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

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

Conferring NiTi alloy with controllable antibacterial activity and enhanced corrosion resistance by exploiting Ag@PDA films as a platform through a one-pot construction route.

The lack of antibacterial activity and the leaching of Ni ions seriously limit the potential applications of the near equiatomic nickel-titanium (NiTi) alloy in the biomedical field. In this study, a silver nanoparticles (Ag NPs) wrapped in a polydopamine (Ag@PDA) film modified NiTi alloy with controllable antibacterial activity and enhanced corrosion resistance was achieved using a one-pot approach in a mixed solution of AgNO3 and dopamine. The controllable antibacterial activity could be achieved by adjusting the initial concentration of dopamine (Cdop), which obtained Ag@PDA films with varying thickness of polydopamine layers coated on Ag NPs, thereby conferring different levels of antibacterial activity to the modified NiTi alloy. In vitro antibacterial ratios (24 h) of Ag@PDA film-modified NiTi alloy against E.coli and S.aureus ranged from 46 % to 100 % and from 42 % to 100 %, respectively. The release curves of Ag ions indicated the persistent antibacterial effect of Ag@PDA film-modified NiTi alloy for at least 21 days. Moreover, in vitro cytotoxicity and in vivo implantation tests demonstrated the satisfactory biosafety of the Ag@PDA film-modified NiTi alloy when used as bioimplants. This research offers valuable insight into meeting various antibacterial demands for NiTi alloy implantations and highlights the potential of Ag-containing film-modified biomaterials in addressing different types of infections induced by implantations.

Microstructural characterization of gadolinium-rich phases in titanium alloys.

This study explores the microstructural characteristics of gadolinium (Gd)-rich phases in titanium (Ti) alloys through comprehensive electron microscopy analysis. The Ti alloys were produced using plasma arc melting and subsequently hot-forged. Elaborate material characterization, including scanning electron microscopy, electron backscatter diffraction, and energy dispersive spectroscopy, revealed the formation of round or angular Gd oxides and elongated Gd-rich grains within the alloy. High-magnification transmission electron microscopy and X-ray diffraction confirmed the presence of the FCC-type γ-Gd phase, influenced by the oxygen intake during casting, coexisting with Gd2O3 due to their similar crystal structures. The study also observed internal twins in the Gd grains, potentially delaying the transformation to the stable α-Gd phase. The significant mechanical property differences between the Gd-rich phases and the Ti matrix caused defects at phase interfaces during hot processing, weakening the Gd phase. This work enhances the understanding of Gd phase formation and its implications on the mechanical properties of Ti-Gd alloys.

The Role of Deformation and Microstructure Evolution on Texture Formation of a TA15 Alloy Subjected to Plane Strain Compression.

In this study, the texture formation mechanism of a TA15 titanium alloy under different plane strain compression conditions was investigated by analyzing the slipping, dynamic recrystallization (DRX) and phase transformation behaviors. The results indicated that the basal texture component basically appears under all conditions, since the dominant basal slip makes the C-axis of the α grain rotate to the normal direction (ND, i.e., compression direction), but it has a different degree of deflection. With an increase in deformation amount, temperature or strain rate, {0001} poles first approach the ND and then deviate from it. Such deviation is mainly caused by a change in slip behaviors and phase transformation. At a smaller deformation amount and higher strain rate, inhomogeneous deformation easily causes a basal slip preferentially arising from the grain with a soft orientation, resulting in a weak basal texture component. A greater deformation amount can increase the principal strain ratio, thereby promoting other slip systems to be activated, and a lower temperature can increase the critical shear stress of the basal slip, further causing a dispersive orientation under these conditions. At a higher temperature and a lower strain rate, apparent phase transformation will induce the occurrence of lamellar α whose orientation obeys the Burgers orientation of the ß phase, thereby disturbing and weakening the deformation texture. As for DRX, continuous-type (CDRX) is most common under most conditions, whereas CDRX grains have a similar orientation to deformed grains, so DRX has little effect on overall texture. Moreover, the microhardness of samples is basically inversely proportional to the grain size, and it can be significantly improved as lamellar α occurs. In addition, deformed samples with a weaker texture present a higher microhardness due to the smaller Schmidt factors of the activated prism slip at ambient loading.

The Influence of Adding B4C and CeO2 on the Mechanical Properties of Laser Cladding Nickel-Based Coatings on the Surface of TC4 Titanium Alloy.

The development of titanium alloys is limited by issues such as low hardness, poor wear resistance, and sensitivity to adhesive wear. Using laser cladding technology to create high-hardness wear-resistant coatings on the surface of titanium alloys is an economical and efficient method that can enhance their surface hardness and wear resistance. This paper presents the preparation of two types of nickel-based composite coatings, Ni60-Ti-Cu-xB4C and Ni60-Ti-Cu-B4C-xCeO2, on the surface of TC4 titanium alloy using laser cladding. When the B4C addition was 8 wt.%, the hardness of the cladding layer was the highest, with an average microhardness of 1078 HV, which was 3.37 times that of the TC4 substrate. The friction coefficient was reduced by 24.7% compared to the TC4 substrate, and the wear volume was only 2.7% of that of the substrate material. When the CeO2 content was 3 wt.%, the hardness of the cladding layer was the highest, with an average microhardness of 1105 HV, which was 3.45 times that of the TC4 substrate. The friction coefficient was reduced by 33.7% compared to the substrate material, and the wear volume was only 1.8% of that of the substrate material.

Comparison of Single or Double Titanium Mesh Cage for Anterior Reconstruction After Total En Bloc Spondylectomy for Thoracic and Lumbar Spinal Tumors.

OBJECTIVE: To compare the clinical efficacy of anterior column reconstruction using single or double titanium mesh cage (TMC) after total en bloc spondylectomy (TES) of thoracic and lumbar spinal tumors. METHODS: A retrospective cohort study was performed involving 39 patients with thoracic or lumbar spinal tumors. All patients underwent TES, followed by anterior reconstruction and screw-rod instrumentation via a posterior-only procedure. Twenty-two patients in group A were treated with a single TMC to reconstruct the anterior column, whereas 17 patients in group B were reconstructed with double TMCs. RESULTS: The overall follow-up is 20.5 ± 4.6 months. There is no significant difference between the 2 groups regarding age, sex, body mass index, tumor location, operative time, and intraoperative blood loss. The time for TMC placement was significantly shortened in the double TMCs group (5.2 ± 1.3 minutes vs. 15.6 ± 3.3 minutes, p = 0.004). Additionally, postoperative neural complications were significantly reduced with double TMCs (5/22 vs. 0/17, p = 0.046). The kyphotic Cobb angle and mean intervertebral height were significantly corrected in both groups (p ≤ 0.001), without obvious loss of correction at the last follow-up in either group. The bone fusion rates for single TMC and double TMCs were 77.3% and 76.5%, respectively. CONCLUSION: Using 2 smaller TMCs instead of a single large one eases the placement of TMC by shortening the time and avoiding nerve impingement. Anterior column reconstruction with double TMC is a clinically feasible, and safe alternative following TES for thoracic and lumbar tumors.

Three-Dimensional-Printed Modular Titanium Alloy Plates for Osteosynthesis of the Jawbone.

BACKGROUNDS: The titanium-aluminum-vanadium alloy (Ti-6Al-4V) is frequently used in implantology due to its biocompatibility. The use of 3D printing enables the mechanical modification of implant structures and the adaptation of their shape to the specific needs of individual patients. METHODS: The titanium alloy plates were designed using the 3D CAD method and printed using a 3D SLM printer. Qualitative tests were performed on the material surface using a microcomputed tomography scanner. The cytotoxicity of the modular titanium plates was investigated using the MTT assay on the L929 cell line and in direct contact with Balb/3T3 cells. Cell adhesion to the material surface was evaluated with hFOB1.19 human osteoblasts. Microbial biofilm formation was investigated on strains of Lactobacillus rhamnosus, Staphylococcus epidermidis, Streptococcus mutans and Candida albicans using the TTC test and scanning electron microscopy (SEM). RESULTS: The surface analysis showed the hydrophobic nature of the implant. The study showed that the titanium plates had no cytotoxic properties. In addition, the material surface showed favorable properties for osteoblast adhesion. Among the microorganisms tested, the strains of S. mutans and S. epidermidis showed the highest adhesion capacity to the plate surface, while the fungus C. albicans showed the lowest adhesion capacity. CONCLUSIONS: The manufactured modular plates have properties that are advantageous for the implantation and reduction in selected forms of microbial biofilm. Three-dimensional-printed modular titanium plates were investigated in this study and revealed the potential clinical application of this type of materials, regarding lack of cytotoxicity, high adhesion properties for osteoblasts and reduction in biofilm formation. The 3D CAD method allows us to personalise the shape of implants for individual patients.

On Strain-Hardening Behavior and Ductility of Laser Powder Bed-Fused Ti6Al4V Alloy Heat-Treated above and below the ß-Transus.

Laser powder bed-fused Ti6Al4V alloy has numerous applications in biomedical and aerospace industries due to its high strength-to-weight ratio. The brittle α'-martensite laths confer both the highest yield and ultimate tensile strengths; however, they result in low elongation. Several post-process heat treatments must be considered to improve both the ductility behavior and the work-hardening of as-built Ti6Al4V alloy, especially for aerospace applications. The present paper aims to evaluate the work-hardening behavior and the ductility of laser powder bed-fused Ti6Al4V alloy heat-treated below (704 and 740 °C) and above (1050 °C) the ß-transus temperature. Microstructural analysis was carried out using an optical microscope, while the work-hardening investigations were based on the fundamentals of mechanical metallurgy. The work-hardening rate of annealed Ti6Al4V samples is higher than that observed in the solution-heat-treated alloy. The recrystallized microstructure indeed shows higher work-hardening capacity and lower dynamic recovery. The Considère criterion demonstrates that all analyzed samples reached necking instability conditions, and uniform elongations (>7.8%) increased with heat-treatment temperatures.

Impact of Heat Treatment on the Mechanical Properties and Fracture Morphology of Ti555211 Alloy.

Heat treatment is important for optimizing the strength performance and improving the toughness of titanium alloys. In this study, we investigated the impact of three heat treatment methods (ß-annealing, double annealing, and solid-solution and aging treatment) on the mechanical properties and fracture morphology of Ti555211 titanium alloy. The results show that after ß-annealing treatment, the alloy retains a high strength, while showing almost no ductility, and no yield strength. The alloy after double annealing has a high elongation rate (~54%) and lower strength. After solid-solution and aging heat treatment, the alloy was able to retain both high strength and a certain degree of ductility. The optimal heat-treatment process is solid-solution treatment at 820 °C/2 h and aging at 560 °C/12 h, which results in a maximum tensile strength of 1404 MPa and an elongation rate of 11%.

The Chemistry-Process-Structure Relationships of a Functionally Graded Ti-6Al-4V/Ti-1B Alloy Processed with Laser-Engineered Net Shaping Creates Borlite.

We quantify the chemistry-process-structure-property relationships of a Ti-6Al-4V alloy in which titanium-boron alloy (Ti-B) was added in a functionally graded assembly through a laser-engineered net shaping (LENS) process. The material gradient was made by pre-alloyed powder additions to form an in situ melt of the prescribed alloy concentration. The complex heterogeneous structures arising from the LENS thermal history are completely discussed for the first time, and we introduce a new term called "Borlite", a eutectic structure containing orthorhombic titanium monoboride (TiB) and titanium. The ß-titanium grain size decreased nonlinearly until reaching the minimum when the boron weight fraction reached 0.25%. Similarly, the transformed α-titanium grain size decreased nonlinearly until reaching the minimum level, but the grain size was approximately 2 µm when the boron weight fraction reached 0.6%. Alternatively, the α-titanium grain size increased nonlinearly from 1 to 5 µm as a function of the aluminum concentration increasing from 0% to 6% aluminum by weight and vanadium increasing from 0% to 4% by weight. Finally, the cause-effect relationships related to the creation of unwanted porosity were quantified, which helps in further developing additively manufactured metal alloys.

Structure and Properties of Metastable ß Ti-25Nb-8Sn Alloy following Cold Rolling and Aging Treatments.

Metal implants require an elastic modulus close to cortical bone (<30 GPa) to avoid stress shielding and ensure adequate load-bearing strength. The metastable ß-type Ti-25Nb-8Sn alloy has a low elastic modulus (52 GPa), but its yield strength (<500 MPa) needs enhancement. This study enhances Ti-25Nb-8Sn's elastic admissible strain through cold rolling and aging heat treatments, investigating the microstructure's impact on mechanical and corrosion properties. The results show that lower-temperature aging (<450 °C) leads to ω-phase precipitation, yielding a 300% increase in yield strength (>1900 MPa). However, this also increases the elastic modulus (~80 GPa), limiting the deformation ability. Higher-temperature aging (>500 °C) eliminates the ω phase, transforming it into α precipitates, resulting in a lower elastic modulus (~65 GPa) and improved deformation ability, with substantial yield strength (>1000 MPa). In summary, the optimal process conditions are determined as 90% cold rolling followed by aging treatment at 550 °C. Under these conditions, Ti-25Nb-8Sn achieves the most suitable yield strength (1207 MPa) and high corrosion resistance, retaining a relatively low elastic modulus (64.7 GPa) and high elastic admissible strain (1.93%). This positions it as an ideal material for biomedical implants.

Processing Optimization for Halbach Array Magnetic Field-Assisted Magnetic Abrasive Particles Polishing of Titanium Alloy.

To extend the working life of products made of titanium alloy, it is necessary to improve the polishing method to diminish the remaining defects on the workpiece surface. The Halbach array-assisted magnetic abrasive particle polishing method for titanium alloy was employed in this work. The distribution of magnetic field strength was simulated and verified at first to learn the characteristics of the Halbach array used in this work. Then, the polishing performance of the polishing tool was studied by conducting the polishing test, which aimed to display the relationship between shear force and surface roughness with polishing time, and the surface morphology during polishing was also analyzed. Following the establishment of the response surface model, a study on the optimal polishing parameters was conducted to obtain the suitable parameters for maximum shear force and minimum surface roughness. The results show that the maximum shear force 6.11 N and minimum surface roughness Sa 88 nm can be attained, respectively, under the conditions of (1) polishing tool speed of 724.254 r·min-1, working gap of 0.5 mm, and abrasive particle size of 200 µm; and (2) polishing tool speed of 897.87 r·min-1, working gap of 0.52 mm, and abrasive particle size of 160 µm.

Analysis of the Microstructure and Mechanical Performance of Resistance Spot-Welding of Ti6Al4V to DP600 Steel Using Copper/Gold Cold-Sprayed Interlayers.

In this article, an attempt was made to join DP600 steel and Ti6Al4V titanium alloy sheets by resistance spot-welding (RSW) using an interlayer in the form of Cu and Au layers fabricated through the cold-spraying process. The welded joints obtained by RSW without an interlayer were also considered. The influence of Cu and Au as an interlayer on the resulting microstructure as well as mechanical properties (shear force and microhardness) of the joints were determined. A typical type of failure of Ti6Al4V/DP600 joints produced without the use of an interlayer is brittle fracture. The microstructure of the resulting joint consisted mainly of the intermetallic phases FeTi and Fe2Ti. The microstructure of the Ti6Al4V/Au/DP600 joint contained the intermetallic phases Ti3Au, TiAu, and TiAu4. The intermetallic phases TiCu and FeCu were found in the microstructure of the Ti6Al4V/Cu/DP600 joint. The maximum tensile/shear stress was 109.46 MPa, which is more than three times higher than for a welded joint fabricated without the use of Cu or Au interlayers. It has been observed that some alloying elements, such as Fe, can lower the martensitic transformation temperature, and some, such as Au, can increase the martensitic transformation temperature.

Effect of Co-Sputtered Copper and Titanium Oxide Coatings on Bacterial Resistance and Cytocompatibility of Osteoblast Cells.

One of the primary risk factors for implant failure is thought to be implant-related infections during the early healing phase. Developing coatings with cell stimulatory behaviour and bacterial adhesion control is still difficult for bone implants. This study proposes an approach for one-step deposition of biocompatible and antimicrobial Cu-doped TiO2 coatings via glow-discharge sputtering of a mosaic target. During the deposition, the bias of the Ti6Al4V substrates was changed. Structure examination, phase analysis, and surface morphology were carried out using X-ray diffraction (XRD) analysis, scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS). The hardness values and hydrophilic and corrosion performance were also evaluated together with cytocompatible and antibacterial examinations against E. coli and S. aureus. The results show great chemical and phase control of the bias identifying rutile, anatase, CuO, or ternary oxide phases. It was found that by increasing the substrate bias from 0 to -50 V the Cu content increased from 15.3 up to 20.7 at% while at a high bias of -100 V, the copper content reduced to 3 at%. Simultaneously, apart from the Cu2+ state, Cu1+ is also found in the biased samples. Compared with the bare alloy, the hardness, the water contact angle and corrosion resistance of the biased coatings increased. According to an assessment of in vitro cytocompatibility, all coatings were found to be nontoxic to MG-63 osteoblast cells over the time studied. Copper release and cell-surface interactions generated an antibacterial effect against E. coli and S. aureus strains. The -50 V biased coating combined the most successful results in inhibiting bacterial growth and eliciting the proper responses from osteoblastic cells because of its phase composition, electrochemical stability, hydrophilicity, improved substrate adhesion, and surface roughness. Using this novel surface modification approach, we achieved multifunctionality through controlled copper content and oxide phase composition in the sputtered films.

Selective Tumor Inhibition Effect of Drug-Free Layered Double Hydroxide-Based Films via Responding to Acidic Microenvironment.

Nickel-titanium alloy stents are widely used in the interventional treatment of various malignant tumors, and it is important to develop nickel-titanium alloy stents with selective cancer-inhibiting and antibacterial functions to avoid malignant obstruction caused by tumor invasion and bacterial colonization. In this work, an acid-responsive layered double hydroxide (LDH) film was constructed on the surface of a nickel-titanium alloy by hydrothermal treatment. The release of nickel ions from the film in the acidic tumor microenvironment induces an intracellular oxidative stress response that leads to cell death. In addition, the specific surface area of LDH nanosheets could be further regulated by heat treatment to modulate the release of nickel ions in the acidic microenvironment, allowing the antitumor effect to be further enhanced. This acid-responsive LDH film also shows a good antibacterial effect against S. aureus and E. coli. Besides, the LDH film prepared without the introduction of additional elements maintains low toxicity to normal cells in a normal physiological environment. This work offers some guidance for the design of a practical nickel-titanium alloy stent for the interventional treatment of tumors.

Oral and Extra-Oral Manifestations of Hypersensitivity Reactions in Orthodontics: A Comprehensive Review.

Although rare, oral manifestations of hypersensitivity reactions in orthodontic patients pose a significant clinical challenge due to their heterogeneous presentations, and can cause discomfort and pain, possibly impacting patients' quality of life and orthodontic treatment duration and outcomes. This comprehensive review aimed to elucidate the oral, perioral, and systemic manifestations of hypersensitivity reactions in orthodontic subjects, focusing on patients with fixed appliances, removable appliances, and clear aligners, and detailing their epidemiology, macroscopic and microscopic features, allergy testing, clinical implications, and specific management strategies. Oral and extra-oral manifestations of (immediate and delayed) hypersensitivity reactions occur rarely and are due to the release of metal and non-metal ions from orthodontic appliances. They typically present as erythema, erosive-ulcerative lesions, and gingival hyperplasia, with histopathological findings showing inflammatory infiltrates. Nickel is a significant allergen, and diagnostic tests like patch tests are essential for managing these reactions. Likely due to prolonged contact with oral tissues, fixed orthodontic appliances pose a higher risk compared to removable appliances and clear aligners. Early identification and removal of allergenic materials, combined with effective treatments, can resolve symptoms and prevent recurrence. Keeping dental and medical records updated and knowing family and personal medical histories helps clinicians choose appropriate materials and counsel patients about potential risks. Proper patient education, regular monitoring, and using hypoallergenic materials are key strategies for managing these reactions.

Hydroxyapatite-Coated Ti6Al4V ELI Alloy: In Vitro Cell Adhesion.

The high rate of rejection and failure of orthopedic implants is primarily attributed to incomplete osseointegration and stress at the implant-to-bone interface due to significant differences in the mechanical properties of the implant and the surrounding bone. Various surface treatments have been developed to enhance the osteoconductive properties of implants. The aim of this work was the in vitro characterization of titanium alloy modified with a nanocrystalline hydroxyapatite surface layer in relative comparison to unmodified controls. This investigation focused on the behavior of the surface treatment in relation to the physiological environment. Moreover, the osteogenic response of human osteoblasts and adipose stem cells was assessed. Qualitative characterization of cellular interaction was performed via confocal laser scanning microscopy focusing on the cell nuclei and cytoskeletons. Filipodia were assessed using scanning electron microscopy. The results highlight that the HA treatment promotes protein adhesion as well as gene expression of osteoblasts and stem cells, which is relevant for the inorganic and organic components of the extracellular matrix and bone. In particular, cells grown onto HA-modified titanium alloy are able to promote ECM production, leading to a high expression of collagen I and non-collagenous proteins, which are crucial for regulating mineral matrix formation. Moreover, they present an impressive amount of filipodia having long extensions all over the test surface. These findings suggest that the HA surface treatment under investigation effectively enhances the osteoconductive properties of Ti6Al4V ELI.

In-Depth Characterization of Two Bioactive Coatings Obtained Using MAPLE on TiTaZrAg.

TiZrTaAg alloy is a remarkable material with exceptional properties, making it a unique choice among various industrial applications. In the present study, two types of bioactive coatings using MAPLE were obtained on a TiZrTaAg substrate. The base coating consisted in a mixture of chitosan and bioglass in which zinc oxide and graphene oxide were added. The samples were characterized in-depth through a varied choice of methods to provide a more complete picture of the two types of bioactive coating. The analysis included Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), ellipsometry, and micro-Raman. The Vickers hardness test was used to determine the hardness of the films and the penetration depth. Film adhesion forces were determined using atomic force microscopy (AFM). The corrosion rate was highlighted by polarization curves and by using electrochemical impedance spectroscopy (EIS). The performed tests revealed that the composite coatings improve the properties of the TiZrTaAg alloy, making them feasible for future use as scaffold materials or in implantology.

Development of Rapid Bioactivity-Expressed Zr-50Ti Alloys by Surface Treatment with Modified Simulated Body Fluid.

Zr-50Ti alloys are promising biomaterials due to their excellent mechanical properties and low magnetic susceptibility. However, Zr-50Ti alloys do not inherently bond well with bone. This study aims to enhance the bioactivity and bonding strength of Zr-50Ti alloys for orthopedic implant materials. Initially, the surface of Zr-50Ti alloys was treated with a sulfuric acid solution to create a microporous structure, increasing surface roughness and area. Subsequently, low crystalline calcium phosphate (L-CaP) precipitation was controlled by adding Mg2+ and/or CO32- ions in modified simulated body fluid (m-SBF). The treated Zr-50Ti alloys were then subjected to cold isostatic pressing to force m-SBF into the micropores, followed by incubation to allow L-CaP formation. The apatite-forming process was tested in simulated body fluid (SBF). The results demonstrated that the incorporation of Mg2+ and/or CO32- ions enabled the L-CaP to cover the entire surface of Zr-50Ti alloys within only one day. After short-term soaking in SBF, the L-CaP layer, modulated by Mg2+ and/or CO32- ions, formed a uniform hydroxyapatite (HA) coating on the surface of the Zr-50Ti alloys, showing potential for optimized bone integration. After soaking in SBF for 14 days, the bonding strength between the apatite layer and alloy has the potential to meet the orthopedic application requirement of 22 MPa. This study demonstrates an effective method to enhance the bioactivity and bonding strength of Zr-50Ti alloys for orthopedic applications.

Robot-Assisted Correction of a Supra-Long Tracheal Stenosis Using C-Type Nickel-Titanium Alloy Exterior Stenting and Suspension Fixation Technique: A Case Report.

T-tubes and airway stents are commonly used but have limited effectiveness and frequent complications. A 50-year-old male patient presented with severe tracheal stenosis, affecting an 8.7 cm length of the airway. We employed an innovative approach known as external suspension fixation of tracheal stent using robotic assistance. This method involves surgically attaching the stent to the exterior of the trachea to provide support and stabilize the softened or collapsed tracheal segments. We designed a C-shaped nickel-titanium alloy exterior stent and successfully fixed it using robotic assistance. This intervention effectively restored tracheal function and led to a favorable postoperative recovery. The technique does not affect tracheal membrane function or airway mucociliary clearance. It could potentially be considered as a new option for treating long-segment benign tracheal softening or collapse.