Abstract
This study was aimed to investigate the osseointegration ability of poly(ether ether ketone) (PEEK) implants with modified surface roughness and/or surface chemistry. The roughened surface was prepared by a sandblast method, and the phosphate groups on the substrates were modified by a two-step chemical reaction. The in vitro osteogenic activity of rat mesenchymal stem cells (MSCs) on the developed substrates was assessed by measuring cell proliferation, alkaline phosphatase activity, osteocalcin expression, and bone-like nodule formation. Surface roughening alone did not improve MSC responses. However, phosphorylation of smooth substrates increased cell responses, which were further elevated in combination with surface roughening. Moreover, in a rabbit tibia implantation model, this combined surface modification significantly enhanced the bone-to-implant contact ratio and corresponding bone-to-implant bonding strength at 4 and 8 weeks post-implantation, whereas modification of surface roughness or surface chemistry alone did not. This study demonstrates that combination of surface roughness and chemical modification on PEEK significantly promotes cell responses and osseointegration ability in a synergistic manner both in vitro and in vivo. Therefore, this is a simple and promising technique for improving the poor osseointegration ability of PEEK-based orthopedic/dental implants.
Highlights
Titanium and titanium alloy implants have been used in the fields of orthopedics and dentistry owing to their cytocompatibility, high mechanical strength, and excellent corrosion resistance[1]
The C=O peak decreased and -OH peak increased as the reaction time increased, indicating that C=O was reduced to -OH (Supplementary Fig. S2)
Modification of surface topography alone failed to improve mesenchymal stem cells (MSCs) osteogenesis a slight increase in the osteocalcin level was observed on day 14
Summary
Titanium and titanium alloy implants have been used in the fields of orthopedics and dentistry owing to their cytocompatibility, high mechanical strength, and excellent corrosion resistance[1] Their much higher elastic moduli compared with bone tissue as well as metal allergy cause implant failure from post-operative complications, such as metal allergy, osteolysis, and eventual loosening[2,3]. Despite the many advantages of PEEK for application as an orthopedic and dental implant, its inert nature limits osseointegration and leads to implant subsidence and nonunion To overcome this clinical obstacle, PEEK/hydroxyapatite (HA) composites and HA-coated PEEK have been developed to take advantage of the highly osseointegration ability of HA6–10. Bone tissue can infiltrate and grow into a roughened surface, enhancing the stability of implant fixation These effects are material-dependent and have not been investigated well with respect to PEEK. We assessed various characteristics of osseointegration ability in vivo, including bone-implant contact and bonding strength, after implantation of the modified PEEK into rabbit tibia
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