Synthetic Calcium-Phosphate Materials for Bone Grafting.

Synthetic bone grafting materials play a significant role in various medical applications involving bone regeneration and repair. Their ability to mimic the properties of natural bone and promote the healing process has contributed to their growing relevance. While calcium-phosphates and their composites with various polymers and biopolymers are widely used in clinical and experimental research, the diverse range of available polymer-based materials poses challenges in selecting the most suitable grafts for successful bone repair. This review aims to address the fundamental issues of bone biology and regeneration while providing a clear perspective on the principles guiding the development of synthetic materials. In this study, we delve into the basic principles underlying the creation of synthetic bone composites and explore the mechanisms of formation for biologically important complexes and structures associated with the various constituent parts of these materials. Additionally, we offer comprehensive information on the application of biologically active substances to enhance the properties and bioactivity of synthetic bone grafting materials. By presenting these insights, our review enables a deeper understanding of the regeneration processes facilitated by the application of synthetic bone composites.

From Synthesis to Clinical Trial: Novel Bioinductive Calcium Deficient HA/ß-TCP Bone Grafting Nanomaterial.

Maxillary sinus augmentation is a commonly used procedure for the placement of dental implants. However, the use of natural and synthetic materials in this procedure has resulted in postoperative complications ranging from 12% to 38%. To address this issue, we developed a novel calcium deficient HA/ß-TCP bone grafting nanomaterial using a two-step synthesis method with appropriate structural and chemical parameters for sinus lifting applications. We demonstrated that our nanomaterial exhibits high biocompatibility, enhances cell proliferation, and stimulates collagen expression. Furthermore, the degradation of ß-TCP in our nanomaterial promotes blood clot formation, which supports cell aggregation and new bone growth. In a clinical trial involving eight cases, we observed the formation of compact bone tissue 8 months after the operation, allowing for the successful installation of dental implants without any early postoperative complications. Our results suggest that our novel bone grafting nanomaterial has the potential to improve the success rate of maxillary sinus augmentation procedures.

Nitrilotriacetic Acid Improves Plasma Electrolytic Oxidation of Titanium for Biomedical Applications.

Dental implants have become a routine, affordable, and highly reliable technology to replace tooth loss. In this regard, titanium and its alloys are the metals of choice for the manufacture of dental implants because they are chemically inert and biocompatible. However, for special cohorts of patients, there is still a need for improvements, specifically to increase the ability of implants to integrate into the bone and gum tissues and to prevent bacterial infections that can subsequently lead to peri-implantitis and implant failures. Therefore, titanium implants require sophisticated approaches to improve their postoperative healing and long-term stability. Such treatments range from sandblasting to calcium phosphate coating, fluoride application, ultraviolet irradiation, and anodization to increase the bioactivity of the surface. Plasma electrolytic oxidation (PEO) has gained popularity as a method for modifying metal surfaces and delivering the desired mechanical and chemical properties. The outcome of PEO treatment depends on the electrochemical parameters and composition of the bath electrolyte. In this study, we investigated how complexing agents affect the PEO surfaces and found that nitrilotriacetic acid (NTA) can be used to develop efficient PEO protocols. The PEO surfaces generated with NTA in combination with sources of calcium and phosphorus were shown to increase the corrosion resistance of the titanium substrate. They also support cell proliferation and reduce bacterial colonization and, hence, lead to a reduction in failed implants and repeated surgeries. Moreover, NTA is an ecologically favorable chelating agent. These features are necessary for the biomedical industry to be able to contribute to the sustainability of the public healthcare system. Therefore, NTA is proposed to be used as a component of the PEO bath electrolyte to obtain bioactive surface layers with properties desired for next-generation dental implants.

Bioactivity Performance of Pure Mg after Plasma Electrolytic Oxidation in Silicate-Based Solutions.

The biodegradable metals, including magnesium (Mg), are a convenient alternative to permanent metals but fast uncontrolled corrosion limited wide clinical application. Formation of a barrier coating on Mg alloys could be a successful strategy for the production of a stable external layer that prevents fast corrosion. Our research was aimed to develop an Mg stable oxide coating using plasma electrolytic oxidation (PEO) in silicate-based solutions. 99.9% pure Mg alloy was anodized in electrolytes contained mixtures of sodium silicate and sodium fluoride, calcium hydroxide and sodium hydroxide. Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), contact angle (CA), Photoluminescence analysis and immersion tests were performed to assess structural and long-term corrosion properties of the new coating. Biocompatibility and antibacterial potential of the new coating were evaluated using U2OS cell culture and the gram-positive Staphylococcus aureus (S. aureus, strain B 918). PEO provided the formation of a porous oxide layer with relatively high roughness. It was shown that Ca(OH)2 was a crucial compound for oxidation and surface modification of Mg implants, treated with the PEO method. The addition of Ca2+ ions resulted in more intense oxidation of the Mg surface and growth of the oxide layer with a higher active surface area. Cell culture experiments demonstrated appropriate cell adhesion to all investigated coatings with a significantly better proliferation rate for the samples treated in Ca(OH)2-containing electrolyte. In contrast, NaOH-based electrolyte provided more relevant antibacterial effects but did not support cell proliferation. In conclusion, it should be noted that PEO of Mg alloy in silicate baths containing Ca(OH)2 provided the formation of stable biocompatible oxide coatings that could be used in the development of commercial degradable implants.

Effects of the sources of calcium and phosphorus on the structural and functional properties of ceramic coatings on titanium dental implants produced by plasma electrolytic oxidation.

Plasma Electrolytic Oxidation (PEO) is as a promising technique to modify metal surfaces by application of oxide ceramic coatings with appropriate physical, chemical and biological characteristics. Therefore, objective of this research was to find the simplest settings, yet able to produce relevant bioactive implant surfaces layers on Ti implants by means of PEO. We show that an electrolyte containing potassium dihydrogen phosphate as a source of P and either calcium hydroxide or calcium formate as a source of Ca in combination with a chelating agent, ethylenediamine tetraacetic acid (EDTA), is suitable for PEO to deliver coatings with desired properties. We determined surface morphology, roughness, wettability, chemical and phase composition of titanium after the PEO process. To investigate biocompatibility and bacterial properties of the PEO oxide coatings we used microbial and cell culture tests. The electrolyte based on Ca(OH)2 and EDTA promotes active crystallization of apatites after PEO processing of the Ti implants. The PEO layers can increase electrochemical corrosion resistance. The PEO can be potentially used for development of bioactive surfaces with increased support of eukaryotic cells while inhibiting attachment and growth of bacteria without use of antibacterial agents.

Biocompatibility and Antibacterial Properties of ZnO-Incorporated Anodic Oxide Coatings on TiZrNb Alloy.

In a present paper, we demonstrate novel approach to form ceramic coatings with incorporated ZnO nanoparticles (NPs) on low modulus TiZrNb alloy with enhanced biocompatibility and antibacterial parameters. Plasma Electrolytic Oxidation (PEO) was used to integrate ZnO nanoparticles (average size 12-27 nm), mixed with Ca(H2PO2)2 aqueous solution into low modulus TiZrNb alloy surface. The TiZrNb alloys with integrated ZnO NPs successfully showed higher surface porosity and contact angle. XPS investigations showed presence of Ca ions and absence of phosphate ions in the PEO modified layer, what explains higher values of contact angle. Cell culture experiment (U2OS type) confirmed that the surface of as formed oxide-ZnO NPs demonstrated hydrophobic properties, what can affect primary cell attachment. Further investigations showed that Ca ions in the PEO coating stimulated proliferative activity of attached cells, resulting in competitive adhesion between cells and bacteria in clinical situation. Thus, high contact angle and integrated ZnO NPs prevent bacterial adhesion and considerably enhance the antibacterial property of TiZrNb alloys. A new anodic oxide coating with ZnO NPs could be successfully used for modification of low modulus alloys to decrease post-implantation complications.

Formation of a Bacteriostatic Surface on ZrNb Alloy via Anodization in a Solution Containing Cu Nanoparticles.

High strength, excellent corrosion resistance, high biocompatibility, osseointegration ability, and low bacteria adhesion are critical properties of metal implants. Additionally, the implant surface plays a critical role as the cell and bacteria host, and the development of a simultaneously antibacterial and biocompatible implant is still a crucial challenge. Copper nanoparticles (CuNPs) could be a promising alternative to silver in antibacterial surface engineering due to low cell toxicity. In our study, we assessed the biocompatibility and antibacterial properties of a PEO (plasma electrolytic oxidation) coating incorporated with CuNPs (Cu nanoparticles). The structural and chemical parameters of the CuNP and PEO coating were studied with TEM/SEM (Transmission Electron Microscopy/Scanning Electron Microscopy), EDX (Energy-Dispersive X-ray Dpectroscopy), and XRD (X-ray Diffraction) methods. Cell toxicity and bacteria adhesion tests were used to prove the surface safety and antibacterial properties. We can conclude that PEO on a ZrNb alloy in Ca-P solution with CuNPs formed a stable ceramic layer incorporated with Cu nanoparticles. The new surface provided better osteoblast adhesion in all time-points compared with the nontreated metal and showed medium grade antibacterial activities. PEO at 450 V provided better antibacterial properties that are recommended for further investigation.

New Zr-Ti-Nb Alloy for Medical Application: Development, Chemical and Mechanical Properties, and Biocompatibility.

The concept of mechanical biocompatibilities is considered an important factor for orthopedics and dental implants. The high Young modulus of traditional Ti-based alloys can lead to stress-shielding syndrome and late postoperative complications. The development of new Al- and V-free Ti alloys with a low elastic modulus is a critical task for implantology. Despite the relatively low Young modulus and appropriate biological response of metastable beta-Ti alloys, their production requires complex metallurgical solutions and a high final cost that limit commercial application. The current research aimed to develop a Zr-Ti-Nb system with a low Young modulus suitable for biomedical application, including orthopedics and dental implantology. Two different charges were used for new alloy production with melting in a vacuum-arc furnace VDP-1 under atmospheric control (argon + helium) with a non-consumable tungsten electrode and a water-cooled copper crystallizer. Post-treatment included a forging-rolling process to produce a bar suitable for implant production. SEM with EDX and the mechanical parameters of the new alloy were evaluated, and a cell culture experiment provided a biocompatibility assessment. The chemical composition of the new alloy can be represented as 59.57-19.02-21.41 mass% of Zr-Ti-Nb. The mechanical properties are characterized by an extremely low Young modulus-27,27 GPa for the alloy and 34.85 GPa for the bar. The different master alloys used for Zr-Ti-Nb production did not affect the chemical compound and mechanical parameters so it was possible to use affordable raw materials to decrease the final price of the new product. The cell culture experiment demonstrated a full biocompatibility, indicating that this new alloy can be used for dental and orthopedics implant production.

Ag Nanoparticle-Decorated Oxide Coatings Formed via Plasma Electrolytic Oxidation on ZrNb Alloy.

Plasma electrolytic oxidation (PEO) can provide an ideal surface for osteogenic cell attachment and proliferation with further successful osteointegration. However, the same surface is attractive for bacteria due to similar mechanisms of adhesion in prokaryotic and eukaryotic cells. This issue requires the application of additional surface treatments for effective prevention of postoperative infectious complications. In the present work, ZrNb alloy was treated in a Ca-P solution with Ag nanoparticles (AgNPs) for the development of a new oxide layer that hosted osteogenic cells and prevented bacterial adhesion. For the PEO, 0.5 M Ca(H2PO2)2 solution with 264 mg L-1 of round-shaped AgNPs was used. Scanning electron microscopy with energy-dispersive x-ray and x-ray photoelectron spectroscopy were used for morphology and chemical analysis of the obtained samples; the SBF immersion test, bacteria adhesion test, and osteoblast cell culture were used for biological investigation. PEO in a Ca-P bath with AgNPs provides the formation of a mesoporous oxide layer that supports osteoblast cell adhesion and proliferation. Additionally, the obtained surface with incorporated Ag prevents bacterial adhesion in the first 6 h after immersion in a pathogen suspension, which can be an effective approach to prevent infectious complications after implantation.

Cell and tissue response to nanotextured Ti6Al4V and Zr implants using high-speed femtosecond laser-induced periodic surface structures.

In this paper, the effect of femtosecond laser nanotexturing of surfaces of Ti6Al4V and Zr implants on their biological compatibility is presented and discussed. Highly regular and homogeneous nanostructures with sub-micrometer period were imprinted on implant surfaces. Surfaces were morphologically and chemically investigated by SEM and XPS. HDFa cell lines were used for toxicity and cell viability tests, and subcutaneous implantation was applied to characterize tissue response. HDFa proliferation and in vivo experiments evidenced the strong influence of the surface topography compared to the effect of the surface elemental composition (metal or alloy). The effect of protein adsorption from blood plasma on cell proliferation is also discussed.