Abstract

Titanium and its alloys, specially Ti6Al4V, are among the most employed materials in orthopedic and dental implants. Cells response and osseointegration of implant devices are strongly dependent on the body–biomaterial interface zone. This interface is mainly defined by proteins: They adsorb immediately after implantation from blood and biological fluids, forming a layer on implant surfaces. Therefore, it is of utmost importance to understand which features of biomaterials surfaces influence formation of the protein layer and how to guide it. In this paper, relevant literature of the last 15 years about protein adsorption on titanium-based materials is reviewed. How the surface characteristics affect protein adsorption is investigated, aiming to provide an as comprehensive a picture as possible of adsorption mechanisms and type of chemical bonding with the surface, as well as of the characterization techniques effectively applied to model and real implant surfaces. Surface free energy, charge, microroughness, and hydroxylation degree have been found to be the main surface parameters to affect the amount of adsorbed proteins. On the other hand, the conformation of adsorbed proteins is mainly dictated by the protein structure, surface topography at the nano-scale, and exposed functional groups. Protein adsorption on titanium surfaces still needs further clarification, in particular concerning adsorption from complex protein solutions. In addition, characterization techniques to investigate and compare the different aspects of protein adsorption on different surfaces (in terms of roughness and chemistry) shall be developed.

Highlights

  • Almost 1000 tons of titanium-based biomaterials are worldwide used every year as orthopedic and dental implants [1] mainly as commercially pure titanium and αβ-alloy Ti6Al4V (Ti64), eventually as extra low interstitial (ELI) [2]

  • In the past 15 years, great efforts have been put into building deeper knowledge of how proteins and titanium-based biomaterials interact

  • Many different aspects of the complex adsorption phenomenon have been investigated by using a wide range of different surfaces, tailoring specific characteristics and exploiting adsorption environments ranging from a simple single protein solution to actual human biological fluids or even in human body

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Summary

Introduction

Almost 1000 tons of titanium-based biomaterials are worldwide used every year as orthopedic and dental implants [1] mainly as commercially pure titanium (cp-Ti) and αβ-alloy Ti6Al4V (Ti64), eventually as extra low interstitial (ELI) [2]. In order to remove larger debris, monocytes and macrophages can fuse together forming foreign body giant cells (FBGCs) Concerning osseointegration, it takes place when mesenchymal stem cells (MSC) differentiate into osteoblasts and osteocytes, leading to new bone formation and it is triggered by an early pro-inflammatory response. Activation of platelets within the blood clot on the implant surface provides a natural gradient of signal molecules with a high concentration on the surface of the implant and consequent attraction of monocytes, neutrophilis, and mesenchymal cells This allows the “contact osteogenesis” mechanism with formation of immature bone characterized by irregularly arranged, interwoven collagenous fibers, and, as last, of mature lamellar bone through bone remodeling. Relevant literature of the past 15 years was researched and selected

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