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Many postsurgical complications stem from bacteria colony formation on the surface of implants, but the usage of antibiotic agents may cause antimicrobial resistance. Therefore, there is a strong demand for biocompatible materials with an intrinsic antibacterial resistance not requiring extraneous chemical agents. In this study, homogeneous nanocones were fabricated by oxygen plasma etching on the surface of natural, biocompatible Bombyx mori silk films. The new hydroxyl bonds formed on the surface of the nanopatterned film by plasma etching increased the surface energy by around 176%. This hydrophilic nanostructure reduced the bacterial attachment by more than 90% for both Gram-negative ( Escherichia coli ) and Gram-positive ( Staphylococcus aureus ) bacteria and at the same time improved the proliferation of osteoblast cells by 30%. The nanoengineered substrate and pristine silk were cultured for 6 h with three different bacteria concentrations of 10 7 , 10 5 , and 10 3 CFU mL -1 and the cell proliferation on the nanopatterned samples was significantly higher due to limited bacteria attachment and prevention of biofilm formation. The concept and materials described here reveal a promising alternative to produce biomaterials with an inherent biocompatibility and bacterial resistance simultaneously to mitigate postsurgical infections and minimize the use of antibiotics.

Copper (Cu) has garnered increasing interest due to its excellent antimicrobial activity and important roles in human metabolism. Although the biological effects of Cu have been studied, the effects of Cu nanoparticles (NPs) on cell behavior are not well understood. In this study, porous TiO 2 coatings doped with different amounts of Cu NPs (designated as 0 Cu, 0.3 Cu, and 3.0 Cu) are deposited on titanium by micro-arc oxidation (MAO). The Cu NPs coated samples exhibit excellent antibacterial activity against Staphylococcus aureus (S. aureus). In vitro cytocompatibility evaluation discloses that 0 Cu and 0.3 Cu have no toxicity to osteoblasts but 3.0 Cu shows cytotoxicity. 0.3 Cu promotes proliferation and adhesion of osteoblasts and enhances extracellular matrix mineralization (ECM), but has little effects on the alkaline phosphatase activity (ALP) and collagen secretion. Surprisingly, the Cu NPs coated samples show a different behavior with endothelial cells. Both 0.3 Cu and 3.0 Cu show no cytotoxicity on endothelial cells and promote cell proliferation. Production of nitric oxide (NO) and secretion of vascular endothelial growth factor (VEGF) by the endothelial cells are observed from the Cu NPs doped TiO 2 coatings., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Bacterial infection and lack of bone tissue integration are two major concerns of orthopedic implants. In addition, osteoinductivity often decreases and toxicity may arise when antibacterial agents are introduced to increase the antibacterial ability. Here hybrid ZnO/polydopamine (PDA)/arginine-glycine-aspartic acid-cysteine (RGDC) nanorod (NR) arrays are designed and prepared on titanium (Ti) implants to not only enhance the osteoinductivity but also effectively kill bacteria simultaneously, which are ascribed to the selective physical puncture and the biofunctionalization of ZnO/PDA/RGDC nanorods during the competition between bacteria and osteoblasts. That is, owing to the much larger size of osteoblasts than bacteria, the hybrid NRs can puncture bacteria but not damage osteoblasts. Meanwhile, the cytocompatibility can be enhanced through the suppression of both reactive oxygen species and higher Zn 2+ concentration by the covering of PDA and RGDC. The in vitro results confirm the selective puncture of the bacterial membrane and the better osteoinductivity. In vivo tests also show much higher antibacterial efficacy of the hybrid NRs with far less amounts of lobulated neutrophils and adherent bacteria in the surrounding tissues. In addition, the hybrid NRs also accelerate formation of new bone tissues (20.1% higher than pure Ti) and osteointegration between implants and newly formed tissues (32.0% higher than pure Ti) even in the presence of injected bacteria. This work provides a surface strategy for designing implants with desirable ability of osseointegration and infection prevention simultaneously, which will exhibit tremendous clinical potential in orthopedic and dental applications.

To achieve enhanced biological response and controlled degradation of magnesium alloy, a modified biodegradable polymer coating called polycaprolactone (PCL) is fabricated by a thermal approach in which the heat treatment neither alters the chemical composition of the PCL membrane nor the rate of magnesium ion release, pH value, or weight loss, compared with the untreated sample. The changes in the crystallinity, hydrophilicity, and oxygen content of heat-treated PCL coating not only improve the mechanical adhesion strength between the coating and magnesium substrate but also enhance the biological properties. Moreover, the thermally modified sample can lead to higher spreading and elongation of osteoblasts, due to the enhanced hydrophilicity and CO to CO functional group ratio. In the analyses of microcomputed tomography from one to four weeks postoperation, the total volume of new bone formation on the heat-treated sample is 10%-35% and 70%-90% higher than that of the untreated and uncoated controls, respectively. Surprisingly, the indentation modulus of the newly formed bone adjacent to the heat-treated sample is ≈20% higher than that of both controls. These promising results reveal the clinical potential of the modified PCL coating on magnesium alloy in orthopedic applications., (© 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

A versatile strategy to endow biomaterials with long-term antibacterial ability without compromising the cytocompatibility is highly desirable to combat biomaterial related infection. TiO2 nanotube (NT) arrays can significantly enhance the functions of many cell types including osteoblasts thus having promising applications in orthopedics, orthodontics, as well as other biomedical fields. In this study, TiO2 NT arrays with Ag2O nanoparticle embedded in the nanotube wall (NT-Ag2O arrays) are prepared on titanium (Ti) by TiAg magnetron sputtering and anodization. Well-defined NT arrays containing Ag concentrations in a wide range from 0 to 15 at % are formed. Ag incorporation has little influence on the NT diameter, but significantly decreases the tube length. Crystallized Ag2O nanoparticles with diameters ranging from 5 nm to 20 nm are embedded in the amorphous TiO2 nanotube wall and this unique structure leads to controlled release of Ag(+) that generates adequate antibacterial activity without showing cytotoxicity. The NT-Ag2O arrays can effectively kill Escherichia coli and Staphylococcus aureus even after immersion for 28 days, demonstrating the long lasting antibacterial ability. Furthermore, the NT-Ag2O arrays have no appreciable influence on the osteoblast viability, proliferation, and differentiation compared to the Ag free TiO2 NT arrays. Ag incorporation even shows some favorable effects on promoting cell spreading. The technique reported here is a versatile approach to develop biomedical coatings with different functions., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Magnesium alloys are potential biodegradable materials and have received increasing attention due to their outstanding biological performance and mechanical properties. However, rapid degradation in the physiological environment and potential toxicity limit clinical applications. Recently, special magnesium-calcium (Mg-Ca) and magnesium-strontium (Mg-Sr) alloys with biocompatible chemical compositions have been reported, but the rapid degradation still does not meet clinical requirements. In order to improve the corrosion resistance, a rough, hydrophobic and ZrO(2)-containing surface film is fabricated on Mg-Ca and Mg-Sr alloys by dual zirconium and oxygen ion implantation. Weight loss measurements and electrochemical corrosion tests show that the corrosion rate of the Mg-Ca and Mg-Sr alloys is reduced appreciably after surface treatment. A systematic investigation of the in vitro cellular response and antibacterial capability of the modified binary magnesium alloys is performed. The amounts of adherent bacteria on the Zr-O-implanted and Zr-implanted samples diminish remarkably compared to the unimplanted control. In addition, significantly enhanced cell adhesion and proliferation are observed from the Zr-O-implanted sample. The results suggest that dual zirconium and oxygen ion implantation, which effectively enhances the corrosion resistance, in vitro biocompatibility and antimicrobial properties of Mg-Ca and Mg-Sr alloys, provides a simple and practical means to expedite clinical acceptance of biodegradable magnesium alloys., (Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Porous biomaterials with the proper three-dimensional (3D) surface network can enhance biological functionalities especially in tissue engineering, but it has been difficult to accomplish this on an important biopolymer, polyetheretherketone (PEEK), due to its inherent chemical inertness. In this study, a 3D porous and nanostructured network with bio-functional groups is produced on PEEK by sulfonation and subsequent water immersion. Two kinds of sulfonation-treated PEEK (SPEEK) samples, SPEEK-W (water immersion and rinsing after sulfonation) and SPEEK-WA (SPEEK-W with further acetone rinsing) are prepared. The surface characteristics, in vitro cellular behavior, in vivo osseointegration, and apatite-forming ability are systematically investigated by X-ray photoelectron spectroscopy, Fourier-transform infrared spectroscopy, scanning electron microscopy, cell adhesion and cell proliferation assay, real-time RT-PCR analysis, micro-CT evaluation, push-out tests, and immersion tests. SPEEK-WA induces pre-osteoblast functions including initial cell adhesion, proliferation, and osteogenic differentiation in vitro as well as substantially enhanced osseointegration and bone-implant bonding strength in vivo and apatite-forming ability. Although SPEEK-W has a similar surface morphology and chemical composition as SPEEK-WA, its cytocompatibility is inferior due to residual sulfuric acid. Our results reveal that the pre-osteoblast functions, bone growth, and apatite formation on the SPEEK surfaces are affected by many factors, including positive effects introduced by the 3D porous structure and SO3H groups as well as negative ones due to the low pH environment. Surface functionalization broadens the use of PEEK in orthopedic implants., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

A newly developed magnesium implant is used to stimulate bone formation in vivo. The magnesium implant after undergoing dual aluminum and oxygen plasma implantation is able to suppress rapid corrosion, leaching of magnesium ions, as well as hydrogen gas release from the biodegradable alloy in simulated body fluid (SBF). No released aluminum is detected from the SBF extract and enhanced corrosion resistance properties are confirmed by electrochemical tests. In vitro studies reveal enhanced growth of GFP mouse osteoblasts on the aluminum oxide coated sample, but not on the untreated sample. In addition to that a small amount (50 ppm) of magnesium ions can enhance osteogenic differentiation as reported previously, our present data show a low concentration of hydrogen can give rise to the same effect. To compare the bone volume change between the plasma-treated magnesium implant and untreated control, micro-computed tomography is performed and the plasma-treated implant is found to induce significant new bone formation adjacent to the implant from day 1 until the end of the animal study. On the contrary, bone loss is observed during the first week post-operation from the untreated magnesium sample. Owing to the protection offered by the Al2O3 layer, the plasma-treated implant degrades more slowly and the small amount of released magnesium ions stimulate new bone formation locally as revealed by histological analyses. Scanning electron microscopy discloses that the Al2O3 layer at the bone-implant interface is still present two months after implantation. In addition, no inflammation or tissue necrosis is observed from both treated and untreated implants. These promising results suggest that the plasma-treated magnesium implant can stimulate bone formation in vivo in a minimal invasive way and without causing post-operative complications., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Micro/nano-texturing is a promising approach to produce biomaterials with better tissue integration properties, but the underlying mechanisms are only partially understood. We propose that the integrin-linked kinase (ILK)/β-catenin pathway may play a role in mediating the signals of topographical cues to cells. To confirm the hypothesis, human MG63 osteoblasts are cultured on the micro/nano-textured topographies (MNTs) to assess the cell differentiation in terms of collagen secretion, extracellular matrix mineralization, and osteogenesis-related gene expression. The expression of β-catenin, ILK and integrin β1 and β3 is assayed by real-time polymerase chain reaction and the protein levels of β-catenin, phosphorylated glycogen synthase kinase 3β (p-GSK3β) and ILK are determined by western blot. The ILK silenced MG63 induced by small interfering RNA is cultured on the samples and the cell functions and the levels of β-catenin, GSK3β and p-GSK3β are determined. The results show that the MNTs enhance MG63 differentiation and it is related to the higher expression of integrin β1 and β3 and ILK, which activate the β-catenin signaling by initiating β-catenin expression and inhibiting its degradation by phosphorylating GSK3β. ILK silencing attenuates the β-catenin signaling activation and the enhanced MG63 differentiation by the MNTs. Our results explicitly demonstrate the role of the ILK/β-catenin pathway in mediating the signals from topographical cues to osteoblasts to tailor differentiation and provide new target points for biomaterials modification and biofunctionalization to attain better clinical performance., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Wnt/β-catenin signaling plays a key role in bone formation. To assess the role of this signaling cascade in the response of osteoblasts to the implant topography, human MG63 osteoblasts are cultured on micropitted/nanotubular surface topographies (MNTs) and the transcriptional expressions of Wnt/β-catenin pathway receptors, activators, and inhibitors are measured. β-catenin signaling and cell differentiation are studied in the absence and presence of exogenous Dickkopf 1 (Dkk1) on the MNTs and exogenous Wnt3a on a smooth surface. The expressions of the Wnt/β-catenin pathway receptor low-density lipoprotein receptor-related protein 6 and pathway ligand Wnt3a are up-regulated by the MNTs whereas those of the pathway inhibitors including Dkk1/2 and secreted frizzled-related protein 1/2 are down-regulated by the MNTs, indicating regulation of the Wnt/β-catenin pathway modulators to activate the pathway. Consequently, the β-catenin signaling activity is enhanced by the MNTs as well as cell differentiation in terms of osteogenesis-related gene expressions and alkaline phosphatase and collagen products. On the smooth surface, exogenous Wnt3a stimulates β-catenin signaling and cell differentiation while exogenous Dkk1 attenuates the enhancement by the MNTs. The results explicitly demonstrate that the implant topography regulates the product of the Wnt/β-catenin pathway modulators from the cells and in turn activates the cell Wnt/β-catenin pathway promoting osteoblast differentiation., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Titiania nanotubes have large potential in medical implant applications but their tissue compatibility is still controversial. Considering that the biological behavior of primary osteoblasts is closer to the in vivo situation than other common cell lines, we investigate the response of primary osteoblasts on anodized nanotextured titania surfaces. Two nanotextured surface morphologies, namely the 5 V anodized surface with a pore diameter of 25 nm and the 20 V anodized surface with a tube diameter of 80 nm are chosen for this study. Initial cell adhesion is not obviously affected by the anodized surfaces. With the exception of slightly higher intracellular alkaline phosphatase activity and more extracellular matrix deposition, cell growth, and cell differentiation represented by the expressions of osteogenesis-related genes are impaired on both anodized surfaces. This may be attributed to the compromised focal contact formation on the anodized surfaces. The difference in the phenotypes of the primary osteoblasts and the osteoblastic cell lines may partly account for the controversy in osteoblast cytocompatibility on titania nanotubes., (Copyright © 2010 Wiley Periodicals, Inc.)

Plasma technology is widely employed to tailor the surface chemistry of polymeric biomaterials. In this work, nitrogen-containing functional groups were generated on a polymer surface by N₂ plasma immersion ion implantation (PIII). We evaluated the abilities of the resulting surface to inhibit bacterial growth and to enhance osteoblast differentiation from the perspective of bone tissue engineering. Our results demonstrate that the N₂ PIII-treated polymer surface exhibits antibacterial properties against Escherichia coli. Moreover, the N₂ PIII-treated polymer surface has the ability to enhance differentiation of osteoblasts. N₂ PIII-treated polymer surface may therefore be useful in bone tissue engineering.

Cell-repelling structures are often required in biosensors, bioelectronics, and drug delivery systems, but the search for satisfactory cell-repelling structures with good biocompatibility and long-term stability is challenging. In this work, two types of quasi-aligned nanowire arrays (QANWA) with different surface chemistry but similar surface topography, namely titanium carbide-carbon core-shell (TiC/C) and titania (TiO(2)), are fabricated on Ti6Al4V. Both QANWAs inhibit cell adhesion consequently leading to cell apoptosis possibly due to disruption in the adhesion assembly. Other cell functions such as proliferation and differentiation as monitored by extracellular matrix secretion and mineralization are also substantially depressed. The cell-repelling property is related to the nanostructure but independent of the surface chemistry and surface wettability. It is also not related to protein adsorption which is in fact slightly enhanced on the nanowire arrays. The QANWAs can be modified to have a larger loading capacity thereby enhancing the controlled release kinetics in drug delivery applications and to resist protein adsorption resulting in better biosensor performance. This concept which can be readily extended to other types of QANWAs and biomaterials has broad clinical potential., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

Hierarchical hybrid micro/nano-textured titanium surface topographies with titania nanotubes were produced by simple acid etching followed by anodization to mimic the hierarchical structure of bone tissues. Primary rat osteoblasts were used to evaluate the bioactivity. The microtopography formed by acid etching of titanium induced inconsistent osteoblast functions with initial cell adhesion and osteogenesis-related gene expression being dramatically enhanced while other cell behaviors such as proliferation, intracellular total protein synthesis and alkaline phosphatase activity, collagen secretion, and extracellular matrix mineralization being depressed. In comparison, addition of nanotubes to the microtopography led to enhancement of multiple osteoblast functions. Nearly all the cell functions investigated in this study were retained or promoted. Compared to a microtopography, the enhancement of multiple cell functions observed from the hierarchical micro/nano-textured surfaces is expected to lead to faster bone maturation around the titanium implants without compromising the bone mass. In addition, the hierarchical micro/nano-textured surfaces still retain the mechanical interlocking ability of the microtopography thereby boding well for osseointegration. Our study reveals a synergistic role played by the micro and nanotopographies in osteoblast functions and provides insight to the design of better biomedical implant surfaces., (Copyright 2010 Elsevier Ltd. All rights reserved.)

A monoclinic zirconia coating with a nanostructural surface was prepared on the Ti-6Al-4V substrate by an atmospheric plasma-spraying technique, and its microstructure and composition, as well as mechanical and biological properties, were investigated to explore potential application as a bioactive coating on bone implants. X-ray diffraction, transmission electron microscopy, scanning electron microscopy and Raman spectroscopy revealed that the zirconia coating was composed of monoclinic zirconia which was stable at low temperature, and its surface consists of nano-size grains 30-50 nm in size. The bond strength between the coating and the Ti-6Al-4V substrate was 48.4 + or - 6.1 MPa, which is higher than that of plasma-sprayed HA coatings. Hydrothermal experiments indicated that the coating was stable in a water environment and the phase composition and Vickers hardness were independent of the hydrothermal treatment time. Bone-like apatite is observed to precipitate on the surface of the coating after soaking in simulated body fluid for 6 days, indicating excellent bioactivity in vitro. The nanostructured surface composed of monoclinic zirconia is believed to be crucial to its bioactivity. Morphological observation and the cell proliferation test demonstrated that osteoblast-like MG63 cells could attach to, adhere to and proliferate well on the surface of the monoclinic zirconia coating, suggesting possible applications in hard tissue replacements., (Copyright 2009 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Polytetrafluoroethylene (PTFE) is a commonly used medical polymer due to its biological stability and other attractive properties such as high hardness and wear resistance. However, the low surface energy and lack of functional groups to interact with the cellular environment have severely limited its applications in bone or cartilage replacements. Plasma immersion ion implantation (PIII) is a proven effective surface modification technique. However, when conducted on polymeric substrates, conventional PIII experiments typically employ a low pulsing frequency and short pulse duration in order to avoid sample overheating, charging, and plasma sheath extension. In this paper, a long pulse, high frequency O(2) PIII process is described to modify PTFE substrates by implementing a shielded grid in the PIII equipment without these aforementioned adverse effects. X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), and contact angle measurements are carried out to reveal the surface effects of PTFE after long pulse, high frequency O(2) PIII and the results are compared to those obtained from conventional short pulse, low frequency O(2) PIII, O(2) plasma immersion, and the untreated control samples. Our results show that less oxygen-containing, rougher, and more hydrophobic surfaces are produced on PTFE after long pulse, high frequency O(2) PIII compared to the other 2 treatments. Cell viability assay, ALP activity test, and real-time PCR analysis are also performed to investigate the osteoblast behavior. It is clear that all 3 surface modification techniques promote osteoblast adhesion and proliferation on the PTFE substrates. Improvements on the ALP, OPN, and ON expression of the seeded osteoblasts are also obvious. However, among these treatments, only long pulse, high frequency O(2) PIII can promote the OCN expression of osteoblasts when the incubation time is 12 days. Our data unequivocally disclose that the long pulse, high frequency O(2) PIII technique is better than the other two types of traditional plasma treatment in the development of PTFE for bone or cartilage repair.

Poly(butylene succinate), a novel biodegradable aliphatic polyester with excellent processability and mechanical properties, was modified by O(2) or N(2) plasma immersion ion implantation (PIII). X-ray photoelectron spectroscopy and contact angle measurements were carried out to reveal the surface characteristics of the treated and control specimens. The in vitro effects of the materials on seeded osteoblasts were detected by cell viability assay, alkaline phosphatase activity test, and real-time polymerase chain reaction analysis. Plate counting was performed to investigate the antibacterial properties. Our results show that both PIII treatments significantly improve the hydrophilicity of PBSu, and CO and nitrogen groups (CNH and CNH(2)) can be detected on the PBSu after O(2) and N(2) PIII, respectively. The modified samples exhibit similar compatibility to osteoblasts, which is better than that of the control, but O(2) PIII and N(2) PIII produce different effects according to the osteogenic gene expressions of seeded osteoblasts on the materials. Moreover, the N(2) plasma-modified PBSu exhibits anti-infection effects against Staphylococcus aureus and Escherichia coli but no such effects can be achieved after O(2) PIII.

Polyethylene (PE) is one of the most common materials used for medical implants. However, it usually possesses low biocompatibility and insufficient antibacterial properties. In the work described here, plasma immersion ion implantation (PIII) is employed to implant silver into PE to enhance both its antibacterial properties and its biocompatibility. Our results show that Ag PIII can give rise to excellent antibacterial properties and induces the formation of functional groups such as C-O and C=C. These C-O and C=C groups on the modified surface can trigger the growth of the human fetal osteoblastic cell line (hFOB). Furthermore, combining N(2) and Ag PIII prolongs the antibacterial effects, but nitrogen-containing functional groups such as C-N and C=N created by N(2) co-PIII negatively impact proliferation of hFOB on the surface. According to our experimental investigation on cell proliferation, functional groups such as C-N and C=N created by nitrogen PIII are disadvantageous to cell growth whereas the C-O and C=C groups benefit cell growth. Both the antibacterial activity and biocompatibility of PE can be enhanced by means of the proper plasma surface treatment.

Porous NiTi shape memory alloys are one of the promising biomaterials for surgical implants because of their unique shape memory effects and porous structure with open pores. However, the complex surface morphology and larger area of porous NiTi compared to dense NiTi make it more vulnerable from the viewpoint of release of nickel, which can cause deleterious effects in the human body. It is also more difficult to modify the exposed surfaces of a porous structure using conventional surface modification technologies. In this work, oxidation in conjunction with postreaction heat treatment was used to modify the surfaces of porous single-phase NiTi prepared by capsule-free hot isostatic pressing to mitigate Ni leaching and enhance the surface properties. Differential scanning calorimetry thermal analysis, uniaxial compression tests, inductively-coupled plasma mass spectrometry, and cell cultures reveal that porous NiTi alloys oxidized at 450 degrees C for 1 h have an austenite transition temperature below 37 degrees C, excellent superelasticity, lower nickel release, and no cytotoxicity., ((c) 2007 Wiley Periodicals, Inc.)

Silicon has gradually been recognized to be an essential trace element in the normal metabolism of higher animals, and the role of silicon in the human body has aroused interests in the biomedical community. In fact, the interactions between silicon-based devices and the human body such as biosensors and microelectromechanical systems (MEMS) often suffer from poor biocompatibility. In this work, hydrogen plasma immersion ion implantation (H-PIII) is conducted to improve the bioactivity or bone conductivity of silicon. In order to investigate the formation mechanism of bone-like apatite on the surface of the hydrogen implanted silicon wafer, two comparative experiments, hydrogenation and argon bombardment, are performed. The H-PIII sample exhibits an amorphous surface consisting of Si-H bonds. After immersion in simulated body fluids, a negatively charged surface containing the functional group ([triple bond]Si-O-) is produced and bone-like apatite is observed to nucleate and grow on the surface. The surface of the H-PIII silicon wafer favors the adhesion and growth of osteoblast cells and good cytocompatibility may be inferred.

We have investigated the surface bioactivity of titanium after water and hydrogen plasma immersion ion implantation. Plasma immersion ion implantation (PIII) excels in the surface treatment of components possessing a complicated shape such as medical implants. In addition, water and hydrogen PIII has been extensively studied as a method to fabricate silicon-on-insulator (SOI) substrates in the semiconductor industry and so it is relatively straightforward to transfer the technology to the biomedical field. In our investigation, water and hydrogen were plasma-implanted into titanium sequentially. Our objective is that water PIII introduces near-surface damages that trap hydrogen implanted in the subsequent step to improve the surface bioactivity while the desirable bulk properties of the materials are not compromised. Ti-OH functional groups can be detected on the (H(2)O+H(2))-implanted titanium surface by X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared (FTIR) spectroscopy. After incubation in simulated body fluids (SBF) for cytocompatibililty evaluation in vitro, bone-like hydroxyapatite was found to precipitate on the (H(2)O+H(2)) implanted samples while no apatite was found on titanium samples plasma implanted with water or hydrogen alone. Human osteoblast cells were cultured on the (H(2)O+H(2))-implanted titanium surface and they exhibited good adhesion and growth. Our results suggest a practical means to improve the surface bioactivity and cytocompatibility of medical implants made of titanium.

Dicalcium silicate coating was deposited onto a Ti-6Al-4V substrate using plasma-spraying technology. The coating was immersed in simulated body fluid (SBF) for 1, 3, 6, 12, 24, and 48 h to investigate early apatite formation on the coating. Osteoblasts were also seeded onto the surface of the dicalcium silicate coating to evaluate its biocompatibility. Cold field-emission scanning electron microscopy and energy-dispersive X-ray spectrometry were used to evaluate the morphologies and determine the chemical composition of the coatings. The surface structural changes caused by immersion in SBF were analyzed using thin-film X-ray diffraction. After the dicalcium silicate coating was soaked in SBF solution 1-6 h, two types of particles containing calcium and phosphorus were formed on the surface. One type consisted of relatively larger particles (P1) precipitated on the surface of the coating from the precursor cluster formed in the SBF solution. The second type was composed of particles (P2) nucleated on the surface of the coating. With increasing immersion time, the particles coalesced to form a surface Ca-P layer. The Ca-P layer was composed of amorphous calcium phosphate that was not transformed to crystalline apatite until the immersion time in SBF exceeded 24 h. The formation mechanism of the Ca-P layer and apatite on the surface of the coating is believed to be involved in the formation of the Si 3-ring active surface site with negative charge. The cell-seeding test revealed that osteoblasts grew and proliferated very well on the surface of the dicalcium silicate coating., (Copyright (c) 2005 Wiley Periodicals, Inc.)

Nickel-titanium (NiTi) shape memory alloys possess super-elasticity in addition to the well-known shape memory effect and are potentially suitable for orthopedic implants. However, a critical concern is the release of harmful Ni ions from the implants into the living tissues. We propose to enhance the corrosion resistance and other surface and biological properties of NiTi using carbon plasma immersion ion implantation and deposition (PIII&D). Our corrosion and simulated body fluid tests indicate that either an ion-mixed amorphous carbon coating fabricated by PIII&D or direct carbon PIII can drastically improve the corrosion resistance and block the out-diffusion of Ni from the materials. Our tribological tests show that the treated surfaces are mechanically more superior and cytotoxicity tests reveal that both sets of plasma-treated samples favor adhesion and proliferation of osteoblasts.