Surface Of Implants Research Articles

The Addition of Hydroxyapatite Nanoparticles on Implant Surfaces Modified by Zirconia Blasting and Acid Etching to Enhance Peri-Implant Bone Healing.

This study investigated the impact of adding hydroxyapatite nanoparticles to implant surfaces treated with zirconia blasting and acid etching (ZiHa), focusing on structural changes and bone healing parameters in low-density bone sites. The topographical characterization of titanium discs with a ZiHa surface and a commercially modified zirconia-blasted and acid-etched surface (Zi) was performed using scanning electron microscopy, profilometry, and surface-free energy. For the in vivo assessment, 22 female rats were ovariectomized and kept for 90 days, after which one implant from each group was randomly placed in each tibial metaphysis of the animals. Histological and immunohistochemical analyses were performed at 14 and 28 days postoperatively (decalcified lab processing), reverse torque testing was performed at 28 days, and histometry from calcified lab processing was performed at 60 days The group ZiHa promoted changes in surface morphology, forming evenly distributed pores. For bone healing, ZiHa showed a greater reverse torque, newly formed bone area, and bone/implant contact values compared to group Zi (p < 0.05; t-test). Qualitative histological and immunohistochemical analyses showed higher features of bone maturation for ZiHa on days 14 and 28. This preclinical study demonstrated that adding hydroxyapatite to zirconia-blasted and acid-etched surfaces enhanced peri-implant bone healing in ovariectomized rats. These findings support the potential for improving osseointegration of dental implants, especially in patients with compromised bone metabolism.

The treatment of bacterial biofilms cultivated on knee arthroplasty implants using the bioelectric effect.

Introduction: The formation of bacterial biofilms on knee arthroplasty implants can have catastrophic consequences. The aim of this study was to analyze the effectiveness of the bioelectric effect in the elimination of bacterial biofilms on cultivated knee arthroplasty implants. Methods: A novel device was designed to deliver a bioelectric effect on the surface of knee arthroplasty implants. 4-femoral prosthetic implants were cultivated with a staphylococcus aureus inoculum for 15days. The components were divided into four different groups: A (not treated), B (normal saline 20-minutes), C (bioelectric effect 10-minutes), D (bioelectric effect 20-minutes). The implants were sonicated, and the detached colonies were quantified as the number of colony-forming unit (CFUs). The implants were sterilised and the process was repeated in a standardized manner four more times, to obtain a total of five samples per group. Results: The number of the CFUs after a 10-minute exposure to the bioelectric effect was of 208.2 ± 240.4, compared with 6,041.6 ± 2010.7 CFUs in group A, representing a decrease of 96.5% ± 4.3 (p = 0.004). And a diminution of 91.8% ± 7.9 compared with 2,051.0 ± 1,364.0 CFUs in group B (p = 0.109). The number of bacterial colonies after a 20-minute exposure to the bioelectric effect was 70 ± 126.7 CFUs, representing a decrease of 98.9% ± 1.9 (p = 0.000) compared with group A. And a decrease of 97.8% ± 3.0 (p = 0.019) compared with group B. Conclusions: The bioelectric effect was effective in the elimination of bacterial biofilm from knee arthroplasty implants. This method could be used in the future as part of conventional surgical procedures.

Electrophoretic Deposition and Characterization of Curcumin/Chitosan Coatings

The purpose of the study was to investigate the electrophoretic deposition (EPD) route, microstructure and surface properties of composite curcumin/chitosan coatings on commercially pure titanium substrates for biomedical applications. Multiple routes of preparation of the dispersed systems for the EPD process and their electrokinetic properties have been investigated to obtain homogeneous coatings. The zeta potential of solutions with various curcumin content in ethanol or isopropanol proved their relatively low electrophoretic mobility. Thus, curcumin was co-deposited with chitosan molecules on the cathode. The surface morphology of the coatings consisted of submicrometric curcumin particles embedded in the chitosan matrix. The increase in the curcumin content in the ethanol caused large agglomerates and undissolved curcumin particles to appear on the coating surface. The coatings were characterized by high adhesion to the substrate and a water contact angle in the range of 85° to 95°. The coatings changed the zeta potential of the titanium surface from significantly negative (−46.7 ± 2.3 mV) to less negative values (−20.6 ± 2.6 mV). The developed coatings are promising for mitigating biofilm formation on the surface of titanium bone implants.

Plasma-Sprayed Osseoconductive Hydroxylapatite Coatings for Endoprosthetic Hip Implants: Phase Composition, Microstructure, Properties, and Biomedical Functions

This contribution attempts to provide a state-of-the-art account of the physicochemical and biomedical properties of the plasma-sprayed hydroxylapatite (HAp) coatings that are routinely applied to the surfaces of metallic endoprosthetic and dental root implants designed to replace or restore the lost functions of diseased or damaged tissues of the human body. Even though the residence time of powder particles of HAp in the plasma jet is extremely short, the high temperature applied induces compositional and structural changes in the precursor HAp that severely affect its chemical and physical properties and in turn its biomedical performance. These changes are based on the incongruent melting behavior of HAp and can be traced, among many other analytical techniques, by high resolution synchrotron X-ray diffraction, vibrational (Raman) spectroscopy, and nuclear magnetic resonance (NMR) spectroscopy. In vivo reactions of the plasma-sprayed coatings to extracellular fluid (ECF) can be assessed and predicted by in vitro testing using simulated body fluids (SBFs) as proxy agents. Ways to safeguard the appropriate biological performance of HAp coatings in long-term service by controlling their phase content, porosity, surface roughness, residual stress distribution, and adhesion to the implant surface are being discussed.

A comparison of textured vs smooth surfaced implants in sub fascial breast augmentation.

Subfascial placement of breast implants has the advantages of subglandular and submuscular placement without the adverse outcomes. This study examined the differences in outcomes between textured and smooth implants. A total of 385 patients underwent subfascial breast augmentation in two cohorts. The initial series (n=209) employed textured implants and the second (n=176) employed smooth implants. In all other respects, patient management was identical. Adverse outcomes, changes in breast morphometry, and patient satisfaction were compared between the two groups. The follow-up period ranged from to 74-272 weeks for smooth implants (mean 164 weeks, STD 50.6) and 78-279 weeks for textured implants (mean= 186 weeks, STD=54). The incidence of capsular contracture was the same for smooth and textured implants (4.7% and 6.2%, P=.64). Changes in breast shape at the lower pole, patient satisfaction, and the incidence of other adverse outcomes were the same in both groups. Subfascial placement of smooth and textured breast implants yielded similar outcomes.

Impact of surface chemical treatment in surgical regenerative treatment of ligature-induced peri-implantitis: A canine study.

Implant surface decontamination is a critical step in peri-implantitis treatment. The aim of this study was to assess the effect chemotherapeutic agents have on reosseointegration after treatment on ligature-inducted peri-implantitis. Six male canines had 36 implants placed and ligatures were placed around them for 28 weeks to establish peri-implantitis. The peri-implant defects were randomly treated by 1 of 3 methods: 0.12% chlorhexidine (CHX test group), 1.5% sodium hypochlorite (NaOCl test group), or saline (Control group). Sites treated with NaOCl and CHX were grafted with autogenous bone, and all sites then either received a collagen membrane or not. Histology sections were obtained at 6 months postsurgery to assess percentage of reosseointegration. Thirty-five implants were analyzed (CHX: 13; NaOCl: 14; Control:8). NaOCl-treated sites demonstrated reosseointegration with direct bone-to-implant-contact on the previously contaminated surfaces (42% mean reosseointegration), which was significantly higher than Controls (p<0.05). Correspondingly, clinical improvement was noted with a significant reduction in probing depth from 5.50±1.24mm at baseline to 4.46±1.70mm at 6-months postsurgery (p=0.006). CHX-treated sites demonstrated a nonsignificant reosseointegration of 26% (p>0.05); however, in the majority of cases, the new bone growth was at a distance from the implant surface without contact. Probing depths did not improve in the CHX group. The use of membrane did not influence reosseointegration or probing depths (all p>0.05). Titanium implants with peri-implantitis have the capacity to reosseointegrate following regenerative surgery. However, treatment response is contingent upon the chemotherapeutic agent selection. Additional chemical treatment with 1.5% NaOCl lead to the most favorable results in terms of changes in defect depth and percentage of reosseointegration as compared to CHX, which may hinder reosseointegration.

Strontium-doped bioactive glass-functionalized polyetheretherketone enhances osseointegration by facilitating cell adhesion

In the field of orthopedics, surgeons have long been facing the challenge of loosening of external fixation screws due to inherent material characteristics. Despite Polyetheretherketone (PEEK) being employed as an orthopedic implant material for many years, its bio-inert nature often hinders bone healing due to the limited bioactivity, which restricts its clinical applications. Herein, a new type of orthopedic implant (Sr-SPK) was developed by introducing strontium (Sr)-doped mesoporous bioactive glass (Sr-MBG) onto the surface of PEEK implants through a simple and feasible method. In vitro experiments revealed that Sr-SPK effectively promotes osteogenic differentiation while concurrently suppressing the formation of osteoclasts. The same results were validated in vivo with Sr-SPK significantly improving bone integration. Upon investigation, it was found that Sr-SPK promotes adhesion among bone marrow mesenchymal stem cells (BMSCs) thereby promoting osteogenesis by activating the regulation of actin cytoskeletal and focal adhesion pathways, as identified via transcriptome analysis. In essence, these findings suggest that the newly constructed Sr-doped biofunctionalized PEEK implant developed in this research can promote osteoblast differentiation and suppress osteoclast activity by enhancing cell adhesion processes. These results underline the immense potential of such an implant for wide-ranging clinical applications in orthopedics.

Bioinspired Nanotopography for Combinatory Osseointegration and Antibacterial Therapy.

The ongoing global health has highlighted the critical issue of secondary infections, particularly antibiotic-resistant bacterial infections, which have been significant contributors to mortality rates. Orthopedic implants, while essential for trauma and orthopedic surgeries, are particularly susceptible to these infections, leading to severe complications and economic burdens. The traditional use of antibiotics in treating these infections poses further challenges including the risk of developing antibiotic-resistant bacteria. This study introduces a novel approach to combat this issue by developing nanostructured surfaces for orthopedic implants using target ion-induced plasma sputtering. Inspired by the natural design of dragonfly wings, these surfaces aim to prevent bacterial adhesion while promoting preosteoblast activity, offering a dual-function solution to the problems of bacterial infection and implant integration without relying on antibiotics. The in vitro results demonstrate the effectiveness of these bioinspired surfaces in eradicating bacteria and supporting cell proliferation and differentiation, presenting a promising alternative for the development of biomedical implants.

Analysis of the Cellular Response to Different Dental Implant Surfaces: An In vitro Study.

Dental implant surfaces play a crucial role in determining the success of osseointegration and long-term stability. Understanding the cellular response to various implant surfaces is essential for optimizing implant design and clinical outcomes. In this in vitro study, we investigated the cellular response to different dental implant surfaces. Titanium implants with three distinct surface treatments (polished, acid-etched, and sandblasted) were prepared. Human osteoblast-like cells were cultured on these surfaces, and cellular behaviors including adhesion, proliferation, and morphology were evaluated using standard assays and imaging techniques. Our results revealed significant differences in cellular responses among the different implant surfaces. Cells exhibited higher adhesion and proliferation rates on the acid-etched and sandblasted surfaces compared to the polished surface. Furthermore, cells displayed a more spread-out morphology with well-defined filopodia and lamellipodia on the acid-etched and sandblasted surfaces, indicating enhanced cellular interaction and spreading. The cellular response to dental implant surfaces varies depending on surface characteristics. Acid-etched and sandblasted surfaces promote better cellular adhesion, proliferation, and spreading compared to polished surfaces. These findings underscore the importance of surface modifications in enhancing osseointegration and ultimately improving the success rates of dental implant procedures.

Improved Biocompatibility and Osseointegration of Nanostructured Calcium-Incorporated Titanium Implant Surface Treatment (XPEED®).

Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. A microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p < 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration.

Influence of age-related bone density changes on primary stability in stemless shoulder arthroplasty: a multi-implant finite element study

BackgroundStemless implants were introduced to prevent some of the stem-related complications associated with the total shoulder arthroplasty. Although general requirements for receiving these implants include good bone quality conditions, little knowledge exists about how bone quality affects implant performance. The goal of this study was to evaluate the influence of age-induced changes in bone density, as a metric of bone quality, in the primary stability of five anatomic stemless shoulder implants using 3D finite element (FE) models. MethodsThe implant designs considered were based on the Global Icon, Sidus, Simpliciti, SMR, and Inhance stemless implants. Shoulder arthroplasties were virtually simulated in Solidworks. The density distributions of 20 subjects from two age groups, 20 to 40 and 60 to 80 years old, were retrieved from medical image data and integrated into three-dimensional FE models of a single humerus geometry, developed in Abaqus, to avoid confounding factors associated with geometric characteristics. For the designs which do not have a solid collar covering the entire bone surface, i.e., the Sidus, Simpliciti, SMR, and Inhance implants, contact and non-contact conditions between the humeral head component and bone were considered. Primary stability was evaluated through the assessment of micromotions at the bone-implant interface considering eight load cases related to rehabilitation activities and demanding tasks. Three research variables, considering 20 μm, 50 μm, and 150 μm as thresholds for osseointegration, were used for a statistical analysis of the results. ResultsThe decreased bone density registered for the 60-80 age group led to larger micromotions at the bone-implant interface when compared to the 20-40 age group. The Global Icon-based and Inhance-based designs were the least sensitive to bone density, whereas the Sidus-based design was the most sensitive to bone density. The establishment of contact between the humeral head component and bone for the implants that do not have a solid collar led to decreased micromotions. DiscussionAlthough the age-induced decline in bone density led to increased micromotions in the FE models, some stemless shoulder implants presented good overall performance regardless of the osseointegration threshold considered, suggesting that age alone may not be a contraindication to anatomic total shoulder arthroplasty. If only primary stability is considered, the results suggested superior performance for the Global Icon-based and Inhance-based designs. Moreover, the humeral head component should contact the resected bone surface when feasible. Further investigation is necessary to combine these results with the long-term performance of the implants and allow more precise recommendations.

Optimal ultrasonic treatment frequency and duration parameters were used to detect the pathogenic bacteria of orthopedic implant-associated infection by ultrasonic oscillation

IntruductonThe most accurate method for detecting the pathogen of orthopedic implant-associated infections (OIAIs) is sonication fluid (SF). However, the frequency and duration of ultrasound significantly influence the number and activity of microorganisms. Currently, there is no consensus on the selection of these two parameters. Through this study, the choice of these two parameters is clarified. MethodsWe established five ultrasonic groups (40kHz/10min, 40kHz/5min, 40 kHz/1min, 20kHz/5min, and 10kHz/5min) based on previous literature. OIAIs models were then developed and applied to ultrasound group treatment. Subsequently, we evaluated the efficiency of bacteria removal by conducting SEM and crystal violet staining. The number of live bacteria in the SF was determined using plate colony count and live/dead bacteria staining. ResultsThe results of crystal violet staining revealed that both the 40kHz/5min group and the 40kHz/10min group exhibited a significantly higher bacterial clearance rate compared to the other groups. However, there was no significant difference between the two groups. Additionally, the results of plate colony count and fluorescence staining of live and dead bacteria indicated that the number of live bacteria in the 40kHz/5min SF group was significantly higher than in the other groups. Conclusion40kHz/5min ultrasound is the most beneficial for the detection of pathogenic bacteria on the surface of orthopedic implants.

Biodegradable PTMC-MAO composite coatings on AZ31 Mg-alloys for enhanced corrosion-resistance

Bio-absorbable magnesium (Mg) alloys exhibit significant promise for implantable medical devices, particularly in orthopedic applications. However, their limited corrosion resistance and rapid degradation rates have hindered their clinical translation. To address this long-standing challenge, here we developed a composite coating system (PTMC-MAO) for Mg-alloys, seamlessly integrating Microarc oxidation (MAO) and Poly-(Trimethylene Carbonate) (PTMC) layers. Leveraging the synergistic effects between MAO coatings, generated through micro-arc oxidation, and PTMC coatings, synthesized via gradual dropwise addition, our approach effectively controls corrosion and degradation rates of a widely applied Mg-alloy (AZ31) both in terms of kinetics and thermodynamics. Compared with the uncoated AZ31, the PTMC-MAO coatings exhibited greater positive Ecorr of −1290 mV and lower icorr of 5.3 nA· cm-2 with a significant 851-fold reduction. The coatings reached up to a distinguished protection efficiency (η) of 99.9 %, accompanying with the higher impedance |Z| of 4×105 Ω·cm2. The ΔpH change and the released Mg2+ concentration were 0.25 and 42 μg/ml, respectively, after 21 days of immersion. Both values were superior to those observed for the AZ31 substrate. These results highlight the transformational potential of PTMC-MAO composite coatings, indicating their feasibility as a new class of materials for engineering the surfaces of Mg-based degradable implants.

Nano‐Fat Actuated Lipometabolic Reprogramming of Macrophages for Intracellular Infections in Biofilm Microenvironment

AbstractMetabolic competition is a zero‐sum game between bacterial biofilms and host immune responses on the surface of medical implants. In an in vitro biofilm‐macrophages co‐culture system, it is found that suppressed lipid metabolic processes in host macrophages in the biofilm microenvironment correlates with immune tolerance and intracellular persistence. Reactivation of immune cells against bacterial infection by reprogramming lipid metabolism through the supply of lipids such as oleic acid (OA) is a promising strategy, but this cannot completely destroy the bacterial biofilms. Nanomaterial‐based zinc ion interference therapy in antibacterial field emerges relying on the outstanding benefits of nanomaterials. Therefore, a targeted nano‐fat HSA‐IR820@OA@ZIF‐8 (HIROZ) with near infrared‐II (NIR‐II) photothermal capacities is developed for the destrcution of the biofilms via zinc ion combined photothermal therapy. The improved cellular compatibility and enhanced intracellular uptake make HIROZ induce intracellular lipid droplets (LDs) formation in macrophages. Photothermal combined zinc ion‐induced metabolic interference augments the antimicrobial effect of LDs and activates lipometabolic reprogramming‐mediated antibacterial immune responses via mitochondrial stress. In the mouse wound biofilm infections model and subcutaneous implant‐associated biofilm infections (IABIs) model, HIROZ demonstrates sustained and thorough biofilm scavenging based on reprogramming of lipid metabolism, providing a new idea for metabolic interference‐centered therapeutic strategies for full‐scale IABIs eliminations.

First experience of focal pulsed field ablation for premature ventricular contractions

Abstract Introduction Pulsed field ablation (PFA) has emerged as a novel strategy to achieve ablation of cardiac tissue. Clinical evidence suggests a remarkable lesion durability and safety profile for AF ablation. Nonetheless, a growing interest exists in broadening its field of application for catheter ablation of ventricular arrhythmias (VA). The CENTAURI system arises as a promising PFA system for targeting VA as it allows pulsed electric field (PEF) delivery via standard, commercially available focal ablation catheters and concomitant coupling with their mapping systems. Purpose To assess, for the first time, the feasibility of focal PFA via the CENTAURI system for premature ventricular complex (PVC) ablation. Methods We conducted a prospective analysis of patients with either high burden (&amp;gt;10%) or symptomatic idiopathic PVC undergoing focal PFA using CENTAURI system at our institution. Procedures were performed between December 2022 and August 2023. Acute and long-term success were defined as no PVC recurrence during a 24h in-hospital monitoring period, and ≥80% burden reduction with absence of symptoms after at least 30 days post-ablation, respectively. PVC monitoring was performed by implantable loop recorder (ILR) or surface ECG Holter monitoring. Results Fourteen patients (age range: 16-87 years; 10 females) were included. Procedures were performed via the CENTAURI system in combination with CARTO 3 system and EnSite X EP system in 4 (28.6%) and 10 cases (71.4%) respectively. Targeted ablation sites were the right ventricular outflow tract (6 cases), right moderator band (2 cases), left postero-medial papillary muscle -PM- (2 cases), and right posterior PM, tricuspid annulus, left posterior fascicle and aortomitral continuity (AMC) in one case. On average, 6.5 applications were delivered to the site of origin with a mean contact force of 11g. Procedural duration and fluoroscopy time were 102 and 8.9 minutes. Two minor complications were observed: one transitory ST depression (solved after i.v. nitrate administration) after repeated applications to AMC, and a femoral pseudoaneurysm. The remaining 12 procedures were uneventful. Although most of the procedures were performed under general anesthesia due to concerns about potential significant muscular contraction, 3 cases (21.4%) were successfully managed with light sedation, without significant muscular contraction nor map shift. Incomplete abolishment of PVC during first 24 h was observed in 2 patients (14.3%). After a median follow-up of 113 days (IQR: 83-188), recurrences were detected in one patient (7.14%). Conclusion Herein we report the feasibility and efficacy of PVC ablation using a focal PEF delivery system (CENTAURI). Furthermore, we describe the possibility of performing PVC ablation with this technology under light sedation, which might be important for minimizing anesthesia impact on PVC burden.Table of characteristicsPVC morphologies

Biomechanical Investigation of the Osseointegration of Titanium Implants With Different Surfaces Placed With Allogeneic Bone Transfer.

Allogeneic grafts can be preferred to autogenous grafts in plastic and oral-maxillofacial surgery for vertical and horizontal bone deficiencies. Implant surface properties are an important factor in osseointegration. This study aims to evaluate the osseointegration levels of titanium implants with machined, sand-blasted, and acid-etched (SLA) and resorbable blast material (RBM) surfaces placed together with allogeneic bone tissue transplantations obtained from the tibia bone using biomechanical method. Twenty-five female Sprague-Dawley rats were included in the study. The rats were divided into groups in which machined (n=7), SLA (n=7), and RBM (n=7) surface implants were placed with the transplantation of bone taken from the tibia. Four rats (both left and right tibias) were used as donors. Grafts and implants were surgically placed in the corticocancellous part of the metaphyseal area of the tibia bones of rats. At the end of the 4-week experimental setup, all rats were killed, and the implants and surrounding bone tissue were subjected to biomechanical reverse torque analysis (N/cm). Sand-blasted acid-etched surface implants were observed to have higher biomechanical osseointegration levels than RBM and machined surface implants ( P <0.05). No statistical difference could be detected between the RBM and machined surface implants ( P >0.05). On the basis of the limited results of this study, it can be concluded that the osseointegration levels of SLA surface implants placed with allogeneic bone transplantation may be better than those of machined and RBM surface implants.

Loading rutin on surfaces by the layer-by-layer assembly technique to improve the oxidation resistance and osteogenesis of titanium implants in osteoporotic rats

The purpose of this study was to construct a rutin-controlled release system on the surface of Ti substrates and investigate its effects on osteogenesis and osseointegration on the surface of implants. The base layer, polyethylenimine (PEI), was immobilised on a titanium substrate. Then, hyaluronic acid (HA)/chitosan (CS)-rutin (RT) multilayer films were assembled on the PEI using layer-by-layer (LBL) assembly technology. We used scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy and contact angle measurements to examine all Ti samples. The drug release test of rutin was also carried out to detect the slow-release performance. The osteogenic abilities of the samples were evaluated by experiments on an osteoporosis rat model and MC3T3-E1 cells. The results (SEM, FTIR and contact angle measurements) all confirmed that the PEI substrate layer and HA/CS-RT multilayer film were effectively immobilised on titanium. The drug release test revealed that a rutin controlled release mechanism had been successfully established. Furthermore, the in vitro data revealed that osteoblasts on the coated titanium matrix had greater adhesion, proliferation, and differentiation capacity than the osteoblasts on the pure titanium surface. When MC3T3-E1 cells were exposed to H2O2-induced oxidative stress in vitro, cell-based tests revealed great tolerance and increased osteogenic potential on HA/CS-RT substrates. We also found that the HA/CS-RT coating significantly increased the new bone mass around the implant. The LBL-deposited HA/CS-RT multilayer coating on the titanium base surface established an excellent rutin-controlled release system, which significantly improved osseointegration and promoted osteogenesis under oxidative stress conditions, suggesting a new implant therapy strategy for patients with osteoporosis.

Surface modification of biomedical titanium alloy for hard tissue repair and reconstruction

In biomedical applications, various materials are used, including metals and their alloys, polymers and ceramics. Among them, titanium (Ti) and titanium alloys are widely utilised in implant materials due to their excellent corrosion resistance and high mechanical strength. However, despite these advantages, titanium is biologically inert and does not integrate well with human cells. Therefore, surface modification of titanium implants plays a crucial role in determining the rate of osseointegration and the overall success of the implants. The primary objective of this review is to provide a detailed introduction to surface modification technologies for titanium alloy implants. The aim is to enhance the biological activity, wear resistance, corrosion resistance and antibacterial properties and reduce the release of ions from the implants. By modifying the surface of titanium implants, it is possible to create a more favourable environment for cell adhesion, proliferation and differentiation. Various techniques, such as physical methods (e.g. sandblasting, acid etching) and chemical methods (e.g. surface oxidation, plasma treatment) can be employed to modify the surface properties of titanium implants. These surface modification techniques can enhance the interaction between the implant and the surrounding biological environment, promoting osseointegration and improving the long-term stability of the implant. Additionally, surface modifications can help reduce the release of potentially harmful ions from the implant, minimise bacterial adhesion and improve the overall biocompatibility of the implant. In conclusion, surface modification of titanium alloy implants is a critical aspect of biomedical engineering. By improving the biocompatibility of titanium implants, these modifications contribute to the success and longevity of implants used in hard tissue repair and reconstruction.

Implant surface modifications and their impact on osseointegration and peri-implant diseases through epigenetic changes: A scoping review.

Dental implant surfaces and their unique properties can interact with the surrounding oral tissues through epigenetic cues. The present scoping review provides current perspectives on surface modifications of dental implants, their impact on the osseointegration process, and the interaction between implant surface properties and epigenetics, also in peri-implant diseases. Findings of this review demonstrate the impact of innovative surface treatments on the epigenetic mechanisms of cells, showing promising results in the early stages of osseointegration. Dental implant surfaces with properties of hydrophilicity, nanotexturization, multifunctional coatings, and incorporated drug-release systems have demonstrated favorable outcomes for early bone adhesion, increased antibacterial features, and improved osseointegration. The interaction between modified surface morphologies, different chemical surface energies, and/or release of molecules within the oral tissues has been shown to influence epigenetic mechanisms of the surrounding tissues caused by a physical-chemical interaction. Epigenetic changes around dental implants in the state of health and disease are different. In conclusion, emerging approaches in surface modifications for dental implants functionalized with epigenetics have great potential with a significant impact on modulating bone healing during osseointegration.

Enhancing Hip Arthroplasty Outcomes: The Multifaceted Advantages, Limitations, and Future Directions of 3D Printing Technology.

In the evolving field oforthopedic surgery, the integration of three-dimensional printing (3D printing) has emerged as a transformative technology, particularly in addressing the rising incidence of degenerative joint diseases. The integration of 3D printing technology in hip arthroplasty offers substantial advantages throughout the surgical process. In preoperative planning, 3D models enable meticulous assessments, aiding in accurate implant selection and precise surgical strategies. Intraoperatively, the technology contributes to precise prosthesis design, reducing operation duration, X-ray exposures, and blood loss. Beyond surgery, 3D printing revolutionizes medical equipment production, imaging, and implant design, showcasing benefits such as enhanced osseointegration and reduced stress shielding with titanium cups. Challenges include a higher risk of postoperative infection due to the porous surfaces of 3D-printed implants, technical complexities in the printing process, and the need for skilled manpower. Despite these challenges, the evolving nature of 3D printing technologies underscores the importance of relying on existing orthopedic surgical practices while emphasizing the need for standardized guidelines to fully harness its potential in improving patient care.