Improved in vitro angiogenic behavior on anodized titanium dioxide nanotubes.

BACKGROUND: Neovascularization over dental implants is an imperative requisite to achieve successful osseointegration onto implanted materials. The aim of this study was to investigate the effects on in vitro angiogenesis of anodized 70 nm diameter TiO2 nanotubes (NTs) on Ti6Al4V alloy synthesized and disinfected by means of a novel, facile, antibacterial and cost-effective method using super oxidized water (SOW). We also evaluated the role of the surface roughness and chemical composition of materials of materials on angiogenesis. METHODS: The Ti6Al4V alloy and a commercially pure Ti were anodized using a solution constituted by SOW and fluoride as electrolyte. An acid-etched Ti6Al4V was evaluated to compare the effect of micro-surface roughness. Mirror-polished materials were used as control. Morphology, roughness, chemistry and wettability were assessed by field emission scanning electron microscopy (FE-SEM), transmission electron microscopy, atomic force microscopy, energy dispersive X-ray spectroscopy (EDX) and using a professional digital camera. Bovine coronary artery endothelial cells (BCAECs) were seeded over the experimental surfaces for several incubation times. Cellular adhesion, proliferation and monolayer formation were evaluated by means of SEM. BCAEC viability, actin stress fibers and vinculin cellular organization, as well as the angiogenic receptors vascular endothelial growth factor 2 (VEGFR2) and endothelial nitric oxide synthase (eNOS) were measured using fluorescence microscopy. RESULTS: The anodization process significantly increased the roughness, wettability and thickness of the oxidized coating. EDX analysis demonstrated an increased oxygen (O) and decreased carbon (C) content on the NTs of both materials. Endothelial behavior was solidly supported and improved by the NTs (without significant differences between Ti and alloy), showing that endothelial viability, adhesion, proliferation, actin arrangement with vinculin expression and monolayer development were evidently stimulated on the nanostructured surface, also leading to increased activation of VEGFR2 and eNOS on Ti6Al4V-NTs compared to the control Ti6Al4V alloy. Although the rougher alloy promoted BCAECs viability and proliferation, filopodia formation was poor. CONCLUSION: The in vitro results suggest that 70 nm diameter NTs manufactured by anodization and cleaned using SOW promotes in vitro endothelial activity, which may improve in vivo angiogenesis supporting a faster clinical osseointegration process.

Enhanced antifungal activity by disinfected titanium dioxide nanotubes via reduced nano-adhesion bonds.

We have provided evidence that the beneficial effect of super-oxidized water (SOW) disinfected Ti6Al4V-TiO2 nanotubes (NTs) can reduce bacterial adhesion and biofilm formation. However, the need of antifungal nanostructured surfaces with osteoactive capabilities is an important goal that has been arising for dental implants (DI) applications. Thus, in the present study we isolated and tested the effects of Candida albicans (C. albicans) on disinfected, wetter and nanoroughness NTs compared to a non-modified control. Moreover, we elucidated part of the fungal adhesion mechanism by studying and relating the mycotic adhesion kinetics and the formation of fungal nanoadhesion bonds among the experimental materials, to gain new insight of the fungal-material-interface. Similarly, the initial behavior of human alveolar bone osteoblasts (HAOb) was microscopically evaluated. NTs significantly reduced the yeasts adhesion and viability with non-outcomes of biofilm than the non-modified surface. Cross-sectioning of the fungal cells revealed promoted nano-contact bonds with superior fungal spread on the control alloy interface; meanwhile NTs evidenced decreased tendency along time; suggesting, down-regulation by the nanostructured morphology and the SOW treatment. Importantly, the initial performance of HAOb demonstrated strikingly promoted anchorage with effects of filopodia formation and increased vital cell on NTs with SOW. The present study proposes SOW treatment as an active protocol for synthesis and disinfection of NTs with potent antifungal capability, acting in part by the reduction of nano-adhesion bonds at the surface-fungal interface; opening up a novel route for the investigation of mycotic-adhesion processes at the nanoscale for bone implants applications.

Disinfection of titanium dioxide nanotubes using super-oxidized water decrease bacterial viability without disrupting osteoblast behavior.

Amorphous titanium dioxide (TiO2) nanotubes (NTs) on Ti6Al4V alloy were synthesized by anodization using a commercially available super-oxidized water (SOW). The NT surfaces were sterilized by ultraviolet (UV) irradiation and disinfected using SOW. The adhesion and cellular morphology of pig periosteal osteoblast (PPO) cells and the behavior of Staphylococcus aureus (S. aureus) cultured on the sterilized and disinfected surfaces were investigated. A non-anodized Ti6Al4V disc sterilized by UV irradiation (without SOW) was used as control. The results of this study reveal that the adhesion, morphology and filopodia development of PPO cells in NTs are dramatically improved, suggesting that SOW cleaning may not disrupt the benefits obtained by NTs. Significantly decreased bacterial viability in NTs after cleaning with SOW and comparing with non-cleaned NTs was seen. The results suggest that UV and SOW could be a recommendable method for implant sterilization and disinfection without altering osteoblast behavior while decreasing bacterial viability.

Improved Osteoblast and Chondrocyte Adhesion and Viability by Surface-Modified Ti6Al4V Alloy with Anodized TiO2 Nanotubes Using a Super-Oxidative Solution.

Titanium (Ti) and its alloys are amongst the most commonly-used biomaterials in orthopedic and dental applications. The Ti-aluminum-vanadium alloy (Ti6Al4V) is widely used as a biomaterial for these applications by virtue of its favorable properties, such as high tensile strength, good biocompatibility and excellent corrosion resistance. TiO2 nanotube (NTs) layers formed by anodization on Ti6Al4V alloy have been shown to improve osteoblast adhesion and function when compared to non-anodized material. In his study, NTs were grown on a Ti6Al4V alloy by anodic oxidation for 5 min using a super-oxidative aqueous solution, and their in vitro biocompatibility was investigated in pig periosteal osteoblasts and cartilage chondrocytes. Scanning electron microscopy (SEM), energy dispersion X-ray analysis (EDX) and atomic force microscopy (AFM) were used to characterize the materials. Cell morphology was analyzed by SEM and AFM. Cell viability was examined by fluorescence microscopy. Cell adhesion was evaluated by nuclei staining and cell number quantification by fluorescence microscopy. The average diameter of the NTs was 80 nm. The results demonstrate improved cell adhesion and viability at Day 1 and Day 3 of cell growth on the nanostructured material as compared to the non-anodized alloy. In conclusion, this study evidences the suitability of NTs grown on Ti6Al4V alloy using a super-oxidative water and a short anodization process to enhance the adhesion and viability of osteoblasts and chondrocytes. The results warrant further investigation for its use as medical implant materials.