Abstract
Over the past few years, surface modification of implant surfaces has gained substantial attention as a promising solution to avoid the failure of biomaterials after implantation. Although researchers suggest several strategies for surface functionalization of titanium-based implants, only a few studies have compared the osteoimmunomodulatory effects of ionic nanostructures and biofunctionalization in the same biological model. Enamel matrix derivate (EMD) and strontium are both known for their positive influences on bone cell responses. In this study, we functionalized the titanium–zirconium implant surface with EMD and strontium using an electrochemical cathodic polarization method. Afterward, we evaluated the osteoimmunomodulatory effects of EMD or strontium coated titanium–zirconium implants in the tibia of eight Gray Bastard Chinchilla rabbits. We performed 2 and 3D micro-CT, wound fluid, histologic, and histomorphometric analyses on bone tissues after 4- and 8-weeks of implantation. Although the results could indicate some differences between groups regarding the bone quality, there was no difference in bone amount or volume. EMD stimulated higher ALP activity and lower cytotoxicity in wound fluid, as well as a lower expression of inflammatory markers after 8 weeks indicating its osteoimmunomodulatory effects after implantation. Overall, the results suggested that ionic nanostructure modification and biofunctionalization might be useful in regulating the immune responses to implants.
Highlights
Over the past two decades, the prevalence of using bone implants has increased significantly.[1,2] Despite the substantial progress in the material design, surgical implant methods, and sterile surgical principles, a large proportion of implants fail to integrate with the neighboring bone tissue after implantation.[1,3] This failure causes implant encapsulation by fibrotic tissue and bacterial colonization, which causes biofilm formation on the implant surface.[4,5] The fibrous encapsulation can cause poor osseointegration and implant loosening, whereas the biofilm formation is known as the main reason for surgical site infections and surgical removal of the implant.[3]
We evaluated the osteoimmunomodulatory effects of Enamel matrix derivate (EMD) or strontium coated titanium−zirconium implants in the tibia of eight Gray Bastard Chinchilla rabbits
Among orthopedic and dental implants, the titanium−zirconium alloy (TiZr) has gained considerable attention owing to its higher fracture toughness and corrosion resistance over other commercially available implants.[7−9] Despite its benefits and high success rate over the past few years, a TiZr implant could fail in patients suffering from low bone mineral density (BMD), abnormal wound healing, or having systemic disorders like osteoporosis and diabetes.[10,11]
Summary
Over the past two decades, the prevalence of using bone implants has increased significantly.[1,2] Despite the substantial progress in the material design, surgical implant methods, and sterile surgical principles, a large proportion of implants fail to integrate with the neighboring bone tissue after implantation.[1,3] This failure causes implant encapsulation by fibrotic tissue and bacterial colonization, which causes biofilm formation on the implant surface.[4,5] The fibrous encapsulation can cause poor osseointegration and implant loosening, whereas the biofilm formation is known as the main reason for surgical site infections and surgical removal of the implant.[3] In the United States alone, 25.6% of all healthcare-associated infections are related to devices causing a huge financial burden on both individual and public health care systems.[6] Among orthopedic and dental implants, the titanium−zirconium alloy (TiZr) has gained considerable attention owing to its higher fracture toughness and corrosion resistance over other commercially available implants.[7−9] Despite its benefits and high success rate over the past few years, a TiZr implant could fail in patients suffering from low bone mineral density (BMD), abnormal wound healing, or having systemic disorders like osteoporosis and diabetes.[10,11]
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