Titanium Alloy Implants Research Articles

The SCC behavior of MAO/EPD biocomposite coatings on Ti-6Al-4V alloy

Aseptic loosening and inadequate osseointegration are significant issues associated with titanium alloy implants in complex body fluid environments. Surface coatings techniques are often employed to enhance the bioactivity and osseointegration capabilities. In this research, biocomposite coatings were fabricated on Ti-6Al-4V alloy employing micro-arc oxidation (MAO) and the integration of micro-arc oxidation/electrophoretic deposition (MAO/EPD) technology. Microstructure, bioactivity, and corrosion resistance of the coatings were studied. To investigate the effect of the coatings on the stress corrosion cracking (SCC) behavior of Ti-6Al-4V alloy, slow strain rate tension (SSRT) tests were conducted in simulated body fluid (SBF). Results show that the adhesive strength of the MAO/EPD composite coatings is around 28.41N, with an average contact angle of 19.05 °, indicating excellent wettability and biocompatibility. The corrosion rate of biocomposite coatings is 3.43 μm·a−1 and the biocomposite coatings exhibit excellent SCC resistance, with a SCC sensitivity of 9.21%, which is significantly lower than the 18.39% of Ti-6Al-4V alloy. This can be attributed to the lower porosity of the coatings, which can provide excellent protection for the alloy.

Optimization Design and SLM Manufacturing of Porous Titanium Alloy Femoral Stem.

In order to solve the loosening problem caused by stress shielding of femoral stem prostheses in clinical practice, an optimization design method of a personalized porous titanium alloy femoral stem is proposed. According to the stress characteristics of the femur, the porous unit cell structures (TO-C, TO-T, TO-B) under three different loads of compression, torsion, and bending were designed by topology optimization. The mechanical properties and permeability of different structures were studied. Combined with the porous structure optimization, a personalized radial gradient porous titanium alloy femoral stem was designed and manufactured by selective laser melting (SLM) technology. The results show that the TO-B structure has the best comprehensive performance among the three topologically optimized porous types, which is suitable for the porous filling structure of the femoral stem, and the SLM-formed porous femoral stem has good quality. The feasibility of the personalized design and manufacture of porous titanium alloy implants is verified, which can provide a theoretical basis for the optimal design of implants in different parts.

Mussel-inspired bifunctional coating for long-term stability of oral implants

Peri-implantitis and osseointegration failure present considerable challenges to the prolonged stability of oral implants. To address these issues, there is an escalating demand for a resilient implant surface coating that seamlessly integrates antimicrobial features to combat bacteria-induced peri‑implantitis, and osteogenic properties to promote bone formation. In the present study, a bio-inspired poly(amidoamine) dendrimer (DA-PAMAM-NH2) is synthesized by utilizing a mussel protein (DA) known for its strong adherence to various materials. Conjugating DA with PAMAM-NH2, inherently endowed with antibacterial and osteogenic properties, results in a robust and multifunctional coating. Robust adhesion between DA-PAMAM-NH2 and the titanium alloy surface is identified using confocal laser scanning microscopy (CLSM) and attenuated total reflectance-infrared (ATR-IR) spectroscopy. Following a four-week immersion of the coated titanium alloy surface in simulated body fluid (SBF), the antimicrobial activity and superior osteogenesis of the DA-PAMAM-NH2-coated surface remain stable. In contrast, the bifunctional effects of the PAMAM-NH2-coated surface diminish after the same immersion period. In vivo animal experiments validate the enduring antimicrobial and osteogenic properties of DA-PAMAM-NH2-coated titanium alloy implants, significantly enhancing the long-term stability of the implants. This innovative coating holds promise for addressing the multifaceted challenges associated with peri‑implantitis and osseointegration failure in titanium-based implants. Statement of significanceProlonged stability of oral implants remains a clinically-significant challenge. Peri-implantitis and osseointegration failure are two important contributors to the poor stability of oral implants. The present study developed a mussel-bioinspired poly(amidoamine) dendrimer (DA-PAMAM-NH2) for a resilient implant surface coating that seamlessly integrates antimicrobial features to combat bacteria-induced peri‑implantitis, and osteogenic properties to promote bone formation to extend the longevity of oral implants.

Diamond-like carbon (DLC) surface treatment decreases biofilm burden by S. aureus on titanium alloy in vitro- a pilot study.

Periprosthetic joint infection is a complication of total joint arthroplasty with treatment costs over $1.6billion dollars per year in the US with high failure rates. Therefore, generation of coatings that can prevent infection is paramount. Diamond-like carbon (DLC) is an ideal coating for implants as they are wear-resistant, corrosion-resistant, inert, and have a low friction coefficient. The purpose of this study was to test the efficacy of DLC surface treatment in prevention of biofilm on titanium discs infected with Staphylococcus aureus in vitro. Titanium alloy discs (n = 4 non-coated and n = 4 DLC-coated) were infected with 5 × 105 colony-forming units (CFU) of S. aureus for 2 weeks then analysed via crystal violet and scanning electron microscopy (SEM). Crystal violet analysis yielded differences in the appearance of biofilm on implant surface where DLC-coated had a clumpier appearance but no difference in biofilm quantification. Interestingly, this clumpy appearance did lead to differences in SEM biofilm coverage where significantly less biofilm coverage was found on DLC-coated discs (81.78% vs. 54.17%, p < 0.003). DLC-coated titanium alloy implants may have preventative properties in S. aureus infection. Observing differences in biofilm coverage does warrant additional testing including CFU titration and biofilm kinetics with eventual use in an animal model of periprosthetic joint infection.

Enhanced osteogenesis and antibacterial activity of dual-functional PEEK implants via biomimetic polydopamine modification with chondroitin sulfate and levofloxacin

Polyetheretherketone (PEEK) implants have emerged as a clinically favored alternative to titanium alloy implants for cranial bone substitutes due to their excellent mechanical properties and biocompatibility. However, the biological inertness of PEEK has hindered its clinical application. To address this issue, we developed a dual-functional surface modification method aimed at enhancing both osteogenesis and antibacterial activity, which was achieved through the sustained release of chondroitin sulfate (CS) and levofloxacin (LVFX) from a biomimetic polydopamine (PDA) coating on the PEEK surface. CS was introduced to promote cell adhesion and osteogenic differentiation. Meanwhile, incorporation of antibiotic LVFX was essential to prevent infections, which are a critical concern in bone defect repairing. To our delight, experiment results demonstrated that the SPKD/CS-LVFX specimen exhibited enhanced hydrophilicity and sustained drug release profiles. Furthermore, in vitro experiments showed that cell growth and adhesion, cell viability, and osteogenic differentiation of mouse calvaria-derived osteoblast precursor (MC3T3-E1) cells were significantly improved on the SPKD/CS-LVFX coating. Antibacterial assays also confirmed that the SPKD/CS-LVFX specimen effectively inhibited the growth of Escherichia coli and Staphylococcus aureus, attributable to the antibiotic LVFX released from the PDA coating. To sum up, this dual-functional PEEK implant showed a promising potential for clinical application in bone defects repairing, providing excellent osteogenic and antibacterial properties through a synergistic approach.

3D-printed titanium scaffolds loaded with gelatin hydrogel containing strontium-doped silver nanoparticles promote osteoblast differentiation and antibacterial activity for bone tissue engineering.

Bone tissue engineering offers a promising alternative to stimulate the regeneration of damaged tissue, overcoming the limitations of conventional autografts and allografts. Recently, titanium alloy (Ti) implants have garnered significant attention for treating critical-sized bone defects, especially with the advancement of 3D printing technology. Although Ti alloys have impressive versatility, their lack of cellular adhesion, osteogenic and antibacterial properties are significant factors that contribute to their failure. Hence, to overcome these obstacles, this study aimed to incorporate osteoinductive and antibacterial cue-loaded hydrogels into 3D-printed Ti (3D-Ti) scaffolds. 3D-Ti scaffolds were synthesized using the direct metal laser sintering method and loaded with a gelatin (Gel) hydrogel containing strontium-doped silver nanoparticles (Sr-Ag NPs). Compared with Ag NPs, Sr-doped Ag NPs increased the expression of Runx2 mRNA, which is a key bone transcription factor. We subjected the bioactive 3D-hybrid scaffolds (3D-Ti/Gel/Sr-Ag NPs) to physicochemical and material characterization, followed by cytocompatibility and osteogenic evaluation. The microporous and macroporous topographies of the scaffolds with Sr-Ag NPs showed increased Runx2 expression and matrix mineralization, with potent antibacterial properties. Therefore, the 3D-Ti scaffolds incorporated with Sr-Ag NP-loaded Gel hydrogels favored osteoblast differentiation and antibacterial activity, indicating their potential for orthopedic applications.

Various Antibacterial Strategies Utilizing Titanium Dioxide Nanotubes Prepared via Electrochemical Anodization Biofabrication Method.

Currently, titanium and its alloys have emerged as the predominant metallic biomaterials for orthopedic implants. Nonetheless, the relatively high post-operative infection rate (2-5%) exacerbates patient discomfort and imposes significant economic costs on society. Hence, urgent measures are needed to enhance the antibacterial properties of titanium and titanium alloy implants. The titanium dioxide nanotube array (TNTA) is gaining increasing attention due to its topographical and photocatalytic antibacterial properties. Moreover, the pores within TNTA serve as excellent carriers for chemical ion doping and drug loading. The fabrication of TNTA on the surface of titanium and its alloys can be achieved through various methods. Studies have demonstrated that the electrochemical anodization method offers numerous significant advantages, such as simplicity, cost-effectiveness, and controllability. This review presents the development process of the electrochemical anodization method and its applications in synthesizing TNTA. Additionally, this article systematically discusses topographical, chemical, drug delivery, and combined antibacterial strategies. It is widely acknowledged that implants should possess a range of favorable biological characteristics. Clearly, addressing multiple needs with a single antibacterial strategy is challenging. Hence, this review proposes systematic research into combined antibacterial strategies to further mitigate post-operative infection risks and enhance implant success rates in the future.

Comprehensive review of PEO coatings on titanium alloys for biomedical implants

Titanium and its alloys are commonly utilized in the biomedical field for fabricating orthopedic and dental implants due to their favorable mechanical, chemical, and biological properties. However, titanium alloys exhibit limited or no bioactivity, necessitating the application of surface functionalization techniques to enhance their functional characteristics suitable for biomedical applications. Plasma Electrolytic Oxidation (PEO) treatment is a simple and versatile surface modification process for valve metals that can add superior osseointegration and bioactive properties to titanium and its alloys. Therefore, this review aims to summarize the mechanisms involved in obtaining porous coatings on the surface of titanium alloys using the PEO method, as well as to outline some of the physicochemical and biological properties of the resulting surfaces. The article discusses the mechanisms of action of bactericidal agents such as copper, silver, and zinc, commonly incorporated into PEO coatings. Finally, the study concludes by discussing remaining challenges and future perspectives that need to be addressed.

Enhancing the Biological Performance of Titanium Alloy through In Situ Modulation of the Surface Nanostructure: Near-Infrared-Responsive Antibacterial Function and Osteoinductivity.

The poor clinical performance of titanium and its alloy implants is mainly attributed to their lack of antibacterial ability and poor osseointegration. The key and challenge lie in how to enhance their osteoinductivity while imparting antibacterial capability. In this study, a titanium oxide metasurface with light-responsive behavior was constructed on the surface of titanium alloy using an alkaline-acid bidirectional hydrothermal method. The effects of the acid type, acid concentration, hydrothermal time, hydrothermal temperature, and subsequent heat treatments on the optical behavior of the metasurface were systematically investigated with a focus on exploring the influence of the metasurface and photodynamic reaction on the osteogenic activity of osteoblasts. Results show that the type of acid and heat treatment significantly affect the light absorption of the titanium alloy surface, with HCl and post-heat-treatment favoring redshift in the light absorption. Under 808 nm near-infrared (NIR) irradiation for 10 min, in vitro antibacterial experiments demonstrate that the antibacterial rate of the metasurface titanium alloy against Staphylococcus aureus and Escherichia coli were 96.87% and 99.27%, respectively. In vitro cell experiments demonstrate that the nanostructure facilitates cell adhesion, proliferation, differentiation, and expression of osteogenic-related genes. Surprisingly, the nanostructure promoted the expression of relevant osteogenic genes of MC3T3-E1 under 808 nm NIR irradiation. This study provides a method for the surface modification of titanium alloy implants.

Bacterial and corrosion resistance of polytetrafluoroethylene-silver composite coatings by magnetron sputtering

Titanium alloy and stainless steel implants have been widely applied in orthopedics. However, harmful ions released from implant corrosion caused by human body fluids and bacterial infections may inhibit patients’ recovery. In this work, a polytetrafluoroethylene-silver composite coating was prepared by RF unbalanced magnetron sputtering to improve the bacterial and corrosion resistance of the SS316L. The removal rates of the composite coatings for Escherichia coli and Staphylococcus aureus reached 97.27% and 99.99%, respectively. The contact angle of 131.5° and fluorescence staining experiments show that the composite coating has an antiadhesive effect on bacteria and less cytotoxicity against osteoblasts. The corrosion voltage of the composite coating was much higher than that of the control SS316L substrate, and the corrosion current density was reduced to 1/3, implying the enhancement of the corrosion resistance of the SS316L substrate.

Research on Characterization and Biocompatibility of 3D Printed Ti-6Al-4V Pelvic Prosthesis

The treatment of bone defects caused by fractures or bone tissue lesions has always been a difficult problem in the field of orthopedics. Implantation of high-performance titanium alloy prosthesis is an effective method to treat bone defects. 3D printing technology can produce low-modulus titanium alloy implants with porous structures, providing a better solution to the above problems. This technology is convenient to design and has a huge advantage in making orthopedic implants. The article used electron beam melting in 3D printing technology to create two samples of Ti-6Al-4V prosthesis, including solid structural pelvic prosthesis and porous structural pelvic prosthesis. The mechanical properties of the prosthesis showed that the yield and tensile strengths of the rod tensile specimen were 894 MPa and 956 MPa, respectively, and the compressive modulus and compressive strength of the porous pelvic prosthesis were 55 GPa and 65.2 MPa, respectively. The results of the L929 cytotoxicity assay and the MC3T3-E1 cell adhesion assay demonstrated good biocompatibility of the prosthetic samples. New Zealand white rabbits were used to prepare the femoral joint cavity defect models and two pelvic prostheses were implanted. A microscopic CT scan 4 weeks after implantation showed that the bone defect caused by the drill had healed and that the porous structure of the pelvic prosthesis formed a new trabecular structure within the hole. In conclusion, the 3D printed Ti-6Al-4V pelvic prosthesis has excellent mechanical properties, biocompatibility, and the ability to promote new bone growth.

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.

Biofilm ablation on titanium alloy surface by photothermal and chemotherapeutic synergistic therapy

With prolonged exposure in the human body, titanium alloy implants face challenges associated with bacterial attachment and proliferation, leading to implant failure and severe complications. Photothermal therapy (PTT) emerges as an efficient strategy for biofilm elimination. However, the local high temperature of PTT and incomplete bacteria ablation in low-temperature PTT pose risks of damage to normal tissues and biofilm recalcitrance, respectively. In this study, we synergistically combined photothermal therapy and chemotherapy to mildly disrupt biofilms of Staphylococcus aureus (S. aureus) to enhance the efficiency of biofilm ablation. The synergistic nanoplatform comprises near-infrared-light responsive conjugated polymers, heat-sensitive liposomes, and the antibiotic daptomycin for biofilm elimination. The heat generated by conjugated polymers, stimulated with 808 nm light, alters biofilm permeability and releases antibiotics locally to eradicate biofilm. The nanoparticles exhibit biofilm dispersion activity and can effectively inhibit biofilm growth for up to 5 days. Consequently, this nanoplatform based on conjugated polymers offers a reliable method for ablating biofilms on titanium alloy implant and exhibits potential in drug-resistant clinical applications.

Micro/nano-surface modification of titanium implant enhancing wear resistance and biocompatibility

Micro/nano structured surface has been shown to effectively enhance the biological performance of titanium alloy implants, exhibiting faster postoperative recovery. However, a common drawback of bio-functionalized surfaces featuring structured characteristics is their susceptibility to wear. This study proposed a novel micro/nano surface modification method using ultrasonic milling and anodization to enhance both biocompatibility and wear resistance of the implant surface. First, hierarchical structures are fabricated on the titanium surface by utilizing ultrasonic milling and anodization to generate micro-scale and nano-scale structures, respectively. Linear reciprocating tests, contact angle tests, and surface morphology observation were conducted to investigate the surface properties. Then, cell proliferative and adhesive abilities were tested on different modified surfaces by using mouse osteoblasts. Finally, nonosilver coatings were created on the structured surface by vapor deposition and the antibacterial performance was tested using staphylococcus aureus. The experiment results reveal a significant improvement in wear resistance, biological properties, and antibacterial capabilities of the processed surface, demonstrating the great application potential of the proposed method for implant surface modification.

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.

Hierarchical zeolite coatings featuring a spatial gradient architecture for sequentially-controlled bisphosphonate release in the modulation of osteogenic–osteoclastic balance

Osteogenic–osteoclastic microenvironment imbalance impairs osseointegration between joint prostheses and the marrow cavity, which is a crucial contributor to the high incidence of complications such as implant loosening and periprosthetic fractures in osteoporosis (OPs). Previously, we employed hydrogel-based bisphosphonate (BPs) coatings on 3D-printed porous titanium alloy implants (pTi) to modulate the OPs microenvironment through controlled release. However, challenges persisted, including the limited duration of BPs release and associated organic material degradation-induced toxicity. To address these issues, we modified pTi surfaces by introducing chemically stable zeolites and BPs. In this study, we applied Ca2+-functionalized hierarchical zeolite coating on pTi for the first time. By combining mesoporous adsorption and Ca2+ chelation, we achieved efficient encapsulation of zoledronate (ZOL), creating a bioactive interface characterized by a spatial gradient structure with a “microporous-mesoporous-macroporous” morphology. The coating achieves the release of ZOL through the mesoporous structure and facilitates the gradual release of chelated ZOL via ion exchange, resulting in hierarchical drug delivery. Moreover, the spatial gradient structure of the coatings significantly influenced cell extension. Simultaneously, we constructed a bioactive coating with a drug concentration gradient, achieving graded drug release within the microenvironment, which facilitated the accurate regulation of osteogenesis and bone resorption. This coating has the potential to substantially enhance the management of postoperative complications in OPs patients undergoing prosthetic replacement surgery by achieving a balanced osteogenic-osteoclastic response.

Surface Functionalization of Titanium-Based Implants with a Nanohydroxyapatite Layer and Its Impact on Osteoblasts: A Systematic Review.

This study aims to evaluate the influence of a nanohydroxyapatite layer applied to the surface of titanium or titanium alloy implants on the intricate process of osseointegration and its effect on osteoblast cell lines, compared to uncoated implants. Additionally, the investigation scrutinizes various modifications of the coating and their consequential effects on bone and cell line biocompatibility. On the specific date of November 2023, an exhaustive electronic search was conducted in esteemed databases such as PubMed, Web of Science, and Scopus, utilizing the meticulously chosen keywords ((titanium) AND ((osteoblasts) and hydroxyapatite)). Methodologically, the systematic review meticulously adhered to the PRISMA protocol. Initially, a total of 1739 studies underwent scrutiny, with the elimination of 741 duplicate records. A further 972 articles were excluded on account of their incongruence with the predefined subjects. The ultimate compilation embraced 26 studies, with a predominant focus on the effects of nanohydroxyapatite coating in isolation. However, a subset of nine papers delved into the nuanced realm of its modifiers, encompassing materials such as chitosan, collagen, silver particles, or gelatine. Across many of the selected studies, the application of nanohydroxyapatite coating exhibited a proclivity to enhance the osseointegration process. The modifications thereof showcased a positive influence on cell lines, manifesting in increased cellular spread or the attenuation of bacterial activity. In clinical applications, this augmentation potentially translates into heightened implant stability, thereby amplifying the overall procedural success rate. This, in turn, renders nanohydroxyapatite-coated implants a viable and potentially advantageous option in clinical scenarios where non-modified implants may not suffice.

Investigation of Mechanical Properties of Ti6Al4V Alloy Foams produced by Powder Metallurgy Method

In this study, it was aimed to production titanium alloy implants, which are widely used in the biomedical industry, as foamed materials under different mechanical alloying and sintering conditions using the powder metallurgy method Tİ6Al4V alloy is good mechanical properties, good biocompatibility properties and good corrosion resistance used as hard tissue replacements and implants. Similar mechanic properties with bone are expected from the implant to work coherently for long cycles of use and without any failure. Especially, elastic modulus of implant must be similar with bones, if not, some damages at bone surface and fallowing repeats of implant surgeries are reported. This situation has a destructive effect on health, finance, and comfort of the patient/user of the implant. In this study, powder metallurgy and space holder removal methods were used to produce porous Ti6Al4V specimens. Throughout the project study different space holder materials and binder agents were used. As weight percent, 20%, 30%, 40%, 60%, 70%, 80% porous specimens were pressed at uniaxial press machine, and sintered to the 850 ºC at argon atmosphere in furnace to reduce the oxidation to the level as low as possible. The E-Modulus values of the specimens reached the desired values with increasing porosity. It was obtained as 88 MPa in the specimen with 80% porosity, decreasing inversely proportionally, especially from the 60% porosity rate.

Antibiofilm properties of the prototypes of thin-film coatings with copper oxide nanoparticles for orthopedic titanium and titanium alloy implants: An experimental study

Objective: at the assessment of bacteriostatic properties of the thin-film coating prototypes meant for orthopedic titanium and titanium alloys implants. Material and methods. The morphology of the Ti-6AL-4V, ASTM F1472 samples with the 50-70 nm thin-film CuO coating deposited on their surfaces with microarc oxidation was examined by scanning electron microscopy. Then we evaluated the effects of the thin-film prototypes on the clinical strains ability to adhere, form biofilms and their growth properties. Results. The newly designed prototype causes the significant decrease in the mass of biofilms pre-formed by the clinical strains (Staphylococcus aureus by 11%, Staphylococcus epidermidis by 38%, and Pseudomonas aeruginosa by 7%) and inhibits their growth properties (S. aureus by 12.7%, S. epidermidis by 13.3%, and P. aeruginosa by 10%). Conclusion. This thin-film coating prototype on the surfaces of the titanium and titanium alloys implants decreases pathogenic factors in the microorganism clinical strains due to its pronounced bacteriostatic effect, slowdown in adhesive activity and inhibition of their ability to form biofilms.

Titanium Alloy Implants with Lattice Structures for Mandibular Reconstruction.

In recent years, the field of mandibular reconstruction has made great strides in terms of hardware innovations and their clinical applications. There has been considerable interest in using computer-aided design, finite element modelling, and additive manufacturing techniques to build patient-specific surgical implants. Moreover, lattice implants can mimic mandibular bone's mechanical and structural properties. This article reviews current approaches for mandibular reconstruction, their applications, and their drawbacks. Then, we discuss the potential of mandibular devices with lattice structures, their development and applications, and the challenges for their use in clinical settings.