Titanium-6 Aluminium-4 Vanadium Research Articles

Implementation of Computer-Assisted Design, Analysis, and Additive Manufactured Customized Mandibular Implants

Additive manufacturing (AM) in medical applications has been gradually attracting interest due to its customizability, cost-effective production, and fast delivery. For the past decade, the majority of implants have been traditionally produced using casting, forging, machining, and powder metallurgy techniques. These traditional implants require manual bending before surgery using trial and error to custom fit the patient’s bone contour. Any mismatch between the implant and the bone contours would result in implant failure and physiological stress and pain to the patient. The objective of this study is to present an integrated framework model to design, analyze, validate, and develop a new customized mandibular implant from the computed tomography scan, that can precisely fit patients’ bone contours and can effectively withstand chewing load conditions. In this study, a customized implant is designed based on a patient’s Digital Imaging and Communications in Medicine files. A three dimensional finite element model of the designed implant is generated to simulate the mechanical behavior based on the chewing load conditions. Finally, the designed implant is fabricated using electron beam melting and AM technology from Ti6Al4 V ELI [Titanium-6 Aluminium-4 Vanadium (Wt%) extra low interstitials] powder. The finite element analysis results revealed that the designed reconstruction plate model can withstand the maximum stresses (168.79 MPa), which is significantly less than the determined failure limit of the implant material. Moreover, the location of the maximum strain on the reconstruction plate is away from the screw holes, thus providing better stability and fewer chances of the implant screw loosening. The study reveals that the newly designed reconstruction plate can be recommended in the repair of mandibular bone defects, which can effectively improve stability and can guarantee a perfect fit.

A custom-made temporomandibular joint prosthesis for fabrication by selective laser melting: Finite element analysis

A novel and custom-made selective laser melting (SLM) 3D-printed alloplastic temporomandibular joint (TMJ) prosthesis is proposed. The titanium-6aluminium-4vanadium (Ti-6Al-4V) condyle component and ultra-high molecular weight polyethylene (UHMWPE) fossa component comprised the total alloplastic TMJ replacement prosthesis. For the condyle component, an optimized tetrahedral open-porous scaffold with combined connection structures, i.e. an inlay rod and an onlay plate, between the prosthesis and remaining mandible was designed. The trajectory of movement of the intact condyle was assessed via kinematic analysis to facilitate the design of the fossa component. The behaviours of the intact mandible and mandible with the prosthesis were compared. The biomechanical behaviour was analysed by assessing the stress distribution on the prosthesis and strain distribution on the mandible. After muscle force was applied, the magnitude of the compressive strain on the condyle neck of the mandible with the prosthesis was lower than that on the condyle neck of the intact mandible, with the exception of the area about the screws; additionally, the magnitude of the strain at the scaffold–bone interface was relatively high.

Laser and electron-beam powder-bed additive manufacturing of metallic implants: A review on processes, materials and designs.

Additive manufacturing (AM), also commonly known as 3D printing, allows the direct fabrication of functional parts with complex shapes from digital models. In this review, the current progress of two AM processes suitable for metallic orthopaedic implant applications, namely selective laser melting (SLM) and electron beam melting (EBM) are presented. Several critical design factors such as the need for data acquisition for patient-specific design, design dependent porosity for osteo-inductive implants, surface topology of the implants and design for reduction of stress-shielding in implants are discussed. Additive manufactured biomaterials such as 316L stainless steel, titanium-6aluminium-4vanadium (Ti6Al4V) and cobalt-chromium (CoCr) are highlighted. Limitations and future potential of such technologies are also explored.

Multiscale grooved titanium processed with femtosecond laser influences mesenchymal stem cell morphology, adhesion, and matrix organization

The femtosecond laser processing enabled the structuring of six types of surfaces on titanium-6aluminium-4vanadium (Ti-6Al-4V) plates. The obtained hierarchical features consisted of a combination of microgrooves and oriented nanostructures. By adjusting beam properties such as laser polarization, the width of the microgrooves (20 or 60 μm) and the orientation of the nanostructures (parallel or perpendicular to the microgrooves) can be precisely controlled. Mesenchymal stem cells (MSCs) grown on these structured surfaces produced cytoplasmic extensions with focal contacts, while on the smooth titanium, the cells were found to be well spread and without any focal contact 12 h postseeding. The 600-nm wide nanostructures on their own were sufficient to orient the MSCs. For the multiscale structured areas, when the orientation of the nanostructures was orthogonal in relation to the microgrooves, there was an important decrease in or even a loss of cell alignment signifying that cells were sensitive to the directional nanostructures in the microgrooves. At 7 days, cell proliferation was not affected but the direction of nanostructures controlled the matrix organization. The ultrafast laser, as a new method for producing micro-nanohybrid surfaces, is a promising approach to promote desired tissue organization for tissue engineering.

Effects of Ti2448 half-pin with low elastic modulus on pin loosening in unilateral external fixation

The objective of this study was to compare the benefits of titanium 2448 (Ti2448) half-pin and titanium-6 aluminium-4 vanadium (TAV) half-pin on reducing pin loosening during external fracture fixation. Although having similar strength, Ti2448 half-pin had even lower elastic modules (33 GPa) when compared with TAV half-pin (110 GPa), which was similar to that of cortical bone (20 GPa). In the external fixation of tibial model fractures and canine cadaveric tibia fractures, Ti2448 half-pin had greater recoverable deformation and less stress concentration at the pin-bone interface in compression, torsion, and four-points bending test. Then, tibial fractures were created in 24 dogs and stabilized with four half-pins of either Ti2448 or TAV in each animal. At 4 and 8 weeks postoperatively, fracture healing and pin loosening was assessed by radiographic grading scale. The scores of Ti2448 group were significantly higher than those of TAV group. Micro-CT analysis also indicated larger quantity and higher quality of newly formed bone at pin-bone interface in Ti2448 group. Histology observation showed the newly formed bone integrated well into the threads of Ti2448 half-pins. In contrast, there was a layer of necrotic tissue between the bone tissue and TAV half-pin at pin-bone interface in TAV group. The extraction torque values of Ti2448 half-pins near the fracture line were significantly higher than those TAV pins. In conclusion, the Ti2448 half-pin with low elastic modulus could enhance osseointegration and reduce pin loosening when compared with TAV half-pin. It is a promising biomaterial for constructing external fixation system in clinical application.

In vitro osteoblastic differentiation of human mesenchymal stem cells and human dental pulp stem cells on poly‐L‐lysine‐treated titanium‐6‐aluminium‐4‐vanadium

Three-dimensional (3D) titanium-6-aluminium-4-vanadium (Ti6Al4V) is a widely used biomaterial for orthopedic prosthesis and dental implants; thanks to its very high-mechanical strength and resistance to corrosion. Human mesenchymal stem cells (hMSCs) and dental pulp stem cells (hDPSCs) are responsible for bone regeneration following colonization of prosthesis or dental implants. Both hMSCs and hDPSCs have lower ability to colonize this biomaterial in comparison with tissue culture-treated plastic. Both hMSCs and hDPSCs show lack of focal adhesion kinase (FAK) activation when grown on Ti6Al4V. This signal is restored in the presence of poly-L-lysine (poly-L-lys). Poly-L-lys has been used as part of organoapatite or together with zinc and calcium ions. Our results suggest that poly-L-lys alone induces FAK activation through β1-INTEGRIN, because the presence of β1-INTEGRIN blocking antibody avoided FAK autophosphorylation. Presence of poly-L-lys also increases expression of osteoblastic differentiation marker genes in hMSCs and hDPSCs grown on Ti6Al4V.

In vitro and in vivo studies of osteoblast cell response to a titanium-6 aluminium-4 vanadium surface modified by neodymium:yttrium–aluminium–garnet laser and silicon carbide paper

The effects of neodymium:yttrium-aluminium-garnet (Nd:YAG) laser and silicon carbide (SiC) paper on the surface micro-topography of titanium-6 aluminium-4 vanadium (Ti6Al4V) alloy were examined in relation to the response of bone cells. The study was performed in three distinct stages: (1) after surface treatment of samples by laser and SiC paper, the surface hardness, surface roughness, corrosion resistance and surface tension were evaluated; (2) the growth of mouse connective tissue fibroblast cells (L-929) on untreated and treated samples was assessed in vitro; (3) the response of goat osteoblast cells to untreated and treated implanted samples was assessed in vivo. The surface roughness varied between 7 +/- 0.02 for laser-treated samples (LTSs) at 140 J cm(-2) and 21.8 +/- 0.05 for mechanically treated samples (MTSs). The surface hardness was found to vary from 377 Vickers hardness number (VHN) for MTSs to 850 VHN for LTSs. A corrosion potential of -0.21V was achieved for the LTSs compared with -0.51V for the MTSs. The LTSs exhibited a more hydrophilic behaviour (i.e. wettability) than did the MTSs. No cytotoxicity effect, unlike for the MTSs, was observed for the LTSs. The results of in vivo tests indicated longitudinal growth of osteoblast cells along the grooves on the samples formed by the SiC paper, and multidirectional spreading of the cells on the LTSs.

In vitro biocompatibility of duplex stainless steel with and without 0.2% niobium.

Stainless steel is frequently used as a biomaterial. Chemical composition alterations can be undertaken to improve its mechanical and biological properties. This investigation aimed to compare the biocompatibility of duplex stainless steel, with and without 0.2% niobium, with austenitic stainless steel and titanium-6-aluminium-4-vanadium (Ti6Al4V) using rat bone marrow (RBM) cell culture. Cell attachment was evaluated at 24 hr. Cell proliferation, cell viability, total protein content, and alkaline phosphatase (ALP) activity were evaluated at 7, 14 and 21 days. Bone-like nodule formation was evaluated at 21 days. Cell attachment, proliferation and viability were unaffected by the chemical composition of the stainless steels and the Ti6Al4V. Total protein content, ALP activity, and bone-like nodule formation were unaffected by the chemical composition of the stainless steels, but these parameters were greater on the Ti6Al4V than on the stainless steels. Our results demonstrated that initial cell events were unaffected by the chemical composition of the tested alloys, while events indicating osteoblast differentiation including increased ALP activity and bone-like nodule formation were favored by the Ti6Al4V. Moreover, the evaluated parameters were unaffected by the presence of niobium in the stainless steel composition. As niobium affects microstructure and, consequently, improves the mechanical properties of duplex stainless steel, it is suggested that the addition of niobium to metallic alloys could be useful in developing alloys with acceptable biocompatibility and improved mechanical features. (Journal of Applied Biomaterials & Biomechanics 2004; 2: 162-8).

Implant-related inflammatory arthritis

A 54-year-old woman presented with myalgia and arthralgia predominantly in the knees and small joints of the hands and feet with morning stiffness lasting for at least 2 h. The patient had received a wrought titanium 6-aluminium 4-vanadium alloy C cage implant 1.5 years previously, following a severe disc prolapse. No signs of rheumatic disease were evident before the C cage was implanted. Physical examination, radiography, skin and muscle biopsies, serology tests, white blood cell count, HLA genotyping, tumor necrosis factor release assay, skin patch test, lymphocyte transformation test. Implant-related inflammatory arthritis. Combination therapy with corticosteroids, disease-modifying antirheumatic drugs and nonsteroidal anti-inflammatory drugs, and replacement of the titanium cage with a polyetherketone cage.

REGULATION OF BONE CELLS BY PARTICLE-ACTIVATED MONONUCLEAR PHAGOCYTES

Bone loss around replacement prostheses may be related to the activation of mononuclear phagocytes (MNP) by prosthetic wear particles. We investigated how osteoblast-like cells were regulated by human MNP stimulated by particles of prosthetic material. Particles of titanium-6-aluminium-4-vanadium (TiAlV) stimulated MNP to release interleukin (IL)-1β, tumour necrosis factor (TNF)α, IL-6 and prostaglandin E2 (PGE2). All these mediators are implicated in regulating bone metabolism. Particle-activated MNP inhibited bone cell proliferation and stimulated release of IL-6 and PGE2. The number of cells expressing alkaline phosphatase, a marker associated with mature osteo-blastic cells, was reduced. Experiments with blocking antibodies showed that TNFα was responsible for the reduction in proliferation and the numbers of cells expressing alkaline phosphatase. By contrast, IL-1β stimulated cell proliferation and differentiation. Both IL-1β and TNFα stimulated IL-6 and PGE2release from the osteoblast-like cells. Our results suggest that particle-activated mono-nuclear phagocytes can induce a change in the balance between bone formation and resorption by a number of mechanisms.

Regulation of bone cells by particle-activated mononuclear phagocytes.

Bone loss around replacement prostheses may be related to the activation of mononuclear phagocytes (MNP) by prosthetic wear particles. We investigated how osteoblast-like cells were regulated by human MNP stimulated by particles of prosthetic material. Particles of titanium-6-aluminium-4-vanadium (TiAIV) stimulated MNP to release interleukin (IL)-1beta, tumour necrosis factor (TNF)alpha, IL-6 and prostaglandin E2 (PGE2). All these mediators are implicated in regulating bone metabolism. Particle-activated MNP inhibited bone cell proliferation and stimulated release of IL-6 and PGE2. The number of cells expressing alkaline phosphatase, a marker associated with mature osteoblastic cells, was reduced. Experiments with blocking antibodies showed that TNFalpha was responsible for the reduction in proliferation and the numbers of cells expressing alkaline phosphatase. By contrast, IL-1beta stimulated cell proliferation and differentiation. Both IL-1beta and TNFalpha stimulated IL-6 and PGE2 release from the osteoblast-like cells. Our results suggest that, particle-activated mononuclear phagocytes can induce a change in the balance between bone formation and resorption by a number of mechanisms.

Histomorphological reaction of bone to different concentrations of phagocytosable particles of high-density polyethylene and Ti-6Al-4V alloy in vivo

Wear debris has been implicated in the pathogenesis of loosening and osteolysis of total joint replacements by stimulating a foreign body and chronic inflammatory reaction capable of bone resorption. Whether increasing concentrations of wear particles have an adverse biological effect on bone has not been elucidated. We performed a histomorphological and semi-quantitative morphometric analysis of the reaction of bone to different concentrations of phagocytosable particles of high-density polyethylene (HDPE) and titanium 6-aluminium 4-vanadium alloy (Ti-6Al-4V) implanted in the rabbit tibia. The Ti-6Al-4V particles had a diameter of 4.0 ± 4.4 μm (mean ± SD); the HDPE particles averaged 4.7 ± 2.1 μm. Suspensions of 106–109 particles per ml were mixed in saline, sterilized, and introduced through a drill hole into the proximal tibia of 30 mature female rabbits. Controls included drilled, but non-implantable limbs. The animals were killed at 16 weeks and histological sections were made of the implant area. Histomorphological assessment was carried out using an interactive image analysis system. The parameters assessed included the presence of histiocytes, foreign body giant cells and inflammatory cells, the location and number of particles, the presence of haematopoeitic elements, fat or necrosis of the marrow, whether healing of the cortical window had taken place, and whether there was evidence of formation or resorption of bone by the periosteum, cortex and marrow. A semi-quantitative rating system was employed. Phagocytosable particles of Ti-6Al-4V and HDPE, in concentrations of 106–109 particles per ml, evoked a histiocytic reaction without extensive fibrosis, necrosis or granuloma formation. This reaction occurred without disturbing the normal repair processes of bone formation and resorption to the surgical insult. A clear dose-response effect on the histological parameters assessed in this study was not noted. Using the present model, by 16 weeks, a similar ‘one time’ particle load could be accommodated. The ongoing generation of particulate debris over a more extended period of time might be necessary before the remodelling processes of bone would be disturbed.

Electrochemical studies on the influence of proteins on the corrosion of implant alloys

The effect of proteins on corrosion rates of 316L stainless steel, commercially pure titanium and titanium 6-aluminium 4-vanadium was studied in the static and fretting modes. The static mode was studied using cylindrical specimens as per ASTM F-746, and static fracture fixation plates. The fretting mode was studied using a two-hole plate fretting machine which caused a cyclic rocking motion between the plate and the screws, as per ASTM F-897. Electrochemical techniques of polarization resistance and Tafel slope measurements were used to study effects of proteins on the anodic and cathodic corrosion reactions. It was found that proteins increased the corrosion rate of the stainless steel and C.P. titanium cylindrical specimens, but did not have an effect on the Ti-6AI-4V cylinders. In the fretting mode proteins decreased the corrosion rate of the stainless steel plates, but did not have an appreciable effect on either of the titanium alloys. The presence of proteins appeared to cause an increase in the anodic Tafel constant and a decrease in the cathodic Tafel constant of stainless steel specimens. Significant differences in the shapes of the cathodic Tafel slopes were also seen with cylinders with different surface conditions, and static versus fretting plates.