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Purpose: To evaluate the effect of continuous perioperative clopidogrel treatment on the osseointegration of titanium implants. Materials and Methods: A total of 32 New Zealand rabbits were randomly divided between two groups: a clopidogrel group (n = 16) and a control group (n = 16). For 1 week prior to the surgical placement of a titanium implant in their medial femoral condyle, rabbits in the clopidogrel group received 3 mg/kg of clopidogrel daily, and the control group received only the vehicle. This treatment was continued for another 6 weeks postoperatively. At 6 weeks, the rabbits were euthanized and postmortem histologic and histomorphometric evaluation of the implants was performed. Results: The surgical procedures and postoperative period were uneventful and well tolerated by all animals without any surgical wound dehiscence, signs of infection, or other complication. No implant failure was observed in any of the groups. Histomorphometric analysis showed that bone-to-implant contact (BIC) was 48.77% for the clopidogrel group and 34.65% for the control group, with statistically significant difference between them (P < .001). Moreover, clopidogrel group had significantly greater bone tissue density (40.52% vs 28.74%, respectively; P <.001) and mean trabecular thickness (284.7 μm vs 180.7 μm, respectively; P < .001) in proximity to the implant surface than the control group, while the mean trabecular number had no difference between groups (1.56 vs 1.60, respectively; P = .961). Conclusions: The present study showed that continuous clopidogrel treatment does not negatively affect osseointegration, but rather promotes it in terms of BIC and bone density around the titanium implants. Further studies on the effect of the P2Y12 receptor and its antagonists on peri-implant bone homeostasis may provide useful information or applications for long-term success of dental implant therapy. [ABSTRACT FROM AUTHOR]

This paper presents the surface treatment results of titanium, veterinary bone wedges. The functional coating is composed of a porous oxide layer (formed by a plasma electrolytic oxidation process) and a polymer poly(sebacic anhydride) (PSBA) layer loaded with amoxicillin (formed by dip coatings). The coatings were porous and composed of Ca (4.16%-6.54%) and P (7.64%-9.89% determined by scanning electron microscopy with EDX) in the upper part of the implant. The titanium bone wedges were hydrophilic (54° water contact angle) and rough (surface area (Sa):1.16 μm) The surface tension determined using diiodomethane was 68.6 ± 2.0° for the anodized implant and was similar for hybrid coatings: 60.7 ± 2.2°. 12.87 ± 0.91 µg/mL of amoxicillin was released from the implants during the first 30 min after immersion in the phosphate-buffered saline (PBS) solution. This concentration was enough to inhibit the Staphylococcus aureus ATCC 25923, and Staphylococcus epidermidis ATCC12228 growth. The obtained inhibition zones were between 27.3 ± 2.1 mm–30.7 ± 0.6 mm when implant extract after 1 h or 4 h immersion in PBS was collected. Various implant biocompatibility analyses were performed under in vivo conditions, including pyrogen test (3 rabbits), intracutaneous reactivity (3 rabbits, 5 places by side), acute systemic toxicity (20 house mice), and local lymph node assay (LLNA) (20 house mice). The extracts from implants were collected in polar and non-polar solutions, and the tests were conducted according to ISO 10993 standards. The results from the in vivo tests showed, that the implant's extracts are not toxic (mass body change below 5%), not sensitizing (SI < 1.6), and do not show the pyrogen effect (changes in the temperature 0.15ºC). The biocompatibility tests were performed in a certificated laboratory with a good laboratory practice certificate after all the necessary permissions. [ABSTRACT FROM AUTHOR]

Osteosarcoma is one of the major bone cancers, especially for youngsters. The current treatment usually requires systemic chemotherapy and the removal of bone tumors. Titanium (Ti)-based implants can be modified as local drug delivery (LDD) systems for controllable and localized chemotherapeutic drug release. In this work, a pH-responsive Ti-based LDD prototype was designed by introducing polydopamine (PDA) to release doxorubicin (DOX) around osteosarcoma cells with low pH. Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and a contact angle meter were applied for surface characterization. Both direct and indirect cell culture modes were performed for biocompatibility and biofunction assessments. The results indicate that the Ti-based LDD prototype exhibits significant pH-dependent DOX release. The cumulative release can reach up to approximately 40% at pH = 6.0 after 72 h, but only around 20% at pH = 7.4. The Ti-based LDD implant shows good biocompatibility with approximately 93% viability of MC3T3 cells after direct culture in vitro for 24 h. Both direct and indirect culture modes verify the good anti-osteosarcoma function of the LDD implant, which should be attributed to the pH-responsive release of DOX. [ABSTRACT FROM AUTHOR]

Titanium implants, which are widely used in orthopedic implant applications, require surface treatments due to their low osteoinduction properties and the risk of postoperative infection. In this study, apatite wollastonite (AW)-based coatings with chitosan (CHI) and silver (Ag) added were applied to the titanium surface using dip coating and drop casting techniques. The obtained coating surfaces were characterized by FESEM, EDS, XRD, FTIR, and TGA–DSC. Biomineralization behaviors were examined by immersing the resulting coatings in simulated body fluid with pH 7.2–7.4. The antibacterial activities of the coatings obtained using S. aureus and E. coli bacterial colonies were examined. Following the successful coating of AW nanoparticles on the Ag and CHI implant substrate, the Ca/P ratio of the coated surface was obtained as 1.4–1.92% after the biomineralization process performed at 37° for 7 days. Ag particles were successfully distributed homogeneously with a 40–50-nm diameter in Ag-doped coatings. It was concluded that the successfully produced composite coating with bioactive and antibacterial properties is a suitable candidate material for metallic implant surfaces. [ABSTRACT FROM AUTHOR]

Abstract This paper presents the surface treatment results of titanium, veterinary bone wedges. The functional coating is composed of a porous oxide layer (formed by a plasma electrolytic oxidation process) and a polymer poly(sebacic anhydride) (PSBA) layer loaded with amoxicillin (formed by dip coatings). The coatings were porous and composed of Ca (4.16%-6.54%) and P (7.64%-9.89% determined by scanning electron microscopy with EDX) in the upper part of the implant. The titanium bone wedges were hydrophilic (54° water contact angle) and rough (surface area (Sa):1.16 μm) The surface tension determined using diiodomethane was 68.6 ± 2.0° for the anodized implant and was similar for hybrid coatings: 60.7 ± 2.2°. 12.87 ± 0.91 µg/mL of amoxicillin was released from the implants during the first 30 min after immersion in the phosphate-buffered saline (PBS) solution. This concentration was enough to inhibit the Staphylococcus aureus ATCC 25923, and Staphylococcus epidermidis ATCC12228 growth. The obtained inhibition zones were between 27.3 ± 2.1 mm–30.7 ± 0.6 mm when implant extract after 1 h or 4 h immersion in PBS was collected. Various implant biocompatibility analyses were performed under in vivo conditions, including pyrogen test (3 rabbits), intracutaneous reactivity (3 rabbits, 5 places by side), acute systemic toxicity (20 house mice), and local lymph node assay (LLNA) (20 house mice). The extracts from implants were collected in polar and non-polar solutions, and the tests were conducted according to ISO 10993 standards. The results from the in vivo tests showed, that the implant’s extracts are not toxic (mass body change below 5%), not sensitizing (SI

Purpose: To evaluate the performance of one- and two-piece ceramic implants regarding implant survival and success and patient satisfaction. Materials and Methods: This review followed the PRISMA 2020 guidelines using PICO format and analyzed clinical studies of partially or completely edentulous patients. The electronic search was conducted in PubMed/MEDLINE using Medical Subject Headings (MeSH) keywords related to dental zirconia ceramic implants, and 1,029 records were received for detailed screening. The data obtained from the literature were analyzed by single-arm, weighted meta-analyses using a random-effects model. Forest plots were used to synthesize pooled means and 95% CI for the change in marginal bone level (MBL) for short-term (1 year), mid-term (2 to 5 years), and long-term (over 5 years) follow-up time intervals. Results: Among the 155 included studies, the case reports, review articles, and preclinical studies were analyzed for background information. A meta-analysis was performed for 11 studies for one-piece implants. The results indicated that the MBL change after 1 year was 0.94 ± 0.11 mm, with a lower bound of 0.72 and an upper bound of 1.16. For the mid term, the MBL was 1.2 ± 0.14 mm with a lower bound of 0.92 and an upper bound of 1.48. For the long term, the MBL change was 1.24 ± 0.16 mm with a lower bound of 0.92 and an upper bound of 1.56. Conclusion: Based on this literature review, one-piece ceramic implants achieve osseointegration similar to titanium implants, with a stable MBL or a slight bone gain after an individual initial design depending on crestal remodeling. The risk of implant fracture is low for current commercially available implants. Immediate loading or temporization of the implants does not interfere with the course of osseointegration. Scientific evidence for twopiece implants is rare. Purpose: To evaluate the performance of one- and two-piece ceramic implants regarding implant survival and success and patient satisfaction. Materials and Methods: This review followed the PRISMA 2020 guidelines using PICO format and analyzed clinical studies of partially or completely edentulous patients. The electronic search was conducted in PubMed/MEDLINE using Medical Subject Headings (MeSH) keywords related to dental zirconia ceramic implants, and 1,029 records were received for detailed screening. The data obtained from the literature were analyzed by single-arm, weighted meta-analyses using a random-effects model. Forest plots were used to synthesize pooled means and 95% CI for the change in marginal bone level (MBL) for short-term (1 year), mid-term (2 to 5 years), and long-term (over 5 years) follow-up time intervals. Results: Among the 155 included studies, the case reports, review articles, and preclinical studies were analyzed for background information. A meta-analysis was performed for 11 studies for one-piece implants. The results indicated that the MBL change after 1 year was 0.94 ± 0.11 mm, with a lower bound of 0.72 and an upper bound of 1.16. For the mid term, the MBL was 1.2 ± 0.14 mm with a lower bound of 0.92 and an upper bound of 1.48. For the long term, the MBL change was 1.24 ± 0.16 mm with a lower bound of 0.92 and an upper bound of 1.56. Conclusion: Based on this literature review, one-piece ceramic implants achieve osseointegration similar to titanium implants, with a stable MBL or a slight bone gain after an individual initial design depending on crestal remodeling. The risk of implant fracture is low for current commercially available implants. Immediate loading or temporization of the implants does not interfere with the course of osseointegration. Scientific evidence for twopiece implants is rare. [ABSTRACT FROM AUTHOR]

Abstract Titanium and its alloys have been widely applied in many biomedical fields because of its excellent mechanical properties, corrosion resistance and good biocompatibility. However, problems such as rejection, shedding and infection will occur after titanium alloy implantation due to the low biological activity of titanium alloy surface. The structures with specific functions, which can enhance osseointegration and antibacterial properties, are fabricated on the surface of titanium implants to improve the biological activity between the titanium implants and human tissues. This paper presents a comprehensive review of recent developments and applications of surface functional structure in titanium and titanium alloy implants. The applications of surface functional structure on different titanium and titanium alloy implants are introduced, and their manufacturing technologies are summarized and compared. Furthermore, the fabrication of various surface functional structures used for titanium and titanium alloy implants is reviewed and analyzed in detail. Finally, the challenges affecting the development of surface functional structures applied in titanium and titanium alloy implants are outlined, and recommendations for future research are presented.

Titanium implants, widely used in orthopedic and dental applications, often face challenges due to inadequate osseointegration and the risk of postoperative infections, which can potentially lead to implant failure. To address this issue, we developed a titanium implant with an in-situ fabricated anatase TiO 2 metasurface, characterized by a subwavelength thickness and a preferential orientation of the (001) facets. This metasurface, which consists of uniformly distributed nano-crystallites of approximately 30 nm in size, aims to enhance both osseointegration and antibacterial properties. The addition of isopropanol (IPA) to the precursor solution used in the fabrication process played a crucial role in controlling the grain size and coating thickness of the metasurface. This process led to a redshift of the light absorption peak into the near-infrared (NIR)-II region, thereby increasing the penetration depth of photothermal therapy. The implants with TiO 2 metasurface exhibited increased hydrophilicity, rapid apatite formation in simulated body fluid, and an effective photothermal response under NIR-II light, showing significant antibacterial activity against E. coli and S. aureus. In vivo experiments in rabbits indicated superior bone regeneration and osseointegration around the implants with TiO 2 metasurface compared to the control titanium implants. At 4 weeks postoperatively, the bone volume to tissue volume (BV/TV) ratio within the implant was 53.94 %, and by 8 weeks, the implants were nearly entirely filled with new bone, with a BV/TV ratio of approximately 70 %. The findings suggest that the TiO 2 metasurface, which combines antibacterial and bioactive features, has the potential to reduce the risk of postoperative infections and improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Titanium and its alloys have been widely applied in many biomedical fields because of its excellent mechanical properties, corrosion resistance and good biocompatibility. However, problems such as rejection, shedding and infection will occur after titanium alloy implantation due to the low biological activity of titanium alloy surface. The structures with specific functions, which can enhance osseointegration and antibacterial properties, are fabricated on the surface of titanium implants to improve the biological activity between the titanium implants and human tissues. This paper presents a comprehensive review of recent developments and applications of surface functional structure in titanium and titanium alloy implants. The applications of surface functional structure on different titanium and titanium alloy implants are introduced, and their manufacturing technologies are summarized and compared. Furthermore, the fabrication of various surface functional structures used for titanium and titanium alloy implants is reviewed and analyzed in detail. Finally, the challenges affecting the development of surface functional structures applied in titanium and titanium alloy implants are outlined, and recommendations for future research are presented. [ABSTRACT FROM AUTHOR]

Antibacterial sonothermal therapy (ASTT) is attractive for treating implant‐associated infection, which addresses the limitations of poor penetration of photothermal therapy. However, achieving implant surface‐specific ultrasound heating is incredibly challenging. Inspired by the porous acoustic metastructure in noise reduction, the acoustic metastructure would be a new strategy for attaining ASTT. Herein, an "acoustic confinement effect" is proposed to "trap" ultrasound for the metastructure TiO2 porous coating on titanium implants. The metastructure coating accomplishes specific acoustic absorption and efficient acoustic‐to‐thermal conversion, surpassing the non‐specific heating of conventional coatings. The theoretical calculation and experiment of metastructure porous coating prove the acoustic‐to‐thermal conversion mechanism, which is also validated in metastructure porous coatings on medical polyetheretherketone, indicating it is universal. Excitingly, this acoustic metastructure "trap" can capture bacteria and local sonothermal enhancement, exhibiting superior ASTT antibacterial rates (S. aureus, 99.69%; E. coil, 99.58%) at low‐power ultrasound. In addition, the metastructure TiO2 coating mimics human bone and demonstrates outstanding osseointegration. This study sheds substantial light on developing the acoustic responsive surface, broadening a new direction of acoustic metamaterials in medical applications. [ABSTRACT FROM AUTHOR]

Introduction: Osteoblastic responses play a crucial role in the success of oral implants. Enhanced proliferation of osteoblast cells is associated with reduced cell mortality and an increase in bone regeneration. This study aims to evaluate the osteoblastic responses following oral implantation. Materials and Methods: Osteoblast stem cells were harvested and subsequently cultivated using cell culture techniques. The osteoblastic phenotype of the extracted cells was confirmed by examining the extracellular matrix. Cell morphogenesis on functionalized biomaterial surfaces was assessed through indirect immunofluorescence staining. The cellular response was investigated in the presence of two types of implant materials: titanium (Ti) and alumina-toughened zirconia (ATZ). Cell viability and apoptosis were quantitatively assessed using MTT assays and flow cytometry, respectively. Results: The survival of osteoblastic lineage cells was moderately reduced post-implantation. Viability in the Ti implant group remained at approximately 86%, while in the ATZ group, it was observed at 75%, which is considered acceptable. Moreover, there was a significant disparity in cell survival between the two implant groups (p < 0.05). Analysis of apoptosis levels at various concentrations revealed that the rate of apoptosis was 3.6% in the control group and 18.5% in the ATZ group, indicating that apoptosis or programmed cell death in the ATZ-treated group had increased nearly four-fold (p < 0.05). Conclusions: The findings of this study indicate a reduction in osteoblastic cell line survival following implant treatment, with titanium implants exhibiting superior performance in terms of cell survival. However, it was also noted that the incidence of apoptosis in osteoblast cells was significantly higher in the presence of zirconium-based implants. [ABSTRACT FROM AUTHOR]

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

Background: The search for effective antimicrobial agents to mitigate peri-implant infections remains a crucial aspect of implant dentistry. This study aimed to evaluate and compare the antimicrobial efficacy of i-PRF, A-PRF+, and enamel matrix derivative (EMD) on decontaminated rough and smooth titanium (Ti) discs. Materials and Methods: Rough and smooth Ti discs were coated with multispecies biofilm and thoroughly debrided using a chitosan-bristled brush. Subsequently, i-PRF, A-PRF+, and EMD were applied. Untreated discs served as control. Residual adherent bacteria present on the treated Ti discs were visualized by SEM and quantified using culture technique, and colony-forming units (CFUs) were measured after 48 h and 7 days. Results: i-PRF demonstrated better antimicrobial effectiveness on both smooth and rough implant surfaces as compared to A-PRF+ and EMD (p < 0.001). In all the experimental groups, smooth Ti discs displayed a greater reduction in microbes compared to rough Ti discs when treated with the biologics. The major reduction in CFU values was determined after seven days. Conclusions: i-PRF as a regenerative material may also be suitable for decontaminating implant surfaces, which could influence tissue healing and regenerative outcomes positively. [ABSTRACT FROM AUTHOR]

Abstract Objectives This study aimed to investigate the osseointegration of titanium (Ti) implants with micro-nano textured surfaces functionalized with strontium additions (Sr) in a pre-clinical rat tibia model. Methodology Ti commercially pure (cp-Ti) implants were installed bilaterally in the tibia of 64 Holtzman rats, divided into four experimental groups (n=16/group): (1) Machined surface - control (C); (2) Micro-nano textured surface treatment (MN); (3) Micro-nano textured surface with Sr2+ addition (MNSr); and (4) Micro-nano textured surface with a higher complementary addition of Sr2+ (MNSr+). In total, two experimental euthanasia periods were assessed at 15 and 45 days (n=8/period). The tibia was subjected to micro-computed tomography (μ-CT), histomorphometry with the EXAKT system, removal torque (TR) testing, and gene expression analysis by PCR-Array of 84 osteogenic markers. Gene expression and protein production of bone markers were performed in an in vitro model with MC3T3-E1 cells. The surface characteristics of the implants were evaluated by scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), and laser scanning confocal microscopy. Results SEM, confocal, and EDS analyses demonstrated the formation of uniform micro-nano textured surfaces in the MN group and Sr addition in the MNSr and MNSr+ groups. TR test indicated greater osseointegration in the 45-day period for treated surfaces. Histological analysis highlighted the benefits of the treatments, especially in cortical bone, in which an increase in bone-implant contact was found in groups MN (15 days) and MNSr (45 days) compared to the control group. Gene expression analysis of osteogenic activity markers showed modulation of various osteogenesis-related genes. According to the in vitro model, RT-qPCR and ELISA demonstrated that the treatments favored gene expression and production of osteoblastic differentiation markers. Conclusions Micro-nano textured surface and Sr addition can effectively improve and accelerate implant osseointegration and is, therefore, an attractive approach to modifying titanium implant surfaces with significant potential in clinical practice.

Objective To deposit degradable amino-hybrid mesoporous silica (AHMS) in situ on the surface of titanium nanotube (TNT) and explore its protective effect on nanomorphology and osteogenesis. Methods TNT and TNT@AHMS were sequentially prepared via an anodizing method: the oil-water two-phase method (experimental group) and the acid-etched titanium method [control group (Ti)]. The parameters for synthesis were explored by changing the silicon source dosage ratio (3∶1, 1∶1, 1∶3); the surface morphology was observed by scanning electron microscope(SEM), hydrophilicity was detected by Water Contact Angle Tester, elemental composition was detected by X-ray photoelectron spectroscopy (XPS); nanoindentation test and ultrasonic oscillator were used to observe the morphological holding effect as mechanical strength of TNT@AHMS in vitro; simulated immersion experiments in vitro was used to observe the degradation behavior of the material. the MC3T3-E1 cell line was used to observe the effect of cell adhesion, proliferation and differentiation on the material; and an SD rat femoral implant model and micro-CT were used to verify the protective effect and osseointegration effect of AHMS on TNT morphology. Results The morphologies of TNT and TNT@AHMS were successfully prepared, and the silicon source ratio was 1:3. SEM showed that the titanium nanotubes were uniformly covered with AHMS coating, and the mesoporous pore size was about 4 nm. After AHMS was incorporated, the surface of the material was hydrophilic (12.78°), the presence of amino groups (NH2-) was detected, the material was completely degraded within 12 h in vitro, and the active morphology of the TNT was re-exposed with a cumulative silicon release of 10 ppm. Nanoindentation test showed that TNT@AHMS exhibited more ideal surface mechanical strength. SEM revealed that TNT maintains its own morphology under the protection of AHMS, and the TNT group suffered severe exfoliation. In addition, the early adhesion and proliferation rates, ALP activity, and bone volume fraction of cells on the TNT@AHMS surface 4 weeks after implantation were significantly higher than those in the TNT group. Conclusion By depositing AHMS on the surface of TNT, the nanotopography can be protected. It not only prevents the active base topography from exerting subsequent biological effects but also further endows the material with the ability to promote bone regeneration, laying a foundation for the future development of nanotopography-modified titanium implants.

The surface topological features of bioimplants are among the key indicators for bone tissue replacement because they directly affect cell morphology, adhesion, proliferation, and differentiation. In this study, we investigated the physical, electrochemical, and biological responses of sandblasted titanium (SB-Ti) surfaces with pore geometries fabricated using a plasma electrolytic oxidation (PEO) process. The PEO treatment was conducted at an applied voltage of 280 V in a solution bath consisting of 0.15 mol L−1 calcium acetate monohydrate and 0.02 mol L−1 calcium glycerophosphate for 3 min. The surface chemistry, wettability, mechanical properties and corrosion behavior of PEO-treated sandblasted Ti implants using hydroxyapatite particles (PEO-SB-Ti) were improved with the distribution of calcium phosphorous porous oxide layers, and showed a homogeneous and hierarchically porous surface with clusters of nanopores in a bath containing calcium acetate monohydrate and calcium glycerophosphate. To demonstrate the efficacy of PEO-SB-Ti, we investigated whether the implant affects biological responses. The proposed PEO-SB-Ti were evaluated with the aim of obtaining a multifunctional bone replacement model that could efficiently induce osteogenic differentiation as well as antibacterial activities. These physical and biological responses suggest that the PEO-SB-Ti may have a great potential for use an artificial bone replacement compared to that of the controls. [ABSTRACT FROM AUTHOR]

For decades, titanium implants have shown impressive advantages in bone repair. However, the preparation of implants with excellent antimicrobial properties as well as better osseointegration ability remains difficult for clinical application. In this study, black phosphorus nanosheets (BPNSs) were doped into hydroxyapatite (HA) coatings using electrophoretic deposition. The coatings' surface morphology, roughness, water contact angle, photothermal properties, and antibacterial properties were investigated. The BP/HA coating exhibited a surface roughness of 59.1 nm, providing an ideal substrate for cell attachment and growth. The water contact angle on the BP/HA coating was measured to be approximately 8.55°, indicating its hydrophilic nature. The BPNSs demonstrated efficient photothermal conversion, with a temperature increase of 42.2°C under laser irradiation. The BP/HA composite coating exhibited a significant reduction in bacterial growth, with inhibition rates of 95.6% and 96.1% against Staphylococcus aureus and Escherichia coli. In addition, the cytocompatibility of the composite coating was evaluated by cell adhesion, CCK8 and AM/PI staining; the effect of the composite coating in promoting angiogenesis was assessed by scratch assay, transwell assay, and protein blotting; and the osteoinductivity of the composite coating was evaluated by alkaline phosphatase assay, alizarin red staining, and Western blot. The results showed that the BP/HA composite coating exhibited superior performance in promoting biological functions such as cell proliferation and adhesion, antibacterial activity, osteogenic differentiation, and angiogenesis, and had potential applications in vascularized bone regeneration. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study evaluated the fracture strength of screw‐retained zirconia crowns connected to zirconia (Zr) and titanium (Ti) implants after undergoing a simulation of 5 years of clinical use. Materials and methods: Forty‐eight screw‐retained zirconia crowns were fabricated and assembled on four implant systems, with 12 in each group: (1) Zr implant (pure ceramic; Straumann AG) (PZr); (2) Zr implant (NobelPearl; Nobel Biocare) (NPZr); (3) Ti–Zr implant (Bone Level Roxolid; Straumann AG) (RSTiZr); (4) Ti implant (Conical Connection PMC; Nobel Biocare) (NRTi). Crowns were luted to their associated abutments using resin cement and then torqued to their assigned implants at the recommended torque value. Specimens were subjected to dynamic loading for 1,200,000 loading cycles. Fracture strength, measured in Newtons (N), was tested under static compression load using a universal testing machine at an angle of 30°. One‐way ANOVA and Tukey's multiple comparisons post hoc test were used to compare the mean fracture values between the groups at a significance level of 0.05. Results: The average fracture strengths for the RSTiZr and NRTi groups were 1207 ± 202 and 1073 ± 217 N, respectively, which was significantly (p < 0.0001) higher than the PZr and NPZr groups (712 ± 76 and 571.6 ± 167 N, respectively). However, no significant difference was found between the fracture strength value of RSTiZr and NRTi (p = 0.260) or PZr and NPZr (p = 0.256) groups. Conclusions: Zirconia crowns connected to Zr implants have the potential to withstand the average physiological occlusal forces which occur in the anterior and premolar regions. [ABSTRACT FROM AUTHOR]

In this study, a group of active peptides named P3 isolated from soybean protein is used to modify the surface of titanium sheets. The modified titanium sheets are characterized by X-ray photoelectron spectroscopy and contact angle measurement. The effects of modified titanium sheets coated with P3 on the adhesion, proliferation, differentiation and mineralization of MC3T3-E1 cells are investigated. Amino acid analysis showed that the hydrophobic amino acids and aromatic amino acids are enriched in P3. After being coated with P3, the surface nitrogen content of titanium sheets is significantly increased in a dose-dependent manner. The contact angle and surface hydrophobicity of titanium sheets are significantly changed (p < 0.05). In addition, the adhesion and proliferation activity of MC3T3-E1 cells on titanium sheets are significantly enhanced by P3 coating (p < 0.05). Further studies indicated that P3 coating increased the expression of alkaline phosphatase, osteocalcin, consequently promoting the differentiation and mineralization of MC3T3-E1 cells on the surface of titanium sheets. In conclusion, P3 coating enhances the surface hydrophobicity, leading to a significant increase in the cell adhesion, consequently promoting the differentiation and mineralization of MC3T3-E1 cells on the surface titanium sheets, suggesting that P3 may serve as a coating material for titanium-based implants to facilitate fracture healing and other applications. [ABSTRACT FROM AUTHOR]

The aim of this study was to histologically and histomorphometrically investigate the effect of locally applied bovine amniotic fluid (BAF) on osseointegration levels in implants. Adult female Sprague–Dawley rats weighing 300–350 g were used as subjects. The rats were divided into two groups: the sham–operated control group (n=10) and the local BAF group (n=10). Implant cavities were created in the tibias of all subjects under sterile saline cooling with rotating instruments. Local BAF was applied to all implant sockets before the implants were placed. Rats were sacrificed after a four–week osseointegration period. Histological staining was performed using hematoxylin and eosin staining to analyze the osseointegration. Examinations of the bone implant connection (BIC) and peri–implant bone formation (PBF) were performed using a light microscope and an image analyzer. As a result of the analysis, the mean BIC value was 40.3 ± 4.9 for the sham–operated control group and 45.2 ± 7.7 for the local BAF group. The mean PBF was 39.9 ± 6.3 for the sham control group and 40.5 ± 5.7 for the local BAF group. A statistically significant difference was found between the sham control group and the local BAF group for the BIC and PBF values (P>0.05; P: 0.11; P: 0.83). The application of local BAF to the implant socket did not have a clear positive effect on implant osseointegration. More studies are needed to clarify the association between local BAF and osseointegration.

Osteosarcoma is one of the major bone cancers, especially for youngsters. The current treatment usually requires systemic chemotherapy and the removal of bone tumors. Titanium (Ti)-based implants can be modified as local drug delivery (LDD) systems for controllable and localized chemotherapeutic drug release. In this work, a pH-responsive Ti-based LDD prototype was designed by introducing polydopamine (PDA) to release doxorubicin (DOX) around osteosarcoma cells with low pH. Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and a contact angle meter were applied for surface characterization. Both direct and indirect cell culture modes were performed for biocompatibility and biofunction assessments. The results indicate that the Ti-based LDD prototype exhibits significant pH-dependent DOX release. The cumulative release can reach up to approximately 40% at pH = 6.0 after 72 h, but only around 20% at pH = 7.4. The Ti-based LDD implant shows good biocompatibility with approximately 93% viability of MC3T3 cells after direct culture in vitro for 24 h. Both direct and indirect culture modes verify the good anti-osteosarcoma function of the LDD implant, which should be attributed to the pH-responsive release of DOX.

Purpose: The aim of this study was to coat titanium substrate with bioactive glass nanoparticles and characterize the deposited surface coat. Materials and Methods: Amorphous bioglass nanoparticles < 20 nm in diameter were prepared using a modified sol-gel technique followed by a ball-milling process. The prepared nanoparticles were used to coat airborne particle–abraded titanium disks. The in vitro bioactivity of the bioglass nanopowder was confirmed using simulated body fluid. Coated surfaces were characterized in terms of microstructure, composition, thickness, phase structure, surface roughness, wettability, and tissue behavior in a rabbit model. Results: Bioglass nanoparticles showed apatite formation under a scanning electron microscope (SEM) after 5 days, confirming that bioactivity was enhanced with increasing degradation rate for up to 2 weeks. An optimized deposition technique and heat-treatment process produced a homogenous coating with a uniform thickness of 32 to 39 μm. Chemical analysis confirmed the presence of silicon and calcium on the coated disks. Amorphous coated surfaces exhibited porous nano/microroughness with microcracks and super-hydrophilicity. The interface of the coated disks with subcutaneous tissue revealed good tissue adhesion, high cellular activity, and rich vascularization, with multinucleated cells in the microenvironment surrounding the coat, as confirmed using histomorphometric analysis. Conclusion: The results of this study show that it is feasible to coat titanium surfaces with bioactive glass nanoparticles with super-hydrophilicity and high biologic activity. These particles may promote the regenerative environment around dental implants. [ABSTRACT FROM AUTHOR]

Metallic titanium (Ti) implant surfaces need improvement for bioproperties and antibacterial behavior. For this purpose, a new boron-doped bioactive apatite–wollastonite (AW) coating was successfully developed on the Ti plate surface. The effects of boron addition on the microstructure, mechanical properties, and bioproperties of the AW coating were investigated. With the addition of boron (B), the AW coating morphology became less porous and compact. In terms of bio properties, the rate of apatite formation increased with the addition of B, and the cell viability rate increased from approximately 66–81%. B addition increased the elastic modulus of the AW coating from about 24–46 GPa and increased its hardness about 2.5 times. In addition, while no antibacterial activity was observed in the AW coating, the addition of boron slightly introduced antibacterial properties. The novel AW/B composite coating obtained is promising for Ti implant surfaces. [ABSTRACT FROM AUTHOR]

Titanium and its alloys have found extensive use in the biomedical field, however, implant loosening due to weak osseointegration remains a concern. Improved surface morphology and chemical composition can enhance the osseointegration of the implant. Bioactive molecules have been utilized to modify the surface of the titanium‐based material to achieve rapid and efficient osseointegration between the implant and bone tissues. In this study, the bioactive substance MC3T3‐E1 protein‐gelatin polyelectrolyte multilayers were constructed on the surface of the titanium implants by means of layer‐by‐layer self‐assembly to enhance the strength of the bond between the bone tissue and the implant. The findings of the study indicate that the layer‐by‐layer self‐assembly technique can enhance surface roughness and hydrophilicity to a considerable extent. Compared to pure titanium, the hydrophilicity of TiOH LBL was significantly increased with a water contact angle of 75.0 ±$$ \pm $$2.4°. The modified titanium implant exhibits superior biocompatibility and wound healing ability upon co‐culture with cells. MC3T3‐E1 cells were co‐cultured with TiOH LBL for 1, 3, and 5 days and their viability was higher than 85%. In addition, the wound healing results demonstrate that TiOH LBL exhibited the highest migratory ability (243 ± 10 μm). Furthermore, after 7 days of osteogenic induction, the modified titanium implant significantly promotes osteoblast differentiation. [ABSTRACT FROM AUTHOR]

In a previous study, we successfully coated hydroxyapatite (HAp) onto titanium (Ti) plates using the erbium-doped yttrium aluminum garnet pulsed-laser deposition (Er:YAG-PLD) method. In this study, we performed further experiments to validate the in vitro osteogenic properties, macrophage polarization, and in vivo osseointegration activity of HAp-coated Ti (HAp-Ti) plates and screws. Briefly, we coated a HAp film onto the surfaces of Ti plates and screws via Er:YAG-PLD. The surface morphological, elemental, and crystallographic analyses confirmed the successful surface coating. The macrophage polarization and osteogenic induction were evaluated in macrophages and rat bone marrow mesenchymal stem cells, and the in vivo osteogenic properties were studied. The results showed that needle-shaped nano-HAp promoted the early expression of osteogenic and immunogenic genes in the macrophages and induced excellent M2 polarization properties. The calcium deposition and osteocalcin production were significantly higher in the HAp-Ti than in the uncoated Ti. The implantation into rat femurs revealed that the HAp-coated materials had superior osteoinductive and osseointegration activities compared with the Ti, as assessed by microcomputed tomography and histology. Thus, HAp film on sandblasted Ti plates and screws via Er:YAG-PLD enhances hard-tissue differentiation, macrophage polarization, and new bone formation in tissues surrounding implants both in vitro and in vivo. [ABSTRACT FROM AUTHOR]

Objective: Titanium implants are widely used in surgeries for their biocompatibility and mechanical properties. However, excessive titanium particle release can cause implant failure. This study explores Atomic Layer Deposition (ALD) to coat commercially pure titanium (Cp-Ti) with TiO2, aiming to improve its frictional and corrosion resistance while reducing particle release. By comparing TiO2 films with varying ALD cycle numbers, we assess surface properties, particle release, friction, and corrosion performance, providing insights into mitigating particle release from implants.Methods: Cp-Ti surfaces were prepared and coated with TiO2 films of 100, 300, and 500 ALD cycles. Surface characterization involved SEM, EDX, and XRD. Friction was tested using SEM, nanoindentation, and ICP-MS. Corrosion resistance was evaluated through immersion tests and electrochemical analysis. Cytotoxicity was assessed using BMSCs.Results: Surface characterization revealed smoother surfaces with increased ALD cycles, confirming successful TiO2 deposition. Friction testing showed reduced friction coefficients with higher ALD cycles, supported by nanoindentation results. Corrosion resistance improved with increasing ALD cycles, as evidenced by electrochemical tests and reduced titanium release. Cytotoxicity studies showed no significant cytotoxic effects.Conclusion: ALD-coated TiO2 films significantly enhance frictional and corrosion resistance of titanium implants while reducing particle release. The study underscores the importance of ALD cycle numbers in optimizing film performance, offering insights for designing implants with improved properties.

Introduction It has been shown that titanium implants with a structured surface provide an increased rate of osseointegration what makes their application quite promising. The purpose of this work was to conduct a comparative evaluation of the efficiency of osseointegration of new percutaneous implants for prosthetics made of ultrafine-grained Ti Grade 4 alloy. Materials and methods The study was carried out on 12 male rabbits of the Soviet Chinchilla breed. Six rabbits of the control group had implants made of Ti6Al4V powder using selective laser sintering technology that were osseointegrated into the tibia, 6 rabbits of the experimental group had implants made of Ti Grade 4 by equal channel angular pressing. The formation of the "bone-implant" block was examined 26 weeks after the implantation. Results Histologically, after 26 weeks of the experiment, porous changes, enlargement of the Haversian canals, and pronounced osteoclastic resorption were not detected in the animals of the experimental group throughout the stump in the compact plate. Around the implant, a bony case repeating the bone shape was formed, represented by lamellar bone tissue. Using X-ray electron probe microanalysis, it was found that in the substrate formed on the surface of the implant in rabbits of the experimental group, there was significantly more calcium in all areas over the implant relative to the animals of the control group. In the control group, relative to the experimental group, an increased level of C-reactive protein in blood serum was retained longer. Complications and significant clinical and laboratory abnormalities were not found in both groups during the entire experiment. Discussion Our data are consistent with the results of other experimental studies, which unambiguously noted that titanium implants with a structured surface show increased osseointegration characteristics in comparative studies relative to implants without modification of the structure of the material of the threaded surface. The absence of complications and undesirable reactions of the animal organism also indicates the acceptable safety of the tested products. Conclusion Osseointegration of a percutaneous implant that has a mixed nanocrystalline and ultrafine-grained structure was more effective than the reference implant. This makes the use of such implant promising for solving clinical problems in prosthetics.

Introduction: Osteoblastic responses play a crucial role in the success of oral implants. Enhanced proliferation of osteoblast cells is associated with reduced cell mortality and an increase in bone regeneration. This study aims to evaluate the osteoblastic responses following oral implantation. Materials and Methods: Osteoblast stem cells were harvested and subsequently cultivated using cell culture techniques. The osteoblastic phenotype of the extracted cells was confirmed by examining the extracellular matrix. Cell morphogenesis on functionalized biomaterial surfaces was assessed through indirect immunofluorescence staining. The cellular response was investigated in the presence of two types of implant materials: titanium (Ti) and alumina-toughened zirconia (ATZ). Cell viability and apoptosis were quantitatively assessed using MTT assays and flow cytometry, respectively. Results: The survival of osteoblastic lineage cells was moderately reduced post-implantation. Viability in the Ti implant group remained at approximately 86%, while in the ATZ group, it was observed at 75%, which is considered acceptable. Moreover, there was a significant disparity in cell survival between the two implant groups (p < 0.05). Analysis of apoptosis levels at various concentrations revealed that the rate of apoptosis was 3.6% in the control group and 18.5% in the ATZ group, indicating that apoptosis or programmed cell death in the ATZ-treated group had increased nearly four-fold (p < 0.05). Conclusions: The findings of this study indicate a reduction in osteoblastic cell line survival following implant treatment, with titanium implants exhibiting superior performance in terms of cell survival. However, it was also noted that the incidence of apoptosis in osteoblast cells was significantly higher in the presence of zirconium-based implants.

Background: The search for effective antimicrobial agents to mitigate peri-implant infections remains a crucial aspect of implant dentistry. This study aimed to evaluate and compare the antimicrobial efficacy of i-PRF, A-PRF+, and enamel matrix derivative (EMD) on decontaminated rough and smooth titanium (Ti) discs. Materials and Methods: Rough and smooth Ti discs were coated with multispecies biofilm and thoroughly debrided using a chitosan-bristled brush. Subsequently, i-PRF, A-PRF+, and EMD were applied. Untreated discs served as control. Residual adherent bacteria present on the treated Ti discs were visualized by SEM and quantified using culture technique, and colony-forming units (CFUs) were measured after 48 h and 7 days. Results: i-PRF demonstrated better antimicrobial effectiveness on both smooth and rough implant surfaces as compared to A-PRF+ and EMD (p < 0.001). In all the experimental groups, smooth Ti discs displayed a greater reduction in microbes compared to rough Ti discs when treated with the biologics. The major reduction in CFU values was determined after seven days. Conclusions: i-PRF as a regenerative material may also be suitable for decontaminating implant surfaces, which could influence tissue healing and regenerative outcomes positively.

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

3D printing has opened new opportunities for the development of personalized systems for prosthetics of extensive chest wall defects after radical surgical interventions for malignant tumors. However, risk factors for an adverse outcome of such operations have not yet been identified.Clinical cases. A 65-year-old man with primary chondrosarcoma of the V rib, underwent surgical resection of three ribs, plasty with local tissues, and an individual 3D printed titanium implant was installed on the sternum and IV-VI ribs. Follow up for 26 months showed no complaints or signs of recurrence. A 52-year-old woman with radiation-induced soft tissue sarcoma of the chest wall, that developed 9 years after radiation for breast cancer, underwent resection of four ribs and pectoral muscles and a 3D printed titanium implant was installed on the sternum and II-V ribs. The operation was complicated by the marginal necrosis of the soft tissue flap and infection of the endoprosthesis, which required removal of the metal structure and reconstruction using TRAM flap. After 9 months, a local recurrence of the tumor was diagnosed. Discussion. As a factor of a positive outcome in a man should be noted a thick layer of subcutaneous fat with muscle tissue, due to which plastic surgery was performed, covering the defect without tension. An extensive resection of the pectoral muscles in a woman created a tissue deficit. Another factor of an unfavorable outcome can be considered the radio-induced nature of the sarcoma. Further research is needed to improve the strategy for selecting patients with malignant tumors of the chest wall for prosthetics.

Shiyan Yang,1,&ast; Weibo Jiang,1,&ast; Xiao Ma,2,&ast; Zuobin Wang,3 Robert L Sah,4,5 Jincheng Wang,1 Yang Sun1 1Orthopedic Medical Center, the Second Hospital of Jilin University, Changchun, Jilin, 130000, People’s Republic of China; 2Department of Orthopedics, the China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, People’s Republic of China; 3International Research Centre for Nano Handling and Manufacturing of China, Changchun University of Science and Technology, Changchun, Jilin, 130000, People’s Republic of China; 4Department of Bioengineering, University of California–San Diego, La Jolla, CA, 92037, USA; 5Center for Musculoskeletal Research, Institute of Engineering in Medicine, University of California–San Diego, La Jolla, CA, 92037, USA&ast;These authors contributed equally to this workCorrespondence: Yang Sun, Orthopedic Medical Center, the Second Hospital of Jilin University, Changchun, 130000, Jilin, People’s Republic of China, Tel/Fax +86 18744000871, Email sunyang@jlu.edu.cnAbstract: Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone defects. However, the bio-inert nature of Ti material limits its capability for rapid osseointegration and thus influences the implant lifetime in vivo. Despite the macroscale porosity for promoting osseointegration, 3D-printed Ti implant surface morphologies at the nanoscale have gained considerable attention for their potential to improve specific outcomes. To evaluate the influence of nanoscale surface morphologies on osseointegration outcomes of 3D-printed Ti implants and discuss the available strategies, we systematically searched evidence according to the PRISMA on PubMed, Embase, Web of Science, and Cochrane (until June 2022). The inclusion criteria were in vivo (animal) studies reporting the osseointegration outcomes of nanoscale morphologies on the surface of 3D-printed Ti implants. The risk of bias (RoB) was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE’s) tool. The quality of the studies was evaluated using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. (PROSPERO: CRD42022334222). Out of 119 retrieved articles, 9 studies met the inclusion criteria. The evidence suggests that irregular nano-texture, nanodots and nanotubes with a diameter of 40– 105nm on the surface of porous/solid 3D-printed Ti implants result in better osseointegration and vertical bone ingrowth compared to the untreated/polished ones by significantly promoting cell adhesion, matrix mineralization, and osteogenic differentiation through increasing integrin expression. The RoB was low in 41.1% of items, unclear in 53.3%, and high in 5.6%. The quality of the studies achieved a mean score of 17.67. Our study demonstrates that nanostructures with specific controlled properties on the surface of 3D-printed Ti implants improve their osseointegration. However, given the small number of studies, the variability in experimental designs, and lack of reporting across studies, the results should be interpreted with caution.Keywords: nano-pattern, 3D-printed, titanium implant, surface modification, osseointegration

Objective To investigate the effect of cobalt (Co) and calcium-phosphate (Ca/P) doped coating on titanium surfaces and their angiogenic effect. Methods Microarc oxidation (MAO) was used to prepare Co-Ca/P-doped and Co-doped coatings. Titanium (Ti) sheet without MAO treatment was used as control. Scanning electron microscopy (SEM) was used to observe the surface micromorphology of the coatings. Energy dispersive spectrometry (EDS) was also applied to detect the doped chemicals and their contents. Standard soaking solutions of these coatings were prepared using an endothelial cell medium (ECM) solution for subsequent angiogenesis experiments. Human umbilical vein endothelial cells (HUVECs) were cultured on Matrigel with ECM soaking solutions for 4 h and 8 h. The microvessels were observed under a microscope, and the number of microtubules and their interconnecting nodes were analyzed with Image J software. Results Co doped and Co-Ca/P-doped coatings were successfully prepared by MAO, which was demonstrated by both SEM observation and EDS analysis. SEM observation showed that irregular crystals of the above chemicals were present on both Co and Co-Ca/P-doped coatings, commonly with a diameter

Titanium implants are one of the most durable and conventional orthopedic and dental implants. The goal of this research is to improve the bio-compatibility of these implants by implementing nano coating of titanium oxide nanotubes (TNT) to enhance bone graft on the implant surface, and reduction of wound healing duration and risk of implant surgery at the same time. For this purpose, the effects of dimension and atomic structure of titanium oxide nanotubes are examined on the surface properties and biological performance and tried to introduce an optimum status of this nano-tubular structure. TNTs were synthesized by anodizing method on the surface of titanium sheets. Dimensions of TNT can be controlled by anodizing process parameters. Heat treatment affects the atomic structure of TNTs. Contact angle measurement as one of the important surface properties was investigated on different dimensions and structures of TNTs, to study human blood's physical interaction with the implant surface. In addition, the quality and quantity of bone material sediment on the surface were examined by SBF test and SEM analysis. Finally, cell culture provided informative data on bone cells' response to these nanotubular coatings by analyzing MTT results and SEM photography of cells. As a result, the optimum dimension and atomic structure of TNTs were defined and the required process parameters were introduced to obtain this state. This setup can be used as an optimum state of TNT as a nano coating on titanium implant with orthopedic functions to enhance the cell adhesion and acquire the highest proliferation rate which means faster bone graft and shorter convalescence.

Excessive bone resorption is one of the main causes of bone homeostasis alterations, resulting in an imbalance in the natural remodeling cycle. This imbalance can cause diseases such as osteoporosis, or it can be exacerbated in bone cancer processes. In such cases, there is an increased risk of fractures requiring a prosthesis. In the present study, a titanium implant subjected to gallium (Ga)-doped thermochemical treatment was evaluated as a strategy to reduce bone resorption and improve osteodifferentiation. The suitability of the material to reduce bone resorption was proven by inducing macrophages (RAW 264.7) to differentiate to osteoclasts on Ga-containing surfaces. In addition, the behavior of human mesenchymal stem cells (hMSCs) was studied in terms of cell adhesion, morphology, proliferation, and differentiation. The results proved that the Ga-containing calcium titanate layer is capable of inhibiting osteoclastogenesis, hypothetically by inducing ferroptosis. Furthermore, Ga-containing surfaces promote the differentiation of hMSCs into osteoblasts. Therefore, Ga-containing calcium titanate may be a promising strategy for patients with fractures resulting from an excessive bone resorption disease.

One of the basic conditions for the clinical success of osseo-integrated implants is implant stability (Albrektsson and Zarb, 1993). It comprises two components, the primary stability that should be ensured at the time of insertion and the secondary stability, which gradually replaces the primary stability. The primary stability is ensured by the direct contact between the implant surface and that of the bone walls of the insertion hole. Secondary stability begins with the first position of new bone on the implant surface. The aim of the present study was to verify the reinforcing structures proliferated around the titanium implant inserted into the femur of 5 adult female rabbits, in a groove smaller than the screw core diameter. The results suggested that inserting the titanium implant into a hole with a smaller diameter than the screw core produces excessive pressure on the bone, which is felt up to a distance from the bone-implant interface. Consequently, mechanical strength of the bone is decreasing and proliferating bone consolidation formations appears on both periosteum and endosteum areas. Additionally, it was observed that newly proliferated bone extends laterally from the interface to a great distance, causing thickening of the bone wall. The observed structures were represented by branched bone trabeculae and bony protrusions into the medullary cavity, together with bone reshuffling processes with the appearance of numerous osteons, most of which are present at the level of the wall opposite the insertion area. [ABSTRACT FROM AUTHOR]

Traumatized bone tissue has the capacity to repair itself so that it eventually regains its almost original form, even in the case of artificially inserted implants. The process that stays at the base of the regeneration is represented by osteogenesis or remote osteogenesis. The major difference between the two types of bone formation is the location of the cement line, which is located on the surface of the implant for contact osteogenesis and on the surface of the bone defect for remote osteogenesis. The aim of the present study was to assess the contact osteogenesis in the case of inserted titanium screws in holes with diameters of 1.8 mm and 1 mm respectively. The obtained results show, in the case of the groove with 1.8 mm that the newly proliferated bone represents 73.85 % of the total area, while in the case of the groove with 1 mm in diameter the value of the newly proliferated bone is 26.15 %. In conclusion, the insertion of titanium screws by self-tapping into the hole smaller than the core of the screw is accompanied by bone proliferation by contact osteogenesis much more modest than in the case of insertion into the hole larger than the core of the screw. [ABSTRACT FROM AUTHOR]

Purpose: We examined blood and protein dynamics potentially influenced by implant threads and hydrophilic/hydrophobic states of implant surfaces. Methods: A computational fluid dynamics model was created for a screw-shaped implant with a water contact angle of 70° (hydrophobic surface) and 0° (superhydrophilic surface). Movements and density of blood and fibrinogen as a representative wound healing protein were visualized and quantified during constant blood inflow. Results: Blood plasma did not occupy 40-50% of the implant interface or the inside of threads around hydrophobic implants, whereas such blood voids were nearly completely eliminated around superhydrophilic implants. Whole blood field vectors were disorganized and random within hydrophobic threads but formed vortex nodes surrounded by stable blood streams along the superhydrophilic implant surface. The averaged vector within threads was away from the implant surface for the hydrophobic implant and towards the implant surface for the superhydrophilic implant. Rapid and massive whole blood influx into the thread zone was only seen for the superhydrophilic implant, whereas a line of conflicting vectors formed at the entrance of the thread area of the hydrophobic implant to prevent blood influx. The fibrinogen density was up to 20-times greater at the superhydrophilic implant interface than the hydrophobic one. Fibrinogen density was higher at the interface than outside the threads only for the superhydrophilic implant. Conclusions: Implant threads and surface hydrophilicity have profound effects on vector and distribution of blood and proteins. Critically, implant threads formed significant biological voids at the interface that were negated by superhydrophilicity- induced contact hemodynamics. [ABSTRACT FROM AUTHOR]

The key for the long-term success of dental implants is the mechanical stability of the implant and the abutment anchored in it. The conical connection between screwed dental implants and abutments has good mechanical stability. However, with long-term use of the dental restoration fixed on a dental implant in the oral cavity, mechanical deformation of the assembled abutment in the implant and loosening of the fixing screw often occur, which affects long-term functionality. To study these processes, static compression loading tests were performed with various conical angle connections (35°, 55°, 75° and 90°) using Grade 4 and 5 titanium implant materials. After loading the implant and abutment assemblies with up to 500 N, the resulting deformations in length and diameter as well as the reverse-torque of the fixing screw were measured. No significant differences were observed between the results when the tested implant and abutment material was either Grade 4 or 5. Additionally, dynamic compression tests were performed on Grade 4 samples with different conical angles (30°, 45° and 60°). The relative changes in length (strain) of the assembly were determined over 30,000 cycles due to force varying periodically between 100 and 400 N. The reverse torques were also measured after the dynamic loading. The static and dynamic compression tests showed the same trend for different cone angles. Impression of the abutment into the dental implant was observed for lower conical angle connections. On the other hand, lower strain values were observed at larger conical angles. The reverse torque values of the fixing screws were only the half of the forward torque in case of lower conical angles, while high stability was observed with the larger conical angle connections (~ 20-30% reduction in torque). In summary, it is recommended to use a higher angle of the conical connection in order to avoid larger deformations in the lengths and diameters of the assembled implant and abutment system, as well as a significant reduction in the torque of the fixing screw. [ABSTRACT FROM AUTHOR]

One of the basic conditions for the clinical success of osseo-integrated implants is implant stability (Albrektsson and Zarb, 1993). It comprises two components, the primary stability that should be ensured at the time of insertion and the secondary stability, which gradually replaces the primary stability. The primary stability is ensured by the direct contact between the implant surface and that of the bone walls of the insertion hole. Secondary stability begins with the first position of new bone on the implant surface. The aim of the present study was to verify the reinforcing structures proliferated around the titanium implant inserted into the femur of 5 adult female rabbits, in a groove smaller than the screw core diameter. The results suggested that inserting the titanium implant into a hole with a smaller diameter than the screw core produces excessive pressure on the bone, which is felt up to a distance from the bone-implant interface. Consequently, mechanical strength of the bone is decreasing and proliferating bone consolidation formations appears on both periosteum and endosteum areas. Additionally, it was observed that newly proliferated bone extends laterally from the interface to a great distance, causing thickening of the bone wall. The observed structures were represented by branched bone trabeculae and bony protrusions into the medullary cavity, together with bone reshuffling processes with the appearance of numerous osteons, most of which are present at the level of the wall opposite the insertion area.

Background: Stabilization and increased activity of hypoxia-inducible factor 1-α (HIF-1α) can directly increase cancellous bone formation and play an essential role in bone modeling and remodeling. However, whether an increased HIF-1α expression in adipose-derived stem cells (ADSCs) increases osteogenic capacity and promotes bone regeneration is not known. Results: In this study, ADSCs transfected with small interfering RNA and HIF-1α overexpression plasmid were established to investigate the proliferation, migration, adhesion, and osteogenic capacity of ADSCs and the angiogenic ability of human umbilical vein endothelial cells (HUVECs). Overexpression of HIF-1α could promote the biological functions of ADSCs, and the angiogenic ability of HUVECs. Western blotting showed that the protein levels of osteogenesis-related factors were increased when HIF-1α was overexpressed. Furthermore, the influence of upregulation of HIF-1α in ADSC sheets on osseointegration was evaluated using a Sprague–Dawley (SD) rats implant model, in which the bone mass and osteoid mineralization speed were evaluated by radiological and histological analysis. The overexpression of HIF-1α in ADSCs enhanced bone remodeling and osseointegration around titanium implants. However, transfecting the small interfering RNA (siRNA) of HIF-1α in ADSCs attenuated their osteogenic and angiogenic capacity. Finally, it was confirmed in vitro that HIF-1α promotes osteogenic differentiation and the biological functions in ADSCs via the VEGF/AKT/mTOR pathway. Conclusions: This study demonstrates that HIF-1α has a critical ability to promote osteogenic differentiation in ADSCs by coupling osteogenesis and angiogenesis via the VEGF/AKT/mTOR signaling pathway, which in turn increases osteointegration and bone formation around titanium implants. [ABSTRACT FROM AUTHOR]

The mechanisms underlying bone-implant integration, or osseointegration, are still incompletely understood, in particular how blood and proteins are recruited to implant surfaces. The objective of this study was to visualize and quantify the flow of blood and the model protein fibrinogen using a computational fluid dynamics (CFD) implant model. Implants with screws were designed with three different surface topographies: (1) amorphous, (2) nano-trabecular, and (3) hybrid meso-spikes and nano-trabeculae. The implant with nano-topography recruited more blood and fibrinogen to the implant interface than the amorphous implant. Implants with hybrid topography further increased recruitment, with particularly efficient recruitment from the thread area to the interface. Blood movement significantly slowed at the implant interface compared with the thread area for all implants. The blood velocity at the interface was 3- and 4-fold lower for the hybrid topography compared with the nano-topography and amorphous surfaces, respectively. Thus, this study for the first time provides insights into how different implant surfaces regulate blood dynamics and the potential advantages of surface texturization in blood and protein recruitment and retention. In particular, co-texturization with a hybrid meso- and nano-topography created the most favorable microenvironment. The established CFD model is simple, low-cost, and expected to be useful for a wide range of studies designing and optimizing implants at the macro and micro levels. [ABSTRACT FROM AUTHOR]

Literature from recent years uncovers an increased research interest in the machining of biomaterials. In current work, Ti6Al4V ELI grade 23 alloy, specifically used in biomedical applications, has been machined using electro-discharge machining (EDM). The work explores the influence of eco-friendly and biodegradable surfactant additives employed during the process while evaluating the material removal rate (for efficiency enhancement), tool wear rate (for cost reduction) and surface roughness and overcut (for product quality improvement) to relate the adopted approach with one-step sustainable machining aspects. Full factorial design of experiment has been used for the investigation, while analysis of variance has also been carried out to find the significant and non-significant parameters. An improvement of ∼41.7%, ∼75.3%, ∼55.3%, ∼47.4% and ∼80.3% has been reported in MRR, TWR, R a , R z and OC, respectively, with the addition of surfactants, thus justifying the adopted approach for one-step sustainable machining. Additionally, surface topography through optical and scanning electron microscopy reveals, reduction in surface cracks and voids with additive mixed EDM. The compositional analysis of the surface using EDS mapping confirms the presence of oxides and carbides for all the surfaces, which is found to be significantly higher for the case of additives mixed EDM. The formation of these bio-ceramic oxides and carbides is considered favorable for developing bioactive surface with improved corrosion resistance and surface hardness. [ABSTRACT FROM AUTHOR]

Pure titanium (Ti) is investigated in a pre-clinical study in Hank's biological solution using electrochemical methods, open circuit potential, and electrochemical impedance spectroscopy to highlight the time effect in extreme body conditions, such as inflammatory diseases, on degradability due to corrosion processes occurring on the titanium implant. Electrochemical impedance spectroscopy (EIS) data are presented as Nyquist and Bode plots. The results show the increasing reactivity of titanium implants in the presence of hydrogen peroxide, which is an oxygen-reactive compound that describes inflammatory conditions. The polarization resistance, which results from electrochemical impedance spectroscopy measurements, declined dramatically from the highest value registered in Hank's solution to smaller values registered in all solutions when different concentrations of hydrogen peroxide were tested. The EIS analysis provided insights into titanium's in vitro corrosion behavior as an implanted biomaterial, which could not be solely obtained through potentiodynamic polarization testing. [ABSTRACT FROM AUTHOR]

Titanium implants are one of the most durable and conventional orthopedic and dental implants. The aim of this research was to improve the bio-compatibility of these implants by implementing nano-dimension coating of titanium oxide nanotubes (TNT). For this purpose, the effect of dimension and atomic structure of titanium oxide nanotubes on the surface properties and biological performance were examined. TNTs were synthesized by anodizing method on the surface of titanium sheets. Dimension of TNT was controlled by anodizing process parameters. Heat treatment affected the atomic structure of TNTs. Contact angle measurement as one of the important surface properties was conducted on different dimensions and structures of TNTs, to study human blood's physical interaction with the implant surface. In addition, the quality and quantity of bone material sediment on the surface were examined by SBF test and SEM analysis. Finally, cell culture provided informative data on bone cells' response to these nanotubular coatings by analyzing MTT results and SEM photography of cells. As a result, the optimum dimension and atomic structure of TNTs were defined and the required process parameters were introduced to obtain this state. This setup may be used as an optimum state of TNT as a nano-dimension coating on titanium implant with orthopedic functions to enhance the cell adhesion and acquire the highest proliferation rate. [ABSTRACT FROM AUTHOR]

Insufficient osseointegration and biofilm-associated bacterial infection are important challenges for clinical application of titanium (Ti)-based implants. Here, we constructed mesoporous polydopamine (MPDA) nanoparticles (NPs) loaded with luteolin (LUT, a quorum sensing inhibitor), which were further coated with the shell of calcium phosphate (CaP) to construct MPDA-LUT@CaP nanosystem. Then, MPDA-LUT@CaP NPs were immobilized on the surface of Ti implants. Under acidic environment of bacterial biofilm-infection, the CaP shell of MPDA-LUT@CaP NPs was rapidly degraded and released LUT, Ca2+ and PO43− from the surface of Ti implant. LUT could effectively inhibit and disperse biofilm. Furthermore, under near-infrared irradiation (NIR), the thermotherapy induced by the photothermal conversion effect of MPDA destroyed the integrity of the bacterial membrane, and synergistically led to protein leakage and a decrease in ATP levels. Combined with photothermal therapy (PTT) and quorum-sensing-inhibition strategy, the surface-functionalized Ti substrate had an antibacterial rate of over 95.59% against Staphylococcus aureus and the elimination rate of the formed biofilm was as high as 90.3%, so as to achieve low temperature and efficient treatment of bacterial biofilm infection. More importantly, the modified Ti implant accelerated the growth of cell and the healing process of bone tissue due to the released Ca2+ and PO43−. In summary, this work combined PTT with quorum-sensing-inhibition strategy provides a new idea for surface functionalization of implant for achieving effective antibacterial and osseointegration capabilities.

Titanium is the most commonly used material for the production of implants,but titanium dental implants are not immune to corrosion due to the complex oral cavity environments.The concentration of titanium ions increases in tissues around the implants due to the corrosion,leading to allergic reactions and inflammation,which hinder the long-term safe service of implants.In this paper,the research progress on corrosion of titanium implants was reviewed based on different types of influencing factors,including corrosion due to the effect of inorganics and organics,corrosion due to microorganisms and tribocorrosion.Besides,the future research was prospected.

The aim of this study was to determine the average amount of silicon ions on the surface of titanium implants after air abrasion with powders based on glycine and erythritol, and to measure the content of silicon ions in separated water-insoluble fractions of these powders. Methods and Results: The study investigated 2 air-abrasive powders, one based on glycine (Air-Flow Perio, EMS, Switzerland) and another on erythritol (Air-FlowPlus, EMS, Switzerland). These abrasives were tested for solubility in water and the content of Si+ in insoluble fractions of these powders. Also, the weight percent (wt %) of Si+ was measured on the surface of failed titanium implants after air abrasion with Air-Flow Perio (Group 1) and Air-FlowPlus (Group 2). Scanning electron microscopy and determining the elemental composition of obtained samples were carried out on an SEM-EVO MA 10 (Carl Zeiss) and energy dispersive X-ray spectrometer with EDS Aztec Energy Advanced X-Act (Oxford Instruments). It was found that air-abrasive mixtures based on glycine and erythritol are not completely soluble in water due to the presumed presence of silica in them. It was also found that air-abrasive cleaning of contaminated dental implants with an erythritol-based mixture contributed to a significant increase (P=0.000) in the Si+ content on their surfaces in comparison to implants treated with glycine-based powder.