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Infection still present as one of common complications after total hip replacement (∼2.5%), which may cause serious outcomes. For preventing such risk, loading antibiotics onto implants for increasing local drug concentration at targeted sites could be a solution. This study aims at modifying the surface of hydroxyapatite (HA) coated titanium hip implant material (Ti-HA) with polymer of cyclodextrin (polyCD) for loading antibiotics, to achieve a sustained local drug delivery. Two widely applied antibiotics (tobramycin and rifampicin) in orthopedic surgery were loaded alone or in combination. The drug adsorption isotherm, drug release kinetics and drug's efficacy were thoroughly investigated. The results proved that polyCD coating significantly improved the affinity of both drugs to Ti-HA surface, while the mechanism of drug-polyCD interaction varies from the nature of drug, courtesy of the structural complex of polyCD. The advantage of dual-drug loading was highlighted by its strong efficacy against both Staphylococcus aureus and Enterobacter cloacae, which overcomes the limitation of mono-drug loading for an effective treatment against both bacterial strains. The prolonged antibacterial activity of antibiotic loaded Ti-HA-polyCD samples confirmed that polyCD could be a promising drug-delivery system, for sustained antibiotics release or other potential applications e.g., antimitotic agent release., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The aim of the study was to develop a polyester visceral implant modified with a cyclodextrin polymer for the local and prolonged delivery of ropivacaine to reduce post operatory pain. Therefore, we applied a coating of an inguinal mesh with a crosslinked polymer of hydroxypropyl-β-cyclodextrin (HPβCD) whose specific host-guest complex forming properties were expected to improve the adsorption capacity of the implant toward anesthetic, and then to release it within a sustained period. The modification reaction of the textile with cyclodextrin was explored through the study of the influence of the pad/dry/cure process parameters and the resulting implant (PET-CD) was characterized by solid state NMR and SEM. Besides, the inclusion complex between ropivacaine and CD was studied by NMR and capillary electrophoresis in PBS medium. Finally, ropivacaine sorption test showed that a maximum of 30 mg/g of ropivacaine could be adsorbed on the functionalized samples. In dynamic batch tests in PBS at pH 7.4, the release could be observed up to 6h. The cytocompatibility of the PET-CD loaded with ropivacaine was also studied and reached 65% cell vitality after 6 days., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The aim of this study was to develop an antiseptic and blue dyed polyester (PET) vascular graft in order to reach two distinct properties: (i) the prevention of postoperative infections, (ii) the improvement of the graft compatibility with the coelioscopy surgical technique. This work consisted of dyeing a vascular prosthesis with methylene blue (MB) which is known as a cationic dye with antiseptic properties. Therefore, the functionalization of the PET fibers of the prosthesis with a cyclodextrin-citric acid polymer (PolyCD) was achieved in order to improve its sorption capacity. The NMR experiments demonstrated that a 1:2 complex occurred between hydroxypropyl β-cyclodextrin (HP-βCD) and MB. Kinetic and sorption isotherm studies showed that an impregnation of the polyCD modified prosthesis (PET-CD) in a 1 g L(-1) of MB solution for 150 min was sufficient to reach the saturation of the device. Results proved that the adsorption mechanism followed the Langmuir model and a maximum of 20 mg g(-1) of MB on the graft. A sustained release of MB in batch tests was observed in PBS and in vitro microbiological assays displayed a prolongation of the bactericidal effect of PET-CD whose extent varied with the amount of MB preliminarily adsorbed onto the PET-CD., (© 2013 Wiley Periodicals, Inc.)

The progress in bone cancer surgery and multimodal treatment concept achieve only modest improvement in the overall survival, due to failure in clearing out residual cancer cells at the surgical margin and extreme side-effects of adjuvant postoperative treatments. Our study aims to propose a new method based on cyclodextrin polymer (polyCD) functionalized hydroxyapatite (HA) for achieving a high local drug concentration with a sustained release profile and a better control of residual malignant cells via local drug delivery and promotion of the reconstruction of bone defects. PolyCD, a versatile carrier for therapeutic molecules, can be incorporated into HA (bone regeneration scaffold) through thermal treatment. The parameters of polyCD treatment on the macroporous HA (porosity 65%) were characterized via thermogravimetric analysis. Good cytocompatibility of polyCD functionalized bioceramics was demonstrated on osteoblast cells by cell vitality assay. An antibiotic (gentamicin) and an anticancer agent (cisplatin) were respectively loaded on polyCD functionalized bioceramics for drug release test. The results show that polyCD functionalization leads to significantly improved drug loading quantity (30% more concerning gentamicin and twice more for cisplatin) and drug release duration (7 days longer concerning gentamicin and 3 days longer for cisplatin). Conclusively, this study offers a safe and reliable drug delivery system for bioceramic matrices, which can load anticancer agents (or/and antibiotics) to reduce local recurrence (or/and infection)., (© 2014 Wiley Periodicals, Inc.)

Absorbent points widely used in endodontic therapy were transformed into bioresorbable chlorhexidine delivery systems for the treatment of the periodontal pocket by preventing its recolonization by the subgingival microflora. These paper points (PPs) were first oxidized to promote their resorption, then grafted with β-cyclodextrin (CD) or maltodextrin (MD) in order to achieve sustained delivery of chlorhexidine. We investigated the oxidation step parameters through the time of reaction and the nitric and phosphoric acid ratios in the oxidizing mixture, and then the dextrin grafting step parameters through the time and temperature of reaction. A first selection of the appropriate functionalization parameters was undertaken in relation to the degradation profile kinetics of the oxidized (PPO) and oxidized-grafted samples (PPO-CD and PPO-MD). Samples were then loaded with chlorhexidine digluconate (digCHX), a widely used antiseptic agent in periodontal therapy. The release kinetics of digCHX from PPO-CD and PPO-MD samples were compared to PP, PPO and to PerioChip(®) (a commercial digCHX containing gelatine chip) in phosphate buffered saline (pH 7.4) by ultraviolet spectrophotometry. The cytocompatibility of the oxidized-grafted PP was demonstrated by cell proliferation assays. Finally, the disc diffusion test from digCHX loaded PPO-MD samples immersed in human plasma was developed on pre-inoculated agar plates with four common periodontal pathogenic strains: Fusobacterium nucleatum, Prevotella melaninogenica, Aggregatibacter actinomycetem comitans and Porphyromonas gingivalis. To conclude, the optimized oxidized-dextrin-grafted PPs responded to our initial specifications in terms of resorption and digCHX release rates and therefore could be adopted as a reliable complementary periodontal therapy., (Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Local antibiotics delivery is an efficient solution to reduce the risk of infections associated with orthopedic implant. This study aims to functionalize plasma-sprayed hydroxyapatite coated titanium (Ti-HA) hip joint implant material with cyclodextrins-polymer (polyCD)-based local drug delivery system for loading therapeutic molecules (e.g. antibiotics), to offer a sustainable drug delivery. The process of polyCD coating on Ti-HA material was optimized with the help of model guest molecule - toluidine blue O (TBO) for evaluating the efficacy of polyCD system. The obtained results clearly showed that polyCD's treatment can firmly coat on the Ti-HA material under the optimized processing parameters concerning the type of CD, thermal treatment temperature and duration. PolyCD system has been proven to have a high capacity of TBO adsorption and long release duration. In vitro study also showed non-cytotoxicity of polyCD functionalized samples to osteoblastic cells. Trial study with gentamicin revealed very promising potential of polyCD system for sustained delivery of antibiotics. To conclude, the study substantiates the prospective flexibility of drug choice when applying polyCD treated implants including antibiotics, antimitotic agents or other therapeutical molecules. One or more drugs can be loaded, thus synergism and multi-factorial effects are feasible., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Close to the bone mineral phase, the calcic bioceramics, such as hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), are commonly used as substitutes or filling materials in bone surgery. Besides, calcium carbonate (CaCO3) is also used for their excellent biocompatibility and bioactivity. However, the problem with the animal-origin aragonite demands the new technique to synthesize pure calcite capable of forming 3D bone implant. This study aims to manufacture and evaluate a highly-pure synthetic crystalline calcite with good cytocompatibility regarding to the osteoblasts, comparing to that of HA and β-TCP. After the manufacture of macroporous bioceramic scaffolds with the identical internal architecture, their cytocompatibility is studied through MC3T3-E1 osteoblasts with the tests of cell viability, proliferation, vitality, etc. The results confirmed that the studied process is able to form a macroporous material with a controlled internal architecture, and this synthesized calcite is non-cytotoxic and facilitate the cell proliferation. Indeed requiring further improvement, the studied calcite is definitely an interesting alternative not only to coralline aragonite but also to calcium phosphate ceramics, particularly in bone sites with the large bone remodelling., (Copyright © 2012 Elsevier B.V. All rights reserved.)

A textile polyester vascular graft was modified with cyclodextrins to obtain a new implant capable of releasing antibiotics (here ciprofloxacin, CFX) over prolonged time periods and thereby reducing the risk of post-operative infections. In this study, we compared samples modified with native and modified cyclodextrins, presenting different cavity sizes (β or γ cyclodextrins) and different substituent groups (hydroxypropyl and methyl). Drug release was measured in water, phosphate buffer pH 7.4 and blood plasma. The inclusion of CFX in the cyclodextrins cavities was observed in solution by two-dimensional (1)H NMR spectroscopy and confirmed by (1)F NMR measurements. Grafts modification with all cyclodextrins induced an increase of their sorption capacity towards CFX whose extent depended on the nature of the cyclodextrin: a 4-fold and 10-fold increase was observed in the cases of hydroxypropyl cyclodextrins and methylated β-cyclodextrin, respectively. Depending on the type of release medium and nature of CD, different CFX release kinetics were obtained. The discussion highlighted not only the role of the host guest complexation, but also that of the electrostatic interactions that occur between the anionic crosslinks of the cyclodextrins polymers, and CFX that presents a zwitterionic character. The microbiological assessment confirmed sustained CFX release in human plasma and demonstrated antibacterial efficiency of CD modified prostheses against Staphylococcus aureus and Escherichia coli for at least 24 h (compared to 4 h in the case of virgin grafts)., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The study aims to validate an original bio-based material, obtained by grafting fatty chains, and more especially lauric chains (C12) onto cellulose, for medical applications. The mechanical properties of the synthesized cellulose laurate (C12) are close to those of petrochemical ones such as low density polyethylene. This cellulose-based polymer is transparent, flexible, and hydrophobic. To evaluate the stability of the cellulosic films in biological fluids the samples are soaked in simulated body fluid or blood plasma for a few hours to 6 months, and then submitted to mechanical and chemical analyses. The simultaneously performed cytocompatibility tests were the colony-forming viability, the vitality and cell proliferation tests using NIH 3T3 fibroblasts and MC 3T3 osteoblast-like cells. The results show the stability, the biocompatibility, and the noncytotoxicity of the synthesized cellulose laurate films. This biomaterial may so be considered for surgical applications., (Copyright © 2012 Wiley Periodicals, Inc.)

Objectives: Polyester vascular prostheses (PVPs) coated with a polymer of hydroxypropyl-β-cyclodextrin (HPβCD) have been designed to provide an in situ reservoir for the sustained delivery of one or more bioactive molecules. The goal of this study was to assess the efficacy, the safety and the healing properties of these prostheses., Methods: Collagen-sealed PVPs were coated with the HPβCD-based-polymer (PVP-CD) using the pad-dry-cure textile finishing method and loaded with one or two antibiotics. Appropriate control and PVP-CD samples were tested in several in vitro and animal model conditions. The study end points included haemolysis, platelet aggregation, antibacterial efficacy, polymer biodegradation, acute toxicity and chronic tolerance., Results: PVP-CD proved to be compatible with human blood, since it did not induce haemolysis nor influenced ADP-mediated platelet aggregation. Sustained antimicrobial efficacy was achieved up to 7 days against susceptible bacteria when PVP-CDs were loaded with the appropriate drugs. Analysis of harvested PVP-CD from the animal model revealed that the HPβCD-based coating was still present at 1 month but had completely disappeared 6 months after implantation. All grafts were patent, well encapsulated without healing abnormalities. Clinical data, blood-sample analysis and histological examination did not evidence any signs of acute or chronic, local or systemic toxicity in the animal models., Conclusion: PVP-CD was proved safe and demonstrated excellent biocompatibility, healing and degradation properties. Effective antimicrobial activity was achieved with PVP-CD in conditions consistent with a sustained-release mechanism., (Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)

The aim of this work was to improve the hemocompatibility and the selectivity according to cells of non-woven poly(ethylene terephthalate) (PET) membranes. Non-woven PET membranes were modified by a combined plasma-chemical process. The surface of these materials was pre-activated by cold-plasma treatment and poly(acrylic acid) (PAA) was grafted by the in situ free radical polymerization of acrylic acid (AA). The extent of this reaction and the number of carboxylic groups incorporated were evaluated by colorimetric titration using toluidine blue O. All samples were characterized by SEM, AFM and thermogravimetric analysis, and the mechanical properties of the PAA grafted sample were determined. A selective cell response was observed when human pulmonary artery smooth muscle cells (HPASMC) or human pulmonary micro vascular endothelial cells (HPMEC) were seeded on the modified surfaces. HPASMC proliferation decreased about 60%, while HPMEC proliferation was just reduced about 10%. PAA grafted samples did not present hemolytic activity and the platelet adhesion decreased about 28% on PAA grafted surfaces.

Autograft is considered as the "gold standard" for bone reconstruction. It provides osteoinductive factors, osteogenic cells, and appropriate osteoconductive scaffold. Donor site morbidity is the main limitation of autograft. Donor disease transmission limits the use of allograft. Synthetic bone substitutes still lack osteoinductive or osteogenic properties. Composite bone substitutes combining synthetic scaffold and biochemical substances initiating proliferation and cell differentiation, and possibly osteogenesis. Bone substitutes and grafts intended for clinical use are listed., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

The aim of this work was to develop a polypropylene (PP) artificial abdominal wall implant for the prolonged release of ciprofloxacin (CFX). This sustained release effect was obtained by functionalization of the textile mesh with citric acid and hydroxypropyl-γ-cyclodextrin (HPγCD) or maltodextrin (MD). In both cases the textile finishing reaction yielded a cyclo- or malto-dextrin crosslinked polymer coating the fibers. The modified supports were characterized by thermogravimetric analysis (TGA), differential scanning calorimetry and scanning electron microscopy. The sorption capacities and the kinetics of CFX release were studied by batch tests coupled with spectrophotometric assays. Microbiological assays were carried out on Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli, while proliferation and viability tests used fibroblasts. The main results were as follows. (i) Due to the differences between the range of temperature of thermal degradation of the (cyclo)dextrins polymers and of the PP fibers TGA was a reliable method for quantifying the degree of functionalization of the textiles. (ii) Both modified supports showed improved sorption/desorption capacities for CFX, compared with the virgin mesh. The HPγCD-finished support showed an increased sorption capacity and a lower release rate of CFX compared with the MD modified support. (iii) Microbiological assays confirmed the latter result, with greater sustained antibacterial activity of the HPγCD treated support. These experiments have demonstrated the role of the cyclodextrin cavity in interactions with CFX: the antibiotic was not only adsorbed via hydrogen and acid-base interactions with the polyCTR-HPγCD network, but also via host-guest complexation. (iv) Biological tests revealed a slight decrease in fibroblast proliferation after 6 days on the modified supports, but cell viability tests showed that this was not due to toxicity of the (cyclo)dextrin polymer coatings., (Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

A textile polyester vascular graft was modified with methyl-β-cyclodextrin (MeβCD) to obtain a new implant capable of releasing antibiotics directly in situ at the site of operation over a prolonged period and thereby prevent post-operative infections. We investigated the influence of the curing parameters (time and temperature) that allow control of the degree of functionalization (DF) of the support by MeβCD. The inclusion of ciprofloxacin (CFX) in the MeβCD cavity was observed in solution by two-dimensional (1)H NMR spectroscopy. The amount of CFX loaded on the modified graft increased with DF. Depending on the release medium (water, phosphate-buffered saline, or human plasma) and the DF of the prostheses, different kinetic profiles of release of CFX were obtained. The sustained release of CFX in human plasma was shown by microbiological assays that indicated prolonged antimicrobial activity against Staphylococcus aureus and Escherichia coli. Viability tests demonstrated the non-toxicity of MeβCD to an epithelial cell line (HPMEC), although a decrease in endothelial cell number was observed on the functionalized prosthesis, probably due to the roughness of the coating and also to the nature of the MeβCD polymer present on the surface of the fibers., (Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

The aim of this work was to better understand the importance of the type of experimental setup used to monitor antibiotic release from functionalized hydroxyapatite implants. Microporous hydroxyapatite discs were prepared by sintering and subsequently functionalized with hydroxypropyl-β-cyclodextrin (HPβCD) polymer crosslinked with butanetetracarboxylic acid. On one hand, polymerization was performed within the implant after its impregnation with the monomers (CD-HA-M implant). On the other hand, a pre-synthesized HPβCD polymer was loaded and fixed onto the HA discs (CD-HA-P implant). Both types of implants were soaked with ciprofloxacin hydrochloride or vancomycin hydrochloride solution and dried at 37°C. The DSC study highlighted that the cyclodextrin polymer could interfere with both drugs, due to the carboxylic groups carried by the crosslinks. Drug release was measured into phosphate buffered saline pH 7.4 in agitated vials, or into agarose gels to more realistically mimic in vivo conditions. Importantly, in all cases, drug release into agarose gels was much slower than into well-agitated phosphate buffer. Non-functionalized discs displayed faster drug release because no complex could be formed and/or due to the absence of the HPβCD polymer network hindering drug diffusion within the implant pores. In the case of ciprofloxacin hydrochloride, drug release from the CD-HA-M implants was faster than drug release from the CD-HA-P implants due to the different polymer structures resulting in different complexation strengths, whereas in the case of vancomycin hydrochloride the release patterns were similar because vancomycin hydrochloride was not included into the cyclodextrin. The agarose gel method seems more biorelevant and discriminatory than the vial method for drug release measurements from bone implants., (Copyright © 2010 Elsevier B.V. All rights reserved.)

In-stent restenosis becomes increasingly prevalent as a difficult-to-treat disease. An alternative therapeutic strategy is enhancing endothelialization on metallic stent surfaces. This study attempted to modify surface chemistry and topography of commercial pure titanium (cp-Ti) by different sol-gel derived oxide coatings (TiO(2), SiO(2), SiO(2)/TiO(2), and Nb(2)O(5)) to improve endothelialization. The physiochemical properties of the modified surfaces were characterized by ellipsometry, atomic force microscope, and sessile-drop method. The cell adhesion/proliferation quantity, cell adhesion morphology, and focal adhesion protein expression were evaluated with human pulmonary microvascular endothelial cell line. The thickness of oxide coatings approximates to 100 nm; significantly rougher nanoporous structure was found in the TiO(2) and Nb(2)O(5) coatings than that of cp-Ti. SiO(2) coating possesses the highest surface energy (75.1 mJ/m(2)) and the lowest was for cp-Ti (45.7 mJ/m(2)). TiO(2) coating showed significantly higher endothelial cell adhesion rate than others; TiO(2), Nb(2)O(5), and TiO(2)/SiO(2) coatings exhibited higher endothelial proliferation in 3-day assays than noncoated Ti. In hemocompatible test, they also showed good hemocompatibility. These results offer the insight into that certain oxide coatings on titanium could significantly improve endothelial cell adhesion and proliferation especially in early period, which will favor reaching the endothelialization rapidly and suitable as matrix for "endothelial seeding" stent., ((c) 2009 Wiley Periodicals, Inc.)

Per-operative infection is a common complication for bone-graft surgery. Combining antiseptic agents with graft materials may offer a solution by increasing local drug concentration at target sites. Aiming to achieve a sustained local antibiotic (ATB) delivery for a widely applied bone substitute material - hydroxyapatite (HA), we attempted incorporating hydroxypropyl-beta-cyclodextrin polymer (polyHPbetaCD) into microporous HA via impregnating either in a CD monomers mixture solution or a pre-synthesized CD polymer solution, followed by thermal fixation processing. In such functionalised material (CD-HA), polyHPbetaCD could entrap ATBs and release them progressively. Infrared-spectroscopic analysis confirmed the presence of polyHPbetaCD in functionalised HA via both processing pathways; polyHPbetaCD functionalisation yields were quantitated by thermogravimetric analysis for optimising the processing regime. Ciprofloxacin (CFX) and vancomycin (VCM), commonly applied in orthopaedics, have been respectively loaded on CD-HA by dip-coating. For both ATBs, kinetic release test in phosphate buffered saline showed significantly increased initial-burst amount and prolonged release from CD-HA compared with those from non-functionalised HA. Encouragingly, ATBs loaded CD-HA also revealed a prolonged bacteriostatic activity against Staphylococcus aureus and progressively increased cytocompatibility to osteoblasts (MC3T3-E1). Overall, polyHPbetaCD functionalisation on HA could be an effective drug-delivery model for loading different drug molecules in prevention of infection.

Corrosion behaviour of biomedical alloys is generally determined in mineral electrolytes: unbuffered NaCl 0.9% (pH 7.4) or artificial saliva (pH 6.8). The assays with exclusive utilization of these electrolytes are of low relevance for the biological condition, to which the alloys will be exposed once implanted in the human organism. As an approach to the biological situation regarding the interaction of proteins, electrolytes and metals, we added the RPMI cell culture medium containing foetal calf serum as a biological electrolyte (pH 7.0). The analysis of corrosion behaviour was also performed in the presence of human lymphoid cells (CEM). The rest potential (Er) and the global polarization were determined on cp-Ti, micro-arc oxidized cp-Ti (MAO-Ti), four different Ti-alloys (Ti6Al4V, Ti12Zr, Ti(AlMoZr), Ti(NbTaZr)) and 316L stainless steel. The 316L exhibited an appropriate Er and a good passive current density (Ip), but a high corrosion potential (Ec) and a very low breakdown potential (Eb) in all electrolytes. All Ti-alloys exhibited a much better electrochemical behaviour: better Er and Ec and very high Eb. No significant differences of the above parameters existed between the Ti-alloys, except for Zr-containing alloys that showed better corrosion behaviour. A remarkable difference, however, was stated with respect to the electrolytes. NaCl 0.9% induced strong variations between the Ti-alloys. More homogeneous results were obtained with artificial saliva and RPMI medium, which induced a favourable Ec and an increased Ip. The presence of cells further decreased these values. The unbuffered NaCl solution seems to be less appropriate for the analysis of corrosion of metals. Additional in vitro biological assessments with CEM cell suspensions and MC3T3-E1 osteoblasts confirmed the advantages of the Ti(AlMoZr) and Ti(NbTaZr) alloys with an improved cell proliferation and vitality rate.

Polyester (PET) vascular grafts are used to replace or bypass damaged arteries. To minimize the risk of infection during and after surgical interventions, a PET vascular prosthesis (Polythese) was functionalized with cyclodextrin polymers (PolyCDs) in order to obtain the controlled release of antibiotics (ABs: ciprofloxacin, vancomcyin and rifampicin). An epithelial cell line (L132) was used to determine the viability of the antibiotics, and human pulmonary microvascular endothelial cells (HPMEC) were used for cell proliferation by cell counting and cell vitality with Alamar Blue fluorescent dye. Staphylococcus aureus, Escherichia coli and Enteroccocus sp. were used to determine the antimicrobial activity of AB-loaded virgin and PolyCD-grafted Polythese by the minimum inhibitory concentration method. The spectrophotometric titration results first showed that a larger amount of ABs was sorbed onto PolyCD-coated Polythese compared to virgin Polythese (26.7 vs. 35.3 mg g(-1), 51.1 vs. 72.4 mg g(-1) and 4.1 vs. 21.0 mg g(-1), respectively, for rifampicin, vancomycin and ciprofloxacin). These results were further confirmed by a microbiological test, which showed AB-loaded PolyCD-coated Polythese displayed better antimicrobial activity. The viability test revealed the toxicity of rifampicin (22 mg l(-1)) and ciprofloxacin (35 mg l(-1)), and the absence of toxicity of vancomycin. These tests allow us to further explain the lower vitality and proliferation of HPMEC on the AB-loaded PolyCD-coated Polythese, which was due not to the functionalization process of prostheses but to the cytotoxicity of certain ABs themselves. Moreover, such a property could be exploited to tackle intracellular bacteria, such as in tuberculosis and other diseases, and will not compromise further in vivo applications of our functionalized vascular prostheses.

In order to improve the osseointegration of endosseous implants made from titanium, the structure and composition of the surface were modified. Mirror-polished commercially pure (cp) titanium substrates were coated by the sol-gel process with different oxides: TiO(2), SiO(2), Nb(2)O(5) and SiO(2)-TiO(2). The coatings were physically and biologically characterized. Infrared spectroscopy confirmed the absence of organic residues. Ellipsometry determined the thickness of layers to be approximately 100nm. High resolution scanning electron microscopy (SEM) and atomice force microscopy revealed a nanoporous structure in the TiO(2) and Nb(2)O(5) layers, whereas the SiO(2) and SiO(2)-TiO(2) layers appeared almost smooth. The R(a) values, as determined by white-light interferometry, ranged from 20 to 50nm. The surface energy determined by the sessile-drop contact angle method revealed the highest polar component for SiO(2) (30.7mJm(-2)) and the lowest for cp-Ti and 316L stainless steel (6.7mJm(-2)). Cytocompatibility of the oxide layers was investigated with MC3T3-E1 osteoblasts in vitro (proliferation, vitality, morphology and cytochemical/immunolabelling of actin and vinculin). Higher cell proliferation rates were found in SiO(2)-TiO(2) and TiO(2), and lower in Nb(2)O(5) and SiO(2); whereas the vitality rates increased for cp-Ti and Nb(2)O(5). Cytochemical assays showed that all substrates induced a normal cytoskeleton and well-developed focal adhesion contacts. SEM revealed good cell attachment for all coating layers. In conclusion, the sol-gel-derived oxide layers were thin, pure and nanostructured; consequent different osteoblast responses to those coatings are explained by the mutual action and coadjustment of different interrelated surface parameters.

Diamond-like carbon (DLC) coating is a convenient means of modifying material surfaces that are sensitive to wear, such as titanium and silica substrates. This work aims to evaluate the osteoblast-like cells' response to DLC-coated Si (Si-DLC), which was treated under different conditions. DLC and deuterated DLC films were deposited by plasma-enhanced chemical vapor deposition to obtain a 200-nm-thick layer on all the samples. Three types of precursor gas were applied for deposition: pure methane (CH(4)), pure deuterated methane (CD(4)) and their half/half mixture. All surface treatments were performed under two different self-bias voltages (V(sb)): -400 and -600V. The modified surfaces were characterized by X-ray photoelectron spectroscopy, Raman spectroscopy, Rutherford backscattering spectroscopy, elastic recoil detection analysis, X-ray reflectometry and the sessile-drop method. MC3T3-E1 osteoblasts were cultured on the Si-DLC wafers for 3 and 6 days. Biological tests to measure cell proliferation, cell vitality, cell morphology and cell adhesion were performed. All DLC coatings produced a slightly more hydrophobic state than non-treated Si. Certain types of amorphous DLC coating, such as the surface treated under the V(sb) of -600V in pure methane (600CH(4)) or in pure deuterated methane (600CD(4)), offered a significantly higher cell proliferation rate to Si substrate. Scanning electron microscopy observations confirmed that the optimal cell adhesion behavior, among all the treated surfaces, occurred on the surface of the 600CH(4) and 600CD(4) groups, which showed increased amounts of filopodia and microvilli to enhance cell-environment exchange. In conclusion, DLC coating on Si could produce better surface stability and improved cellular responses.

This study describes the use of cyclodextrins (CDs) as a finishing agent of polyamide (PA) fibers used in order to obtain inguinal meshes with improved antibiotic delivery properties. The finishing process involved polymerization between citric acid and CDs, which yielded a cross-linked polymer that physically adhered to the surface of PA fibers. This permanent functionalization was characterized by evaluating the damping property with a polar liquid (glycerol) via the drop contact angle method for various rates of modification of the fabrics. The biological and microbiological effects of the PA, which were functionalized with hydroxypropylated derivate of gamma-CD (HP-gamma-CDs) and charged with ciprofloxacin (CFX), were evaluated by cell culture assays. We observed a good adhesion and proliferation of fibroblastic cells (NIH3T3) after 3 and 6 days and no detectable toxicity of the modified substrate. The in vitro antibacterial activity of the HP-gamma-CD grafted PA fabrics charged with CFX against the bacteria Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli was greatly superior to that of the virgin sample within a 24h batch experiment in human blood plasma medium. In conclusion, these results from our study offer an insight into the efficient performance of CDs as drug delivery systems for multiple applications in the fields of biomaterials and medical textiles.

The cytocompatibility of cyclodextrins (CDs) grafting on vascular polyester (PET) prostheses for further loading with biomolecules was investigated in this study. Viability tests demonstrated no toxicity of HP-CDs and PolyHP-CDs at 4,000 mg/l with survival rates of 80 to 96%. Proliferation tests using the human pulmonary microvascular endothelial cell line (HPMEC-ST1) revealed an excellent biocompatibility for Melinex (Film form of PET). For Polythese and Polymaille, a good proliferation rate was observed at 3 days (60-80%) but decreased at 6 days (56-73%). For all CD-grafted samples, low proliferation rates were observed after 6 days (35-38%). Vitality tests revealed excellent functional capacities of HPMEC cells after 3 and 6 days for all samples. Adhesion kinetics tests showed a similar adhesion of HPMEC cells on control and Melinex. A low adhesion was observed on Polythese and especially on Polymaille compared to control. After CD grafting, the cell adhesion was decreased. The woven or knitted architecture and CD grafting were the most likely causes of this weak adhesion. The adhesion kinetic test was confirmed by SEM observations and immunocytochemistry. The low proliferation of HPMEC on virgin prostheses and especially on grafted prostheses was not due to a cytotoxic effect, but to the physical surface characteristics of the prostheses.

Objective: To evaluate the influence of incorporating inorganic antibacterial agents on the systemic toxicity and cytotoxicity of an experimental self-etching primer (ESP)., Methods: Six kinds of inorganic agents were incorporated respectively into the primer. Systemic toxicity in vivo tests in rats and direct contact in vitro cytotoxicity tests with NIH fibrohiasts were conducted., Results: Systemic toxicity tests revealed neither toxic manifestations nor significant differences in body weight gain hetween control and other groups. There were no significant differences between experimental groups and empty control on cell vitality and cell proliferation rates. Toxicity was only observed in areas heneath the specimens and/or in the direct vicinity of the specimen edge. There was no influence on the cell density over the limit of specimens., Conclusion: The incorporation of tested inorganic antibacterial agents with a proper concentration had no significant influence on the systemic toxicity and cytotoxicity of the tested self-etching primer.

Antibacterial activities have been demonstrated on oral bacteria with inorganic antibacterial agents (ABAs) after their incorporations into an experimental self-etching primer (ESP) before curing. This study was to assess their biocompatibility and antibacterial activity after curing. Six ABAs were incorporated respectively into ESP for treating specimens. After curing, their bactericidal activities on Streptococcus mutans and influences to the early bacterial colonization were assessed by direct contact and viable count. Systemic toxicity in rats after short-term oral exposure and direct contact cytotoxicity with NIH3T3 fibroblasts were tested. Incorporation of ZnOw AT-83, Longbei antibiotic, Antim-AMS2 or IONPURE-H significantly enhanced the antibacterial effect of ESP after curing, even after 1 month aging. Specimens treated by ESP with ZnOw AT-83, Longbei antibiotic or Antim-AMS2 showed slightly less bacterial adhesion than control. Animal experiments revealed neither toxic signs nor significant differences in body weight gain between control and other groups. Cell vitality or proliferation rates were ranged from 76% to 100% with respect to controls. Basic magnesium hypochlorite, ZnOw AT-83 and ZnOw AT-88 were less toxic. Toxicity only observed in areas beneath the specimens and/or in the direct vicinity of the specimen edge. From microbiological and biocompatibility aspects, the tested ABAs can be effectively incorporated in ESP to provide antibacterial activity against S. mutans. ZnOw AT-83 was the most promising one.

Cell adhesion on a biomaterial is an important phase of the cell-material interactions and the quality of this phase governs the success of the biomaterial integration. Understanding of the phenomena of cell adhesion and in particular understanding of cell adhesion on biomaterials is of crucial importance for the development of new biomaterials with excellent biocompatibility. One of the physical quantitative indexes to evaluate the quality of cell-material adhesion is its strength. Determining the strength of adhesive bonds requires applying external forces to the cells. Thus, a few methods have been developed to evaluate the strength of cell-material adhesion (micropipette, microplates, microcantilever, ...). These methods apply shear forces on adherent cells. The aim of our work is the development of a new ultrasonic characterization method of cellular adhesion on substrates. With our method, longitudinal acoustic waves are applied on cell culture to impose a longitudinal strain on cells. Only the cells subjected to a sufficient level of strain will be detached from the substrate. The idea is to correlate cell detachment rate to the longitudinal strain threshold supported by cells. From this result, we can deduce the critical force just sufficient to detach the cell. This global method can be adapted for different cell types and for different substrates. This method can provide an evaluation of the effect of functionalization on substrates. The technique is investigated for the 200 kHz ultrasound frequency. An insonificator adapted to the use of cell culture boxes was developed and calibrated. Tests were carried out on a glass substrate with or without biological conditioning. We used the MC3T3-E1 osteoblastic cell line. Our results to date provide the value of the necessary force to detach with reproducibility osteoblastic cells from glass.

In orthopaedics and cardiovascular surgery, titanium has become the metal of choice, due to its excellent mechanical properties and biocompatibility. In many surgical operations, chemicals and/or biomolecules (such as antibiotics or growth factors) are used in conjunction with prostheses, so as to avoid or stimulate targeted biological events. Often, immobilization instead of release of such molecules is preferred to optimize their effects, thus avoiding ectopic transformations. A versatile method for the functionalization of pure Ti is shown here, which allows the covalent immobilization of polypeptides. In order to avoid the hydrolysable Ti-O-Si bond found in directly silanized Ti, we use organic/inorganic silica colloids, derived from commercially available 25 nm Ludox silica nanoparticles. Prior to deposition onto Ti-Cp, the silica nanoparticles are functionalized by a propylsemicarbazide moiety by silanization. After spin-coating onto the Ti substrates, the colloids were shown by SEM to form a uniform layer, and to be very strongly adsorbed; the reactivity of the supported semicarbazide (Sc) functionalities being maintained. Chemoselective reaction of semicarbazide groups on the surface with aldehyde moieties present on the polypeptide of interest was chosen in this work due to its efficiency, to its compatibility with the proteinogenic amino acids and in particular cystein and to the use of mild experimental conditions. Aldehyde groups are also easily introduced onto polypeptides by synthesis, oxidation of N-terminal Ser residue or polysaccharide moieties of glycoproteins. Biological assays with MC3T3-E1 osteoblasts revealed an excellent cytocompatibility as shown by the assessment of cell viability, vitality and morphology.

Maltodextrin (MX) was fixed onto PVDF membranes in order to create a drug delivery Guided Tissue Regeneration (GTR) device with controlled drug delivery properties. PVDF microporous membranes were treated by a mixture of MX and citric acid, resulting to an 18 wt% increase of the supports. MX grafted membrane could capture 103 mg/g chlorhexidin digluconate (DigCHX) instead of 1mg/g for a virgin membrane. A neutralization step was performed before the biological tests. Viability tests confirmed the non-toxicity of the MX polymer coating after neutralisation. In vitro release test in human plasma, and microbiological tests showed that membranes grafted with MX were more performing compared to virgin and beta-CD grafted membranes. The antimicrobial activity was effective during more than 72 h.

In order to prevent the increasing frequency of per-operative infections, bioceramics can be loaded with anti-bacterial agents, which will release with respect to their chemical characteristics. A novel hydroxyapatite (HA) was elaborated with specific internal porosities for using as a bone-bioactive antibiotic (ATB) carrier material. UV spectrophotometry and bacteria inhibition tests were performed for testing the ATB adsorption and the microbiological effectiveness after loading with different antibiotics. The impregnation time, ATB impregnating concentration, impregnation condition and other factors, which might influence the ATB loading effect, were studied by exposure to different releasing solvents and different pathogenic bacteria: Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli. It clearly showed that the facility of ATB loading on this porous HA is even possible just under simple non-vacuum impregnation conditions in a not-so-long impregnating interval. The results also showed that, for all three types of ATB (vancomycin, ciprofloxacin and gentamicin), adsorbed amount on the micro-porous HA were hugely higher than that on dense HA. The micro-porosity of test HA had also significantly prolonged the release time of antibiotics even under mimic physiological conditions. Furthermore, it also has primarily proved by a pilot test that the antibacterial efficiency of crude micro-porous HA could be further significantly improved by other methods of functionalization such as cold plasma technique.

HA with specific internal porosities was loaded with different antibiotics (ATBs) and then tested on its microbiological effectiveness. The HA purity was controlled with X-ray diffraction, IR and Raman spectrometry. Varying the sintering temperature and/or adding graphite and PMMA as porogenous agents lead to obtained micro- and meso-porosities. The biological tests concerned cell viability, proliferation and morphology (SEM), and the cytochemical staining of actin and vinculin. The micro- and meso-porous HA samples had an internal pore size of 1-10 microm and 10-50 microm, respectively. X-ray diffraction and FTIR confirmed the high purity of the HA. The cell viability tests with L132 cells confirmed the excellent cytocompatibility of HA, the graphite powder and the ATB vancomycine. Proliferation rate was assessed with MC3T3-E1 osteoblasts. All HA samples produced a higher proliferation than the controls; the micro-porous HA inducing the highest cell growth. The ATB impregnated HA also stimulated cell proliferation but in lower extend. Cytochemical staining of osteoblasts revealed a well-developed cytoskeleton with strong stress fibres. Labelling of the focal adhesion contacts with anti-vinculin showed a less developed adhesion process in the cells on the different HA substrates. It was possible to realize a highly pure hydroxyapatite with different but controlled porosities by varying the sintering temperature and/or addition of a porogenous agents. This purity and the micro-porosity stimulate significantly cell growth.

Vascular prostheses were functionalised with the aim to obtain a slow release of antibiotics in order to reduce postoperative infections. The original process that we present in this paper is based on the use of a family of cage molecules named cyclodextrins (CD). These compounds have the ability to form reversible inclusion complexes with drugs such as antibiotics. The aim of this work was to graft CD onto the prosthesis, so that an antibiotic can be bound on it by this inclusion phenomenon, and then be progressively released over a prolonged period by a complex dissociation mechanism. This paper presents the first part of this research program and concerns mainly the study of the functionalization parameters. It presents surface characterization results of the modified prostheses. The PET prostheses were immersed into a solution containing a cross linking agent, cyclodextrins (beta-CD, gamma-CD, HP-beta-CD and HP-gamma-CD) and a catalyst and were padded. Grafting occurred by the mean of a thermofixation step at a temperature comprised between 140 and 180 degrees C. It was observed that the support was permanently modified when the CD polymer that coated the fibres resisted to the final washing process. Grafting rates of 12 wt% in CD polymer could be reached. It was also observed that the fibre coating reaction induced an increase of the permeability of the grafts.

Viability tests by the colony forming method show no toxicity for all CDs (beta-CD, gamma-CD, HPbeta-CD and HPgamma-CD) and their associated polymer. A survival rate of 100% is observed for all CDs at high concentration 400 ppm. Proliferation tests revealed a low proliferation of L132 cells on grafted vascular prostheses and untreated prostheses and good proliferation on Melinex (film form of PET). A proliferation of 17% is observed after 3 days of incubation and decrease at 4% after 6 days on prostheses. Melinex exhibits a proliferation rate as the controls. Vitality tests confirm proliferation tests and show a good vitality of cells even for low cell amounts. From these experiments it becomes obvious that the decreasing proliferation rate is not a cytotoxic effect but is due to the chemical and/or physical surface characteristics. A similar result is obtained for cell adhesion kinetics between grafted vascular prostheses and control. After 2 h adhesion, a lower adhesion is observed on untreated prostheses. Theses results were confirmed by immunochemistry and morphology tests. This cell adhesion inhibiting effect of the PET prostheses contributes to a better "survival" of vascular prostheses without secondary obstruction or stenosis.

The purpose of this study was to develop a membrane for guided tissue regeneration applicable in periodontology that could release antimicrobial agent during the healing period. Our strategy consisted to graft beta-cyclodextrin (beta-CD), a molecule that is known to form inclusion complexes with a large variety of drugs, onto PVDF membranes. Grafting occurred by using citric acid that provoked a crosslinking reaction of beta-CD, and the resulting polymer was imprisoned into the porous structure of the PVDF membrane. The reaction produced a weight increase of the membrane, the range of which depended on the temperature and on the time of curing applied in the process. The biological behavior of the membranes evaluated by proliferation and vitality tests showed good proliferation and improved activity of L132 epithelial cells on the raw and on the grafted membranes. Doxycyclin (DOX) and chlorhexidine (CHX) were used as antimicrobial agents. Their inclusion into the beta-CD cavity in aqueous solutions was confirmed by NMR spectroscopy. After the impregnation of the membranes with DOX and CHX, their release was studied in vitro in batch type experiments and measured by UV spectrophotometry. Low amounts of DOX and CHX were delivered from the raw membranes within the first few hours of tests. Grafted membranes, however, delivered DOX and CHX in larger quantities within 24 h and 10 days respectively., ((c) 2006 Wiley Periodicals, Inc)

The antibacterial effects of six inorganic antibacterial agents were assessed using broth dilution and agar dilution tests on six pathogenic bacteria associated with oral infectious diseases: Streptococcus mutans (ATCC 25175), S. mutans (Ingbritt), Actinomyces viscosus (ATCC 15987), Lactobacillus casei (ATCC 393), Staphylococcus aureus (ATCC 29213) and Candida albicans (ATCC 90028). The results of the broth dilution test were significantly lower than those of the agar dilution test (F=38.290; P<0.01). The six inorganic agents notably inhibited the growth of tested common oral bacteria in vitro. Among them, Longbei inorganic antibiotic powder was the strongest antibacterial agent, followed by ZnO whisker antibacterial complex (ZnOw) AT-83, IONPURE-H, basic magnesium hypochlorite, ZnOw AT-88 and Antim-AMS2. The broth dilution test appears to be more suitable for testing insoluble inorganic agents.

A new injectable dicalcium phosphate dehydrate (DCPD)-based cement material "PD" VitalOs Cement was studied to elucidate the process of equilibrium occurring in the early stage of implantation. The present study investigated the pH variations of the cement sample-immersing culture medium at determined intervals, time-dependent calcium/phosphate release, cell proliferation, and vitality in the cells-cement coculture milieu, after different preculture conditionings of the samples. Measurement of pH variation showed that without renewing the medium, pH value of sample lixiviate medium first dropped and, after 70 h, gradually balanced. When medium was renewed each day, pH value of lixiviate medium first descended and, after 24 h, gradually returned to pH 7.2. The cell viability revealed an excellent cytocompatibility of the cement. Both cell proliferation and vitality test showed that the preculture conditioning treatment is important at least for good performance of osteoblasts growing on the surface of calcium phosphate hydraulic cement (CPHC) samples in vitro. The results of calcium and phosphate assays clearly showed that this cement material can continuously dissolve to release calcium and phosphate in the liquid cell culture environment. The decrease of proliferation in some experimental groups with short conditioning is due to an excess of acid, which still can have some influence on cell growth after 24 h, since the biological milieu is not continuously renewed as in in vivo conditions.

The aim of this work was to investigate the consequences of excimer laser irradiation on the physico-chemical and biological properties of polyethylene terephthalate (PET) films, currently used for medical devices. Three PET films from different origins were studied in the present work, chosen with respect to their chemical and physical properties, which are of high importance for ulterior medical application as vascular prostheses. Multiple assays were carried out to characterize the physical and chemical effects of the laser irradiation: surface morphology tests (light microscopy, Dektak profilometer and confocal laser scanning microscopy) showed the strong transformation of the surface with the laser treatment. Contact angle measurements revealed a significant increase of the surface energy for each PET depending on the applied fluency. Finally XPS characterization of the surface demonstrated the appearance of new chemical species favorable for cell attachment. This aspect had to be strongly considered regarding to the multiple biological effects of laser irradiated surfaces on living cells. Different cell culture experiments were carried out with L132 human epithelial cells after 6-days culture: proliferation and vitality rate, cell adhesion and cell morphology. Results clearly revealed that laser treatment improved cell proliferation (up to 140% with respect to controls), vitality (10% higher than controls), morphology and adhesion kinetics (more than 16% of control). A significant correlation (R2=0.906) was also established on one PET between the fluencies of laser treatment and the cellular response. These results emphasized high importance of the choice of the PET material for a medical application: only one of the three considered PET films showed really improved cellular response.

SG600, SG900 and SG1100 were synthesized by the sol-gel method. Further treatments with increasing temperatures influenced and determined the crystallization degree of the material. Primary cultured osteoclasts were incubated for 4h and 48h on samples. Osteoclast actin labeling was examined by cytochemical staining. The concentrations of Ca and P in culture medium were quantified by colorimetric methods. SEM examined osteoclast morphology and resorption lacuna. Actin staining revealed on all three materials the typical adhesion contact ring. The Ca concentration in the culture medium of SG600 was significantly higher than that in control medium, SG900 and SG1100. Ca and P concentrations were always higher in culture media with the presence of osteoclasts. Morphological studies by scanning electron microsopy(SEM) showed a good adhesion behavior of osteoclasts on all three samples. Well-developed and deep resorption lacunae appearing after the osteoclastic resorption action were detected on all three samples. The synthetic bioglasses with different crystallizations caused different solubility, which seemed to have little effect on the osteoclast resorption behavior. The results of morphological studies on osteoclasts and resorption lacunae clearly demonstrate that the synthetic bioglasses are easily resorbed in vitro by osteoclasts.

Purpose: Cyclodextrins (CDs) are torus shaped cyclic oligosaccharides with a hydrophobic internal cavity and a hydrophilic external surface. We performed and analysed an antibiotic binding on Dacron (polyethyleneterephtalate, PET) vascular grafts, previously coated with CDs based polymers., Methods: The CDs coating process was based on the pad-dry-cure method patented in our laboratory. The Dacron prostheses were immersed into a solution containing a polycarboxylic acid, a cyclodextrin and a catalyst, and placed into a thermofixation oven before impregnation with an antibiotic solution (Vancomycin). Biocompatibility tests were performed with L132 human epithelial cells. The antibiotic release in an aqueous medium was assessed by batch type experiments using UV spectroscopy., Results: Viability tests confirmed that the CDs polymers coating the Dacron fibers were not toxic towards L132 cell. Cell proliferation was similar on coated and uncoated grafts. A linear release of Vancomycin was observed over 50 days., Conclusion: Our results demonstrate the feasibility of coating CDs onto vascular Dacron grafts. Biological tests show no toxicity of the different cyclodextrins coated. A linear release of antibiotics was depicted over 50 days, demonstrating that cyclodextrin grafting was an efficient drug delivery system.

Purpose of the Study: The purpose of this study was to determine the frequency of aseptic loosening among a series of total hip arthroplasties evaluated at 84 months and to search for the cause. Two types of acetabular cups had been implanted. It was hypothesized that the ion coating of the titanium head could be involved in the deterioration of titanium/polyethylene implants., Material and Methods: Two non-cemented acetabular cups differing only by the presence or not of a hypoxyapatite coating were studied. Different types of femoral heads (stainless steal, chromium-cobalt, alumina, zincrona, nitrurated titanium, ion-coated titanium) and femoral stems (with or without cement) were implanted. Sixty-two ion-coated titanium heads were implanted and 47 patients with 52 heads were reviewed. Clinical outcome was assessed with the Postel-Merle-d'Aubigné score and the Livermoore method was used for radiological assessment of the bone-implant interface and polyethylene wear. The physico-chemical properties of one titanium head explanted after aseptic loosening were also studied., Results: At 84 months follow-up, the mean clinical score was 15.8/18 points. Mean polyethylene wear was 0.18 mm/year. There were 13 revisions for aseptic loosening: two bipolar, nine acetabular and two femoral. Mean wear for the explanted implants was 0.34 mm/year. Metallosis was observed in eight cases. Arthroplasties with the same types of femoral stem and acetabular implants but with other types of heads (stainless steal, chromium-cobalt, alumina, zincrona, nitrurated titanium) led to only one case of aseptic loosening among 118 implantations. Electron microscopy demonstrated the presence of scratch lines, disappearance of the nitrogen ion layer, decreased hardness, and increased roughness of the titanium head., Discussion: The poor friction properties of titanium are well known. To improve performance, ion coating has been proposed. This technique consists in projecting nitrogen ions onto the surface of the head to form a surface coating measuring about one micron. The high incidence of aseptic loosening, polyethylene wear, metallosis, and modifications of the head surface (disappearance of the nitrogen ion layer, scratch marks, etc.) suggest ion-coated titanium heads could be the cause of these aseptic loosenings., Conclusion: Ion-coating has not provided good protection of the titanium head. Patients with this type of head should be followed carefully in order to detect aseptic loosening or metallosis early.

Osteoblast adhesion on the implant material surface is essential for the success of any implant in which osteointegration is required. Surface properties of implant material have a critical role in the cell adhesion progress. Titanium and its alloys are widespread and increasingly used as implant material in dentistry and orthopedics because of their excellent biocompatibility, which is attributed to a passive layer of TiO2 on the surface. In this study, the micro-arc oxidizing (MAO) and hydrothermally synthesizing (HS) methods were used to modify the TiO2 layer on the titanium surface. The surface microstructure was observed by scanning electron microscopy. The surface energy was assessed. The mouse osteoblastic cell line (MC3T3-E1) was seeded on the treated surfaces to evaluate their effect on cell behavior. This included cell adhesion kinetics, cell proliferation, cell morphology, and cytoskeletal organization. The surface structure of MAO samples exhibited micropores with a diameter of 1-3 microm, whereas the MAO-HS-treated samples showed additional multiple crystalline microparticles on the microporous surface. The surface energy of MAO and MAO-HS was higher than that of titanium. The cell adhesion rate was higher on the MAO-HS surface than on the MAO and titanium surface, but without any significant difference between them. After 3 days of culture, cells proliferated significantly more on the MAO and titanium surface than on the MAO-HS surface. The cytoskeletal organization was analyzed by actin and vinculin staining on all the samples. We conclude that the MAO and MAO-HS methods change the surface energy of TiO2 layer on the titanium surface. This may have an influence on the initial cell attachment. Other surface characteristics may be involved in the cell proliferation, which is different from cell attachment on the sample surface. A longer-duration cell experiment should be conducted to see the effect on cell differentiation. Future in vivo evaluation may give further evidence to optimize the surface character of this kind of implant material., (Copyright 2003 Wiley Periodicals, Inc. J Biomed Mater Res 68A: 383-391, 2004)

The use of carbon is widespread in fields as wide as aeronautics, cars, electricity or electronics. The biomedical applications of carbon are also numerous. The purpose of our work is to test four experimental carbon fibers (A, B, C and D; B being the negative control) to determine the best clinical application. Four tests of cytocompatibility are carried out (cell viability, inflammatory test, cell proliferation and cell morphology). Two different cell lines are used: the L132 cell line (epithelial embryonic pulmonary human cell) and the HaCaT line (human normal spontaneously immortalized skin keratinocytes). The results of the biological tests are compared with those of a carbon fiber sample already marketed as a bandage in the treatment of infected wounds: Actisorb "Plus (J2). The various tests show us that only two experimental samples are slightly cytotoxic (A, D). On the other hand, no sample supports cell adherence. A, B, C and D do not have an inflammatory effect. J2 appears at the same time cytotoxic and inflammatory. Consequently, being given the physical presentation and the biological properties of experimental samples (A, C and D), we intend them for an application in the field of wound healing, as a bandage. Also further experimentation is needed.

This work investigates the role of the surface roughness of Ti6Al4V on the cell morphology, proliferation and adhesion, and in particular on the variation of the expression of cell adhesion proteins. Standardised test samples with five different surface preparations are used: sandblasted, 80, 1200, and 4000 grade polished, mirror polished. Surface roughness is analysed by Scanning Electron Microscopy and LASER Confocal Microscopy. Cell culture experiments are performed with MC3T3-E1 mouse osteoblasts after 3 days culture: proliferation rate, morphology and adhesion are assessed. The variations of expression of cell adhesion proteins are evidenced by indirect immune fluorescence method: actin from the cytoskeleton, vinculin from the focal adhesion complex, fibronectin and collagen I from the extracellular matrix. The results reveal a clear influence of surface roughness of Ti6Al4V on cell proliferation, morphology and adhesion. A significant correlation is established between surface roughness and cell growth. More the surface is smooth more the osteoblasts proliferate and appear spread out on the test samples. In addition, the expression of adhesion proteins varies with respect to the surface roughness. These results indicate a direct relationship between the decrease of cell adhesion and the increase of cell proliferation on mirror polished materials.

A stable connection between the biomaterial surface and the surrounding tissue is one of the most important prerequisites for the long-term success of implants. Therefore, a strong adhesion of the cells on the biomaterial surface is required. Beside the surface composition the surface topography influences the properties of the adherent cells. The quality of the connection between the cell and the biomaterial is-among other factors-determined by the dimensions of the surface topography. Osteoblasts and fibroblast-like cells in contact with a ground biomaterial surface spread in the direction of the surface structures. These aligned cells provide a more favourable adhesion behaviour than a spherically shaped cell. To determine the influence of the surface structure on the cell alignment and cytoskeleton organisation or arrangement, substrate discs of cp-titanium were ground, producing different roughness of the substrates. The oriented cells had a higher density of focal contacts when they were in contact with the edges of the grooves and showed a better organisation of the cytoskeleton and stronger actin fibres. These changes of the aligned cells depend on the peak to valley height of the surface structures.

Investigations on the ceramic degradation caused by osteoclasts are designed to assess osteoclast-ceramic interactions and to determine which ceramics are more suitable for use as bone substitute. This study investigated the resorptive activity of osteoclasts on ceramics presenting different solubility rates. Osteoclasts isolated from new-born rat and from human giant cell tumour were cultured on different bioceramics: hydroxyapatite (HA), beta-tricalcium phosphate (TCP) and calcium carbonate (calcite). Cytoskeletal was revealed by actin labelling and ceramic surfaces were observed by scanning electron microscopy (SEM). On all materials, the distribution of actin in typical ring was revealed. SEM examinations showed a clear difference in the shape and the depth of resorption lacunae on different ceramics. On pure HA, a superficial attack, clearly visible but very little extended. Numerous resorption lacunae, deep and well-delimited were observed on pure beta-TCP, but attacks less punctually were detected too. On pure calcite, an attack with form of spikes, very widespread but superficial was revealed. Degradation measurements revealed a significant increase of P release from the phosphocalcic ceramics and of Ca from all ceramics in the presence of osteoclasts. The both cell models found these characteristics, the rat osteoclasts were also an excellent model to study the ceramic resorption.

Orthodontic arcs and wires are mostly realised from alloys and constitute the motor of dental shifting. Ti-base alloys rapidly replaced the formerly used stainless steel wires due to their excellent corrosion resistance, their high mechanical characteristics and their increased biocompatibility. NiTiNOL shape memory alloys add to these advantages their ability of deforming force. NiTiNOL, highly pure Nickel (hp-Ni) and commercially pure titanium (cp-Ti) were tested by electrochemical assays in artificial saliva and in vitro biological tests with L132 cells and HEPM cells. All tests gave concordant results: the electrochemical assays, the proliferation test, the colony forming method, and the inflammatory test clearly show, that nickel is a corrosive and a cytotoxic material. Ti and NiTiNOL are cytocompatible and in particular corrosion resistant. No significant differences are observed for both materials on the electrochemical and the biological level as well. The NiTiNOL shape memory alloy is a master trump for dental practitioners to repair occlusal defects by shifting teeth under optimal biological conditions. In spite of its high Ni-content, it is biocompatible. It considerably reduces the tune of therapeutic treatment, facilitate the occlusal concept and leads to a result of high clinical quality.

The adhesion process plays a major role in the development of osteoblastic cells on various substrates used in orthopaedic applications such as metals, bioceramics, or glass. High frequency and low power ultrasounds seem to be an appropriate tool for an evaluation of interface mechanical properties. Is it a non-destructive method? We investigated osteoblastic cell cultures, maintained in their medium with high frequency, bulk longitudinal waves. The influence of both acoustical frequency and acoustical power on cell adhesion is evaluated by cell detachment ratio and re-adhesion ratio. We demonstrate the existence of a power threshold depending on the frequency, allowing optimal cellular detachment and re-adhesion. Finally, a qualitative study of the detachment phenomena is performed by use of scanning electron microscopy (SEM), Confocal Laser Scanning Microscopy and cytochemical labelling.