Abstract
Expandable implants including shape memory alloy (SMA) elements have great potential to minimize the risk of implant loosening and to increase the primary stability of bone anchoring. Surface structuring of such elements may further improve these properties and support osteointegration and bone healing. In this given study, SMA sheets were processed by deploying additive and removal manufacturing technologies for 3D-printed surgical implants. The additive technology was realized by applying a new laser beam melting technology to print titanium structures on the SMA sheets. The removal step was realized as a standard process with an ultrashort-pulse laser. The morphology, metabolic activity, and mineralization patterns of human bone marrow stromal cells were examined to evaluate the biocompatibility of the new surface structures. It was shown that both surface structures support cell adhesion and the formation of a cytoskeleton. The examination of the metabolic activity of the marrow stromal cells on the samples showed that the number of cells on the laser-structured samples was lower when compared to the 3D-printed ones. The calcium phosphate accumulation, which was used to examine the mineralization of marrow stromal cells, was higher in the laser-structured samples than in the 3D-printed ones. These results indicate that the additive- and laser-structured SAM sheets seem biocompatible and that the macrostructure surface and manufacturing technology may have positive influences on the behavior of the bone formation. The use of the new additive technique and the resulting macrostructures seems to be a promising approach to combine increased anchorage stability with simultaneously enhanced osteointegration.
Highlights
New concepts for advanced implant designs and geometry modifications aim to enhance bone anchorage to achieve subsequent stability, and are currently within the research focus of a number of groups [1,2,3,4,5,6]
It has been shown that the use of shape memory alloy (SMA) made of nickel-titanium has great potential to increase primary stability in bone [9,10,11]
Elements or surface patterns of surgical implants combined with SMA may enhance bone anchoring stability, improving the surgical implants combined with SMA may enhance bone anchoring stability, improving the functionality and durability of the implant when loaded under physiological stress
Summary
New concepts for advanced implant designs and geometry modifications aim to enhance bone anchorage to achieve subsequent stability, and are currently within the research focus of a number of groups [1,2,3,4,5,6]. Previous studies by our own group were concerned with the development of expandable screws [7] Another preliminary study by our own group showed that unprocessed SMA sheets are biocompatible and appropriate for application in orthopedic surgery [8]. Materials 2020, 13, x FOR PEER REVIEW unprocessed SMA sheets are biocompatible and appropriate for application in orthopedic surgery. Elements or surface patterns of surgical implants combined with SMA may enhance bone anchoring stability, improving the surgical implants combined with SMA may enhance bone anchoring stability, improving the functionality and durability of the implant when loaded under physiological stress. Osteoporosis is one of the surgical challenges, considering the ongoing demographic change in industrialized nations. Osteoporosis is one of the as the primary anchorage stability of standard implants is less likely to be maintained, requiring surgical challenges, as the primary anchorage stability of standard implants is less likely to be adjustments in the implant design
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