogenous biomaterials. Therefore, our discussion is intended to give the readers about successful and obstacles fabrication of FGM and porous FGM in dental implants that will bring state-of-the-art technology to the bedside and develop quality of life and present standards of care.

Mechanical property assessment of bone healing around a titanium-zirconium alloy dental implant

BACKGROUND

It has been reported that titanium-zirconium alloy with 13-17% zirconium (TiZr1317) implants show higher biomechanical stability and bone area percentage relative to commercially pure titanium (cpTi) grade 4 fixtures.

PURPOSE

This study aimed to determine whether the higher stability for TiZr1317 implants is associated with higher mechanical properties of remodeling bone in the areas around the implants.

MATERIALS AND METHODS

This study utilized 36 implants (n = 18: TiZr1317, n = 18: cpTi), which were placed in the healed ridges of the mandibular premolar and first molar of 12 mini pigs (n = 3 implants/animal). After 4 weeks in vivo, the samples were retrieved, and resin-embedded histologic sections of approximately 100 μm in thickness were prepared. In order to determine the nanomechanical properties, nanoindentation (n = 30 tests/specimen) was performed on the bone tissue of the sections under wet conditions with maximum load of 300 μN (loading rate: 60 μN/s).

RESULTS

The mean (± standard deviation) elastic modulus (E) and hardness (H) for the TiZr1317 group were 2.73 ± 0.50 GPa and 0.116 ± 0.017 GPa, respectively. For the cpTi group, values were 2.68 ± 0.51 GPa and 0.110 ± 0.017 GPa for E and H, respectively. Although slightly higher mechanical properties values were observed for the TiZr1317 implants relative to the cpTi for both elastic modulus and hardness, these differences were not significant (E = p > 0.75; H = p > 0.59).

CONCLUSIONS

The titanium-zirconium alloy used in this study presented similar degrees of nanomechanical properties to that of the cpTi implants.

Wettability versus electrostatic forces in fibronectin and albumin adsorption to titanium surfaces

OBJECTIVES

Although the enhancement of plasma protein adsorption to titanium ( Ti ) following wetting has been recognized, the relationship between wettability and electrostatic forces has remained unclear. Thus, we have carried out a series of studies to determine the role of wettability and electrostatic forces on protein adsorption.

METHODS

Titanium disks with different surfaces were wetted with a range of solutions, two of which contained divalent positive ions ( Ca and Mg ). Unwetted disks served as a control. Subsequently, the wetted disks were subjected to three treatment regimes: (1) incubation in human serum albumin (HSA) or human serum fibronectin (HSF); (2) drying the wetted disks, followed by incubation in HSA or HSF; and (3) following protein adsorption, the Ca originating in the wetting solutions was removed by divalent positive ions chelator treatment (EGTA), and the remaining quantities were assessed. The quantity of the adsorbed proteins was determined by ELISA.

RESULTS

It was found that in the case of HSA, adsorption was enhanced by the wettability, the presence of Ca and Mg in the wetting solution, and the existence of rough surfaces. For HSF, the wettability and rough surfaces enhanced adsorption.

CONCLUSION

The results demonstrate that in addition to wettability, the composition of the wetting solution affects the protein adsorption. While wetting reduces the time for the HSA and HSF adsorption to reach saturation, the electrostatic forces enhance the amount of HSA adsorption. Thus, the protein adsorption capacity of titanium rough surfaces can be selectively manipulated by changing of the wetting solution.

Microwave Sintering of Titanium

Effective sintering of titanium requires the use of a high sintering temperature (≥1200 °C), preferably in high vacuum (< 10-2 Pa). This confines the heating and cooling rates to ~ 4 °C/min because of the limited thermal shock resistance of ceramic tube furnaces. Consequently, it leads to lengthy sintering cycles (10-12 hr). This work presents an assessment of microwave (MW) sintering of titanium. Titanium powders in the size ranges of <20 µm, 45-63 µm, and 100-150 µm were used to make green samples with compaction pressures ranging from 200-800 MPa. Sintering was carried out at 1200 °C for 2 hr in a 3 kW MW furnace with a 2.45 GHz multimode cavity under a vacuum of 2-6×10-3 Pa. The characteristics of MW heating of green titanium samples in vacuum are described in terms of the heating rate, vacuum fluctuations, and sparking discharge. The actual MW heating rate achieved from 350 °C to 1200 °C was 34 °C/min. The attendant densities are comparable to those attained by conventional vacuum sintering. Cross-sectional examinations revealed a fairly uniform pore distribution in MW-sintered samples made from either the coarse or fine titanium powder.

Mechanical examinations on dental implants with porous titanium coating

Due to its good biocompatibility, porous titanium is an interesting material for biomedical applications. Bone tissue can grow inside the porous structure and maintain a long and stable connection between the implant and the human bone. To investigate its long term stability, the mechanical behavior of porous titanium was tested under static and dynamic conditions and was compared to human bone tissue. A promising application of this material is the coating of dental implants. A manufacturing technique was developed and implants were produced. These implants were fatigue tested according to modified ISO 14801 and the micro structural change was examined. The fatigue test was statically modeled using finite element analysis (FEA). The results show that the implants resist a continuous load which is comparable to the loading conditions in the human jaw. The experiments show that the porous titanium has bone-like mechanical properties. Additionally the porous titanium shows an anisotropic behavior of its mechanical properties depending on the alignment of the pores. Finally, other potential applications of porous titanium are outlined.