Osseointegration Capacity Research Articles

Synergistic effects of calcium and zinc on bio-functionalized 3D Ti cancellous bone scaffold with enhanced osseointegration capacity in rabbit model

The present research aims to develop a Ca-Zn ion-incorporated surface functionalized 3D Ti cancellous bone scaffold for bone defect repair. The scaffold is designed to mimic human cancellous bone architecture through selective laser melting-based additive manufacturing. The chemical-based surface modification approach employed here created a Ca and Zn ions incorporated nano-porous surface layer with enhanced surface roughness and hydrophilicity. The modified biomimetic scaffold improved the corrosion resistance behaviour with ICORR and ECORR values of 0.174 mA and 0.0097 V respectively. It is learned that incorporating Zn as ZnO over the scaffold has antibacterial activity against Staphylococcus aureus and Escherichia coli. The cellular response of MG-63 to the modified scaffold was evaluated through in-vitro studies which focus on the cytocompatible properties. The intra-osseous biomimetic Ti-Na-Ca:Zn 3D scaffold revealed significant improvement in the osseointegration capabilities in terms of bone mineral density (BMD) and bone volume/total volume (BV/TV) in the rabbit model. The osseointegration potential at the Ti-Na-Ca:Zn interface was evidenced by histological analysis and micro-CT imaging. In addition to this, the remarkable upregulation of osteogenic genes such as OCN, COL1A1, OPN, ALP, RUNX2, and OSX evidences the dynamics of the osseointegration process at each surgical period. This Ca and Zn surface functionalised porous architecture of the 3D Ti cancellous bone scaffold with enhanced biological response and bone integration can potentially give insights into implant customisation along with improved clinical outcomes.

In situ preparation of nano cone-like structures on 3D printed titanium alloy implants via one-step femtosecond laser manufacturing for better osseointegration, anti-corrosion, and anti-fatigue

The poor surface conditions and osseointegration capacity of 3D printed Ti6Al4V implants (3DPT) significantly influence their performance as orthopedic and dental implants. In this work, we creatively introduce a one-step femtosecond laser treatment to improve the surface conditions and osteointegration. The surface characterization, mechanical properties, corrosion resistance, and biological responses were investigated. These results found that femtosecond laser eliminated defects like embedded powders and superficial cracks while forming the nano cones-like structures surface on 3DPT, leading to enhanced osseointegration, anti-corrosion, and anti-fatigue performance. Molecular dynamics simulations revealed the ablation removal mechanism and the formation of nano cone-like structures. These findings were further supported by the in vivo studies, showing that the FS-treated implants had superior bone-implant contact and osseointegration. Hence, the one-step femtosecond laser method is regarded as a promising surface modification method for improving the functional performance of Ti-based orthopedic implants.

Current developments and future perspectives of nanotechnology in orthopedic implants: an updated review.

Orthopedic implants are the most commonly used fracture fixation devices for facilitating the growth and development of incipient bone and treating bone diseases and defects. However, most orthopedic implants suffer from various drawbacks and complications, including bacterial adhesion, poor cell proliferation, and limited resistance to corrosion. One of the major drawbacks of currently available orthopedic implants is their inadequate osseointegration at the tissue-implant interface. This leads to loosening as a result of immunological rejection, wear debris formation, low mechanical fixation, and implant-related infections. Nanotechnology holds the promise to offer a wide range of innovative technologies for use in translational orthopedic research. Nanomaterials have great potential for use in orthopedic applications due to their exceptional tribological qualities, high resistance to wear and tear, ability to maintain drug release, capacity for osseointegration, and capability to regenerate tissue. Furthermore, nanostructured materials possess the ability to mimic the features and hierarchical structure of native bones. They facilitate cell proliferation, decrease the rate of infection, and prevent biofilm formation, among other diverse functions. The emergence of nanostructured polymers, metals, ceramics, and carbon materials has enabled novel approaches in orthopaedic research. This review provides a concise overview of nanotechnology-based biomaterials utilized in orthopedics, encompassing metallic and nonmetallic nanomaterials. A further overview is provided regarding the biomedical applications of nanotechnology-based biomaterials, including their application in orthopedics for drug delivery systems and bone tissue engineering to facilitate scaffold preparation, surface modification of implantable materials to improve their osteointegration properties, and treatment of musculoskeletal infections. Hence, this review article offers a contemporary overview of the current applications of nanotechnology in orthopedic implants and bone tissue engineering, as well as its prospective future applications.

In vitro and in vivo evaluation of the osseointegration capacity of a polycarbonate-urethane zirconium-oxide composite material for application in a focal knee resurfacing implant.

Currently available focal knee resurfacing implants (FKRIs) are fully or partially composed of metals, which show a large disparity in elastic modulus relative to bone and cartilage tissue. Although titanium is known for its excellent osseointegration, the application in FKRIs can lead to potential stress-shielding and metal implants can cause degeneration of the opposing articulating cartilage due to the high resulting contact stresses. Furthermore, metal implants do not allow for follow-up using magnetic resonance imaging (MRI).To overcome the drawbacks of using metal based FKRIs, a biomimetic and MRI compatible bi-layered non-resorbable thermoplastic polycarbonate-urethane (PCU)-based FKRI was developed. The objective of this preclinical study was to evaluate the mechanical properties, biocompatibility and osteoconduction of a novel Bionate® 75D - zirconium oxide (B75D-ZrO2) composite material in vitro and the osseointegration of a B75D-ZrO2 composite stem PCU implant in a caprine animal model. The tensile strength and elastic modulus of the B75D-ZrO2 composite were characterized through in vitro mechanical tests under ambient and physiological conditions. In vitro biocompatibility and osteoconductivity were evaluated by exposing human mesenchymal stem cells to the B75D-ZrO2 composite and culturing the cells under osteogenic conditions. Cell activity and mineralization were assessed and compared to Bionate® 75D (B75D) and titanium disks. The in vivo osseointegration of implants containing a B75D-ZrO2 stem was compared to implants with a B75D stem and titanium stem in a caprine large animal model. After a follow-up of 6 months, bone histomorphometry was performed to assess the bone-to-implant contact area (BIC). Mechanical testing showed that the B75D-ZrO2 composite material possesses an elastic modulus in the range of the elastic modulus reported for trabecular bone. The B75D-ZrO2 composite material facilitated cell mediated mineralization to a comparable extent as titanium. A significantly higher bone-to-implant contact (BIC) score was observed in the B75D-ZrO2 implants compared to the B75D implants. The BIC of B75D-ZrO2 implants was not significantly different compared to titanium implants. A biocompatible B75D-ZrO2 composite approximating the elastic modulus of trabecular bone was developed by compounding B75D with zirconium oxide. In vivo evaluation showed an significant increase of osseointegration for B75D-ZrO2 composite stem implants compared to B75D polymer stem PCU implants. The osseointegration of B75D-ZrO2 composite stem PCU implants was not significantly different in comparison to analogous titanium stem metal implants.

Additively manufactured porous scaffolds by design for treatment of bone defects.

There has been increasing attention to produce porous scaffolds that mimic human bone properties for enhancement of tissue ingrowth, regeneration, and integration. Additive manufacturing (AM) technologies, i.e., three dimensional (3D) printing, have played a substantial role in engineering porous scaffolds for clinical applications owing to their high level of design and fabrication flexibility. To this end, this review article attempts to provide a detailed overview on the main design considerations of porous scaffolds such as permeability, adhesion, vascularisation, and interfacial features and their interplay to affect bone regeneration and osseointegration. Physiology of bone regeneration was initially explained that was followed by analysing the impacts of porosity, pore size, permeability and surface chemistry of porous scaffolds on bone regeneration in defects. Importantly, major 3D printing methods employed for fabrication of porous bone substitutes were also discussed. Advancements of MA technologies have allowed for the production of bone scaffolds with complex geometries in polymers, composites and metals with well-tailored architectural, mechanical, and mass transport features. In this way, a particular attention was devoted to reviewing 3D printed scaffolds with triply periodic minimal surface (TPMS) geometries that mimic the hierarchical structure of human bones. In overall, this review enlighten a design pathway to produce patient-specific 3D-printed bone substitutions with high regeneration and osseointegration capacity for repairing large bone defects.

Osseointegration Potential Assessment of Bone Graft Materials Loaded with Mesenchymal Stem Cells in Peri-Implant Bone Defects.

Many studies have been exploring the use of bone graft materials (BGMs) and mesenchymal stem cells in bone defect reconstruction. However, the regeneration potential of Algipore (highly purified hydroxyapatite) and Biphasic (hydroxyapatite/beta-tricalcium phosphate) BGMs combined with bone marrow-derived mesenchymal stem cells (BMSCs) remains unclear. Therefore, we evaluated their osseointegration capacities in reconstructing peri-implant bone defects. The cellular characteristics of BMSCs and the material properties of Algipore and Biphasic were assessed in vitro. Four experimental groups-Algipore, Biphasic, Algipore+BMSCs, and Biphasic+BMSCs-were designed in a rabbit tibia peri-implant defect model. Implant stability parameters were measured. After 4 and 8 weeks of healing, all samples were evaluated using micro-CT, histological, and histomorphometric analysis. In the energy-dispersive X-ray spectroscopy experiment, the Ca/P ratio was higher for Algipore (1.67) than for Biphasic (1.44). The ISQ values continuously increased, and the PTV values gradually decreased for all groups during the healing period. Both Algipore and Biphasic BGM promoted new bone regeneration. Higher implant stability and bone volume density were observed when Algipore and Biphasic BGMs were combined with BMSCs. Biphasic BGM exhibited a faster degradation rate than Algipore BGM. Notably, after eight weeks of healing, Algipore with BSMCs showed more bone-implant contact than Biphasic alone (p < 0.05). Both Algipore and Biphasic are efficient in reconstructing peri-implant bone defects. In addition, Algipore BGM incorporation with BSMCs displayed the best performance in enhancing implant stability and osseointegration potential.

STABILITY OF BIOFUNCTIONALIZED HIGH-PERFORMANCE OXIDE CERAMICS AGAINST RADIATION STERILIZATION

While high-performance ceramics like alumina and zirconia exhibit excellent wear resistance, they provide poor osseointegration capacity. As osseointegration is crucial for non-cemented joint prostheses, new techniques have been successfully developed for biofunctionalizing high-performance ceramic surfaces. Stable cell adhesion can be achieved by covalently bound specific peptides. In this study we investigate the effect of sterilization processes on organo-chemically functionalized surfaces.To enhance the performance of alumina-toughened zirconia ceramics (ATZ), a 3-aminopropyldiisopropylethoxysilane (APDS) monolayer was applied and coupled with cyclo-RGD peptides (cRGD) by using bifunctional crosslinker bis(sulfosuccinimidyl)suberat (BS³). The samples were sterilized using e-beam or gamma-sterilization at 25 kGy, either before or after biofunctionalization with cRGD. Functionalization stability was investigated by contact angle measurements. The functionality of cRGD after sterilization was demonstrated using proliferation tests and cytotoxicity assays. Immunofluorescence staining (pFAK, Actin, DAPI) was conducted to evaluate the adhesion potential between the samples and human mesenchymal stem cells (hMSCs).Functionalized samples before and after sterilization showed no significant difference regarding their contact angles. A proliferation test demonstrated that the cells on functionalized samples proliferate significantly more than on untreated samples before and after sterilization. hMSCs showed a significant higher proliferation on gamma sterilized samples compared to all other groups after 14 days. It was confirmed that the samples did not exhibit cytotoxic behavior before or after sterilization. Fluorescence microscopy demonstrated that both, cells on sterilized and on non-sterilized samples, expressed high levels of pFAK-Y397.The investigated functionalization enables improved adhesion and proliferation of hMSCs and is stable against the investigated sterilization processes. This is of importance as the option of having a sterile product enables the start of the translation of this biofunctional coating towards preclinical and subsequently first-in-man applications.Acknowledgments: We acknowledge the financial support of the Federal Ministry of Education and Research, BMBF (13GW0452A-C).

Improving Osseointegration Potential of 3D Printed PEEK Implants with Biomimetic Periodontal Ligament Fiber Hydrogel Surface Modifications

AbstractThe bioinertness, poor antibacterial properties, and weak osseointegration of polyether‐etherketone (PEEK) limit its clinical application as oral implants. In this study, it is developed a personalized and customizable PEEK implant with multifunctional capabilities through sequential 3D printing, surface sulfonation (SPEEK), and modification using a drug‐loaded photocured hydrogel composed of acrylic acid‐acrylamide (AA‐AM) containing simvastatin‐cefepime (SIM‐CFP). The modified implant, referred to as SCHSPEEK, mimics the structure of biomimetic periodontal ligament (PDL) fibers. The chemical composition, surface characteristics, and biological properties of SCHSPEEK both in vitro and in vivo are systematically investigated. The results demonstrate that hydrogel modification not only enhances hydrophilicity and reduces surface roughness and friction coefficient, but also improves biocompatibility, drug release, and antibacterial efficacy. Importantly, SCHSPEEK exhibits a significant improvement in osseointegration capacity in vivo. These findings highlight the potential of SCHSPEEK implants to serve as promising orthopedic and dental implants in clinical settings.

Biomimetic Polyphenolic Scaffolds with Antioxidative Abilities for Improved Bone Regeneration.

Bone defects have a severe impact on the health and lives of patients due to their long-lasting and difficult-to-treat features. Recent studies have shown that there are complex microenvironments, including excessive production of reactive oxygen species. Herein, a surface functionalization strategy using metal-polyphenolic networks was used, which was found to be beneficial in restoring oxidative balance and enhancing osseointegration. The surface properties, biocompatibility, intracellular ROS scavenging, and osseointegration capacity were evaluated, and the therapeutic effects were confirmed using a skull defect model. This approach has great potential to improve complex microenvironments and enhance the efficiency of bone tissue regeneration.

Magnesium bioactive glass hybrid functionalized polyetheretherketone with immunomodulatory function to guide cell fate and bone regeneration.

Polyetheretherketone (PEEK) is being increasingly recognized as a highly promising polymer implant in orthopaedics due to its advantageous biocompatibility, favorable processability, and radiation resistance. Nonetheless, the long-term application of PEEK implants in vivo faces challenges due to unfavorable post-implantation inflammatory and immune reactions, which result in suboptimal osseointegration rates. Hence, biofunctionalizing the surface of PEEK implants emerges as a viable strategy to enhance osseointegration and increase the success rate. In this study, we developed a multifunctional PEEK implant through the in-situ incorporation of chitosan-coated bioactive glass nanoparticles (BGNs). This approach can impart immunomodulatory properties and enhance the potential for osseointegration. The resulting biofunctionalized PEEK material exhibited multiple beneficial effects. For instance, it facilitated M2 phenotypic polarization of macrophages, diminished the expression of inflammatory factors, and enhanced the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. Moreover, it exhibited an improved capacity for osseointegration when tested in vivo. The findings of the experiment highlighted the pivotal and complex role of the biofunctionalized PEEK implant in maintaining typical bone immunity and metabolism. The study proposes that the application of chitosan-BGNs presents a straightforward approach to developing multifunctional implants with the ability to promote biomineralization and immunomodulation, specifically tailored for orthopaedic applications.

Highly Malleable Personalized Prostheses with Hierarchical Microstructure Boost the Long‐Term Osteointegration in Irregular Craniofacial Reconstruction

AbstractThe desired clinical bone prostheses should achieve satisfactory interface integration and osteoinduction, as well as good surgical convenience. Here, a highly malleable 3D printed prosthesis with compressive strength at 13 MPa is constructed by dopamine, polyvinyl alcohol, and micro‐sized hydroxyapatite (86 wt%) as composite bioinks, which is endowed with good plasticity and can quickly match irregular defects by easily trimming. Spatially decorated collagen and hyaluronan greatly enriched the hierarchical microstructure and biological activity of malleable prosthesis. This prosthesis accelerates the proliferation and osteogenic differentiation of stem cells, regulates M2 polarization of macrophage, and promotes endogenous stem cell recruitment and early angiogenesis. Meanwhile, it significantly reinforces biomineralized deposition and vascularization, reaches full coverage of new bone in the rabbit cranial defect after 15 weeks (Φ = 10 mm), and achieves well osseointegration capacity with interfacial binding strength at 71.2% of the natural skull. This osteoinductive prosthesis provides a new design idea for bone filling.

Novel parameter optimization lattice design for improving osseointegration in hypo-loading regions – A case study of maxillary tumor reconstruction implant

This study utilizes the Taguchi method and sub-model analysis technique to create a novel optimization lattice for the hypo-loading region. The lattice is designed to mimic the mechanical properties of bone and promote the growth of immature bone under appropriate loading to enhance the osseointegration capacity of implants. The Maxillary lattice implant (ML implant) was developed to address the case of Maxillary antral carcinoma. The implant's structural parameters, including Angle of rotation (A), Concave angle (B), Pillar diameter (C), and Fillet radius (D), were analyzed to design and optimize the Hypo-Loading lattice (HL lattice) with various structures. Through the analysis, the optimal structural parameters for the HL lattice were determined, resulting in the creation of the Optimal HL lattice with exceptional Elastic Admissible Strain (EAS), a comparable elastic modulus to bone, and outstanding mechanical robustness. This feature of the Optimal HL lattice improves the bionic performance.

Clinical evaluation of the three-dimensional printed strut-type prosthesis combined with autograft reconstruction for giant cell tumor of the distal femur.

This study aimed to describe the design and surgical techniques of a three-dimensional (3D) printed strut-type prosthesis with a porous titanium surface for distal femur giant cell tumors of bone (GCTB) and evaluate the short-term clinical outcomes. From June 2018 to January 2021, 9 consecutive patients with grade I or II GCTB in the distal femur underwent extended intralesional curettage followed by 3D-printed strut-type prosthesis combined with autograft reconstruction were retrospectively reviewed to assess their clinical and radiographic outcomes. All patients were followed up for 30.8 ± 7.5 months (18-42 months) after surgery. The mean affected subchondral bone percentage and the mean subchondral bone thickness before surgery was 31.8% ± 9.6% (range, 18.2% ~50.2%) and 2.2 ± 0.8mm (range, 1.2-4.0mm), respectively. At the final follow-up, all the patients were alive without local recurrence; no postoperative complications were observed. Patients had significant improvements in postoperative MSTS-93 score [(26.7 ± 2.4) vs. (18.8 ± 3.7), P < 0.05], and ROM [(122.8° ± 9.1°) vs. (108.3° ± 6.1°), P < 0.05] compared with their preoperative statuses. Furthermore, the mean subchondral bone thickness has increased to 10.9 ± 1.3mm (range, 9.1-12.1mm). 3D-printed strut-type prosthesis combined with autograft reconstruction provides acceptable early functional and radiographic outcomes in patients with grade I or II GCTB in distal femur due to the advantages of the prosthesis such as good biocompatibility, osseointegration capacity, and subchondral bone protection. If our early outcomes can be further validated in studies with more patients and sufficient follow-up, this method may be evaluated as an alternative for the treatment of grade I or II GCTB in the distal femur.

Bone marrow stromal cell-derived exosome combinate with fibrin on tantalum coating titanium implant accelerates osseointegration.

This study aims to present a sustainably releasing system of exosomes-fibrin combinate loaded on tantalum-coating titanium implants. We hope to investigate potential effects of the system on osseointegration between tantalum coating titanium implants and its surrounding bone tissue. Exosomes derived from rabbit bone marrow stromal cells (rBMSCs) and fibrin were deposited onto the micro-nanostructure tantalum coating surface (Ta + exo + FI) and compared to control groups, including tantalum coating (Ta), tantalum coating loaded exosomes (Ta + exo) and tantalum coating loaded fibrin (Ta + FI). The optimal concentration of loading exosomes, exosomes uptake capacity by BMSCs, and the effect of controlled-release by fibrin were assessed by laser scanning confocal microscope (LCSM) and microplate reader. The optimal concentration of exosomes was 1μg/μL. Adhesion, proliferation, and osteogenic differentiation ability of BMSCs on different materials were assessed in vitro. Finally, osseointegrative capacity of Ta, Ta + exo, Ta + FI, Ta + exo + FI implants in rabbit tibia were respectively evaluated with histology and bone-implant contact ratio (BIC%). It was demonstrated that exosome sustained-release system with fibrin loading on the tantalum coating was successfully established. Fibrin contribute to exosomes release extension from 2d to 6d. Furthermore, Ta + exo + FI significantly promoted adhesion, proliferation, and osteogenic differentiation of BMSCs. In vivo, the implants in Ta + exo + FI group displayed the highest osseointegrative capability than those in other groups. It is concluded that this exosome delivery system on the implants may be an effective way for tantalum coating titanium implants to promote osseointegration between implant and its surrounding bone tissue.

Bioactive Glass Modified with Zirconium Incorporation for Dental Implant Applications: Fabrication, Structural, Electrical, and Biological Analysis.

Implantology is crucial for restoring aesthetics and masticatory function in oral rehabilitation. Despite its advantages, certain issues, such as bacterial infection, may still arise that hinder osseointegration and result in implant rejection. This work aims to address these challenges by developing a biomaterial for dental implant coating based on 45S5 Bioglass® modified by zirconium insertion. The structural characterization of the glasses, by XRD, showed that the introduction of zirconium in the Bioglass network at a concentration higher than 2 mol% promotes phase separation, with crystal phase formation. Impedance spectroscopy was used, in the frequency range of 102-106 Hz and the temperature range of 200-400 K, to investigate the electrical properties of these Bioglasses, due to their ability to store electrical charges and therefore enhance the osseointegration capacity. The electrical study showed that the presence of crystal phases, in the glass ceramic with 8 mol% of zirconium, led to a significant increase in conductivity. In terms of biological properties, the Bioglasses exhibited an antibacterial effect against Gram-positive and Gram-negative bacteria and did not show cytotoxicity for the Saos-2 cell line at extract concentrations up to 25 mg/mL. Furthermore, the results of the bioactivity test revealed that within 24 h, a CaP-rich layer began to form on the surface of all the samples. According to our results, the incorporation of 2 mol% of ZrO2 into the Bioglass significantly improves its potential as a coating material for dental implants, enhancing both its antibacterial and osteointegration properties.

Plasma electrolytic oxidation coatings on femtosecond laser-treated Ti-6Al-4V alloy for bio-implant use

Owing to the poor osseointegration capability, titanium implants may fail and are accompanied by bone resorption. As a result, the utilization of lasers for texturing the implant's surface has been deliberated as an indispensable and inventive approach for improved bone-implant contact by generating micro- and nano-scale surface topographies. Hence, the study aimed to examine the effect of femtosecond laser (Fs) and plasma electrolytic oxidation (PEO) coating on the surface characteristics of Ti-6Al-4V alloy with the evaluation of surface characterization, phase analysis, surface roughness, wettability, hardness, corrosion behavior, and adhesion potential. As per our study's result, it has been deduced that Fs texturing with and without PEO coating can be considered to be the innovative surface modification alternatives for biomaterials due to improved hydrophilicity, corrosion resistance, and surface roughness properties with hardness comparable to that of cortical bone thereby enhancing osseointegration capacity of bone to the implant. Also, a cell culture test was performed using MC3T3-E1 cells that indicated that Fs texturing and combined Fs texturing and PEO-coating can promote high cellular proliferation.

INFLUENCE OF ANTIBACTERIAL IMPLANT COATINGS ON THE VIABILITY OF GRAM-POSITIVE AND GRAM-NEGATIVE BACTERIA AND THE IN VITRO MINERALIZATION

The implantation of endoprosthesis is a routine procedure in orthopaedics. Endoprosthesis are mainly manufactured from ceramics, polymers, metals or metal alloys. To ensure longevity of the implants they should be as biocompatible as possible and ideally have antibacterial properties, to avoid periprosthetic joint infections (PJI). Various antibacterial implant materials have been proposed, but have so far only been used sporadically in patients. PJI is one of the main risk factors for revision surgeries. The aim of the study was to identify novel implant coatings that both exhibit antibacterial properties whilst having optimal biocompatibility.Six different novel implant coatings and surface modifications (EBM TiAl6V4, strontium, TiCuN, TiNbN, gentamicin phosphate (GP), gentamicin phosphate+cationic polymer (GP+CP)) were compared to standard CoCrMo-alloy. The coatings were further characterized with regard to the surface roughness. E. coli and S. capitis were cultured on the modified surfaces to investigate the antibacterial properties. To quantify bacterial proliferation the optical density (OD) was measured and viability was determined using colony forming units (CFU). Murine bone marrow derived macrophages (BMMs) were cultured on the surfaces and differentiated into osteoblasts to quantify the mineralisation using the alizarin red assay.All novel coatings showed reduced bacterial proliferation and viability compared to standard CoCrMo-alloy. A significant reduction was observed for GP and GP+CP coated samples compared to CoCrMo (ODGP,E.coli = 0.18±0.4; ODGP+CP,E.coli = 0.13±0.3; p≤0.0002; N≥7-8). An increase in osteoblast-mediated mineralisation was observed on all surfaces tested compared to CoCrMo. Furthermore, GP and GP+CP coated samples showed a statistically significant increase (MGP = 0.21±0.1; MGP+CP = 0.25±0.2; p&lt;0.0001; N≥3-6).The preliminary data indicates that the gentamicin containing surfaces have the most effective antibacterial property and the highest osseointegrative capacity. The use of antibiotic coatings on prostheses could reduce the risk of PJI while being applied on osseointegrative implant surfaces.

Micro-nano porous structured tantalum-coated dental implants promote osteogenic activity in vitro and enhance osseointegration in vivo.

Due to its excellent biocompatibility and corrosion resistance, tantalum demonstrates versatility as an implant material. However, limited studies investigated the role of tantalum coated titanium-based dental implants. This study aimed to investigate the potential application of micro-nano porous structured tantalum coating on the surface of titanium dental implant. In the present study, micro-nano porous structured tantalum coating was prepared by vacuum plasma spraying (VPS) under selected optimum parameters, various characteristics of tantalum coating (Ta/Ti), including the morphology, potential, constituent, and hydrophilia, were investigated in comparison with its respective control groups, sandblasted titanium (Ti) and titanium coating (Ti/Ti). The adhesion, proliferation, and osteogenic differentiation ability of rat bone marrow mesenchymal cells (BMSCs) on different materials were assessed in vitro. Then the osseointegration capacity of Ti, Ti/Ti, Ta/Ti, and Straumann implants in canine mandible was evaluated with micro-CT, histological sections, and energy dispersive X-ray spectroscopy. These results demonstrated that micro-nanostructured, uneven, and granular tantalum coating was successfully prepared on titanium substrate by VPS with pore size ranging from 50 nm to 5μm and thickness ranging from 80 to 100 μm. Tantalum coating revealed the highest surface potential, best hydrophilia, and most protein adsorption among Ta/Ti, Ti/Ti, and Ti. Furthermore, Ta/Ti surfaces significantly promoted the adhesion, proliferation, and osteogenic differentiation of BMSCs. In vivo, Ta/Ti implants displayed positive osseointegration capability associated with increased bone mineral density and formation of new bone around implants without tantalum particles released. Together, these findings indicate that tantalum-coated titanium dental implants may serve as a new type of dental implant.

Strontium/zinc phytate-based self-assembled monolayers on titanium surfaces enhance osteogenesis and antibacterial performance in vitro

The accumulation of bacteria over implant surfaces is still the first cause of failure, and the development of antimicrobial surfaces constitutes a first line in implant research. Besides, the durability and mechanical performance of implants, in special in the dental area, are mainly determined by their osseointegration capacity into the maxillofacial bone and the appearance of infections. Consequently, implant osseointegration and infection prophylaxis remain as big challenges to attain so a huge investigation is being developed on the production of bioactive surfaces to achieve improvements in these aspects. In this work we propose the functionalization of titanium surfaces (Ti Cp) with self-assembled monolayers (SAMs) of bioactive organophosphate compounds: phytic acid (Ti-PA) and its metallic phytate derivatives bearing Sr2+ and/or Zn2+ (Ti-SrPhy, Ti-ZnPhy and Ti-SrPhy/ZnPhy) which exhibited tunable in vitro osteogenic, antimicrobial and antioxidant properties in a previous work. Thus, phytate compounds are chemically anchored onto Ti discs through a simple procedure consisting of a condensation reaction promoted by heat treatment. EDS and XPS spectroscopies confirm the obtaining of the modified surfaces and the topographic properties and wettability analysed by SEM, AFM, profilometry and contact angle measurements, respectively, are explored. Additionally, phytate-SAMs do not release any cytotoxic compound after 14 days and stimulate in vitro adhesion and proliferation of human osteoblast cells after 14 days of culture. The osteogenic ability of the modified surfaces evaluated by the quantification of ALP activity and matrix mineralization degree shows a significant improvement with respect to unmodified surfaces. Furthermore, the antimicrobial activity of phytate-SAMs against Streptococcus mutans cultures is evaluated. The count of viable cells and the quantification of produced biofilm are significantly reduced by all phytate-SAMs groups (p < 0.001). Cell membrane integrity studies by LIVE/DEAD staining and SEM imaging confirm a decreased viability of adhered bacteria when phytate-based surfaces are tested, due to a disruption in the function and permeability of the cell membrane. Therefore, phytate-SAMs exhibit suitable in vitro features suggesting their promising potential as bioactive coatings of dental implants.

Evaluation of Protein Adsorption and Osseointegration Potential of Polyetheretherketone versus Titanium Dental Implants: A Systematic Review

Introduction: The success of implant therapy depends on a number of parameters, including bone volume implant shape, surface topography, the patient’s overall health, and local factors. Despite the fact that polyetheretherketone (PEEK) implants have undergone a lot of alterations, only a small number of studies have examined the bioactivity and osseointegration of PEEK implants with titanium. Aim: To summarise and evaluate protein adsorption and osseointegration capacity of PEEK and titanium dental implants. Materials and Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used and PROSPERO (CRD42023415494) registration was done. Electronic databases were searched for studies assessing the outcome in terms of protein adsorption and osseointegration capacity of PEEK and titanium dental implants. Quality assessment of included studies was evaluated using the Newcastle-Ottawa Scale (NOS). Results: Depending on inclusion and exclusion criteria, seven studies fulfilled the eligibility criteria and were included in qualitative synthesis. Risk of bias assessment revealed that all the included studies were largely comparable in methodological quality. All the included studies had moderate to low-risk of bias with all the respective domains. All the included studies revealed that PEEK with optimal surface roughness might hold great potential for protein adsorption and osseointegration capacity. Conclusion: Within the limitations of the study, it was found that compared to titanium, PEEK is less osseoconductive and bioactive. PEEK is therefore unsuitable for use as a dental implant in its unmodified form. Implantitis and implant failure occurs from improper osseoconductivity and bioactivity of dental implants.