Histological evidence concerning the osseointegration of titanium implants in the fractured rabbit femur

Stabilization of the broken bone is achieved using biocompatible materials. Since histology is still considered the gold standard technique for the assessment of bone formation around metallic implants, this report investigated the titanium implant integration in the accidentally broken bone in rabbits. The experimental protocol was reviewed and approved by the Ethical Committee of the Faculty of Medicine and Pharmacy Oradea, Romania. Holes were drilled in the diaphysis of the femur, and titanium implants were inserted in the created bone defect. In two subjects, fractures occurred on days two and three after the metallic alloy implantation. The other two rabbits presented no fractures following the surgical procedure. The rabbits were euthanized and the bones (with metallic implants) were harvested for histopathological investigation. Following decalcification, the bone samples were processed using the standard paraffin technique and stained by Goldner’s trichrome procedure. In subjects with a perfect immobilization of the titanium implants, the osseointegration occurred with minimal callus formation (i.e. primary cortical healing). In rabbits with bone fractures, the callus was more exuberant. A progressive replacement of the granulation tissue with hyaline cartilage and woven bone occurred soon after. The former aspects suggested an indirect metaplasia in the created callus. In all subjects, no inflammatory cells were identified in the created callus. The bone regeneration occurred either by primary cortical healing (in perfectly immobilized titanium implants) or by a process similar to the endochondral ossification (in poorly immobilized titanium implants following accidental post-implantation bones fracture).     

Osteoblastic cell behaviour on different titanium implant surfaces

The osseointegration of oral implants is related to the early interactions between osteoblastic cells and titanium surfaces. The behaviour of osteoblastic MC3T3-E1 cells was compared on four different titanium surfaces: mirror-polished (Smooth-Ti), alumina grit-blasted (Alumina–Ti) or biphasic calcium phosphate ceramic grit-blasted (BCP–Ti) and a commercially available implant surface (SLA). Scanning electron microscopy and profilometry showed distinct microtopographies. The BCP–Ti group had higher average surface roughness (R_a = 2.5 μm) than the other grit-blasted groups. Hydrophilicity and surfaces energies were determined on the different substrates by dynamic contact angle measurements. The most hydrophilic surface was the Alumina–Ti discs, while SLA was the most hydrophobic. The titanium surfaces were all oxidized as TiO₂ and polluted by carbon contaminants, as determined by X-ray photoelectron spectroscopy. Alumina–Ti samples also exhibited aluminium peaks as a result of the blasting. The BCP–Ti discs contained traces of calcium and phosphorus. MC3T3-E1 cells attached, spread and proliferated on the substrates. For both the SLA and BCP–Ti groups, the entire surface was covered with a layer of osteoblastic cells after 2 days. At high magnification, the cells exhibited cytoplasmic extensions and filopodia. Compared with plastic, cell viability was similar with the Smooth–Ti, slightly lower with the Alumina–Ti and superior with the SLA and BCP–Ti groups. Alkaline phosphatase activity increased with the culture time whatever the substrate. This study shows that BCP-blasting produces rough titanium implants without surface contaminants.     

Balancing osteoblast functions and bacterial adhesion on functionalized titanium surfaces

The demand for orthopedic and dental implants will continue to grow, and for these applications, titanium and its alloys have been used extensively. While these implants have achieved high success rates, two major complications may be encountered: the lack of bone tissue integration and implant-centered infection. The surface of the implant, through its interactions with proteins, bacteria and tissue cells, plays a determining role in the success or failure of the implant. Ideally, to enhance the success of implants, their surfaces should inhibit bacterial colonization and concomitantly promote osteoblast functions. In this article, we discuss strategies for tailoring implant surfaces by exploiting the differences in the response of bacteria and osteoblasts to proteins and surface structures. Nevertheless, limitations still exist in the quest for an ideal implant surface. Further advances in this field will require concurrent development in surface modification techniques and a better understanding of the complex and highly inter-related events occurring at the implant surface after implantation.     

外科植入物产品表面阳极氧化改性应用分析

目的 探讨阳极氧化表面改性技术在外科植入物产品中的应用。方法 本文对30余家生产企业的337批外科植入物产品进行检测,对表面引入元素进行分析,并采用扫描电子显微镜及能谱法进行定性半定量分析。结果 所有的微弧阳极氧化产品检测出少量非基体元素,分别有Na、P、S、Si、Ca等元素; 有15.5%经着色阳极氧化的产品检出Na、P、S、Si等少量元素,其中Na、S可以通过清洗工艺彻底清除。结论 经过阳极氧化的外科植入物,会在其表面层引入除基体外的其他元素,通过工艺控制可以有目的性地调控引入元素的种类和含量。     

Influence of oxidation treatment on fatigue and fatigue-induced damage of commercially pure titanium

In this investigation, the cyclic deformation behaviour of commercially pure titanium was characterized in axial stress controlled constant amplitude and load increase tests, as well as in rotating bending tests. The influence of different clinically relevant surface treatments (polishing, thermal and anodic oxidizing) on the fatigue behaviour was investigated. All tests were realized in oxygen-saturated Ringer’s solution. The cyclic deformation behaviour was characterized by mechanical hysteresis measurements. In addition, the change of the free corrosion potential and the corrosion current during the fatigue tests in simulated physiological media indicated such types of surface damage as slip bands, microcracks and oxide film ablation. Microstructural changes on the specimen surfaces were examined by scanning electron microscopy.     

Biomechanical simulation of various surface roughnesses and geometric designs on an immediately loaded dental implant

Experiment with rapid prototyping technique and validation finite element model was performed to evaluate the biomechanical behavior of an immediately loaded mandibular implant. Also, 18 finite element models of six implant designs and three surface roughnesses with anisotropic bone material properties were analyzed to compare the bone stresses and the sliding at the bone-implant interface under a vertical or lateral force of 130 N. The results show that bone stress (strain) of an immediately loaded implant is heavily dependent on the implant design and surface roughness. Improving the initial interfacial interlocking using a threaded implant has a higher priority than using cylindrical or step designs with a rough surface for an immediately loaded implant.     

纳米银粒子改性种植体的研究进展

关节置换术是治疗终末期关节疾病和老年股骨颈骨折最常用的有效手段,在临床研究中,无菌性松动和假体周围感染是造成假体植入失败的主要原因。而良好的骨整合性是使假体保持长期稳定的关键,因此如何提高骨整合能力是骨组织工程研究关注的热点。纳米银粒子(Silver nanoparticles)的抗菌能力备受推崇,它可以有效减少假体周围感染;同时有研究指出它还具备一定的促成骨能力,这将对无菌性松动有改善作用。以上优点使纳米银改性种植体受到广泛关注,本文就纳米银改性种植体的应用作一综述。     

不同表面处理方法对纯钛表面形貌及成分的影响

分别用HNO3、热H2SO4/H2O2、热H2SO4/HC l处理纯钛片30 m in。采用扫描电子显微镜、X射线光电子能谱对试样的表面形貌及成分进行分析。扫描电镜结果显示,HNO3组表面形貌光滑,平整;而H2SO4/HC l、H2SO4/H2O2处理方法可获得粗糙的表面,其中H2SO4/HC l处理后的表面孔隙更大。X射线光电子能谱分析表明:三组钛片表面的主要成分均为钛、氧和碳,H2SO4/H2O2组的碳含量最低,而H2SO4/HC l组碳含量最高。HNO3组和H2SO4/H2O2组表面除了T iO2还存在T i2O3、T iO、金属T i等多种物质,而H2SO4/HC l组表面只存在T iO2。     

Osseointegration of dental implants in 3D-printed synthetic onlay grafts customized according to bone metabolic activity in recipient site

Onlay grafts made of monolithic microporous monetite bioresorbable bioceramics have the capacity to conduct bone augmentation. However, there is heterogeneity in the graft behaviour in vivo that seems to correlate with the host anatomy. In this study, we sought to investigate the metabolic activity of the regenerated bone in monolithic monetite onlays by using positron emission tomography–computed tomography (PET-CT) in rats. This information was used to optimize the design of monetite onlays with different macroporous architecture that were then fabricated using a 3D-printing technique. In vivo, bone augmentation was attempted with these customized onlays in rabbits. PET-CT findings demonstrated that bone metabolism in the calvarial bone showed higher activity in the inferior and lateral areas of the onlays. Histological observations revealed higher bone volume (up to 47%), less heterogeneity and more implant osseointegration (up to 38%) in the augmented bone with the customized monetite onlays. Our results demonstrated for the first time that it is possible to achieve osseointegration of dental implants in bone augmented with 3D-printed synthetic onlays. It was also observed that designing the macropore geometry according to the bone metabolic activity was a key parameter in increasing the volume of bone augmented within monetite onlays.     

X-Ray Image Review of the Bone Remodeling Around an Osseointegrated Trans-femoral Implant and a Finite Element Simulation Case Study

The insertion of an implant into a bone leads to stress/strain redistribution, hence bone remodeling occurs adjacent to the implant. The study of the bone remodeling around the osseointegration implants can predict the long-term clinical success of the implant. The clinical medial–lateral X-rays of 11 patients were reviewed. To eliminate geometrical distortion of different X-rays, they were converted into a digital format and geometrical correction was carried out. Furthermore, the finite element (FE) method was used to investigate how the bone remodeling was affected by the stress/strain distribution in the femur. The review of clinical X-rays showed cortical bone growth around the proximal end of the implant and absorbtion at the distal end of the femur. The FE simulation revealed the stress/strain distribution in the femur of a selected patient. This provided a biomechanical interpretation of the bone remodeling. The existing bone remodeling theories such as minimal strain and strain rate theories were unable to offer satisfactory explanation for the cortical bone growth at the implant side of the proximal femur, where the stress/strain level was much lower than the one in the intact side of the femur. The study established the correlation between stress/strain distribution obtained from FE simulations and the bone remodeling of the clinical review. The cortical bone growth was initiated by the stress/strain gradient in the bone. Through the review of clinical X-rays and FE simulations, the study confirmed that the bone remodeling in a femur with an implant was influenced by the stress/strain redistribution. The strain level and stress gradient hypothesis is presented to offer an explanation for the implanted cortical bone remodeling observed in this study.     

Bioactive glass microspheres as osteopromotive inlays in macrotextured surfaces of Ti and CoCr alloy bone implants: trapezoidal surface grooves without inlay most efficient in resisting torsional forces

We have tested the efficacy of porous bioactive glass (BG) inlays in enhancement of implant osseointegration. A total of 24 sheep underwent bilateral surgical implantation of three parallel implants on the anteromedial cortical surface of each tibia. The disc-shaped implants made of Ti6Al4V or cobalt chromium (CoCr) alloys had two parallel surface grooves (trapezoidal space with bottom widening) filled with sintered 100% bioactive glass microspheres or a selected mixture of bioactive and biocompatible glass microspheres. The surface of uncoated control implants was smooth, grit-blasted or had unfilled grooves. A subgroup of control smooth CoCr implants was coated with two or three BG layers. Implant incorporation with bone was evaluated using torque testing to failure, scanning electron microscopy and morphometry at 12 and 25 weeks. A total of 144 in vivo implants and 16 ex vivo cemented control implants were analyzed. Control Ti6Al4V implants with unfilled trapezoidal grooves showed highest torsional failure loads with excellent ingrowth of new bone and remodeling of ingrown bone into lamellar bone. Implants with BG inlays and microroughened control Ti6Al4V implants showed significantly lower torsional failure loads than control Ti6Al4V implants with unfilled grooves. In conclusion, BG inlays failed to enhance biological implant fixation. Macrotextured surface was more effective than grit-blasting in promotion of mechanical incorporation.     

牙科钛铸件的表面处理

纯钛在高温下化学性质活泼，故其铸件表面易形成较厚的污染层影响其固有的优良型化性质，即使在常温下暴露在空气中的纯钛表面也易形成一层氧化膜，使其表面光泽变暗，因此钛铸件的表面处理与其他牙科常用合金铸件比较就显著更为重要。本文就牙科钛铸件的表面处理工艺归纳为物理研磨、化学研磨、电解和表面改性等四个方面详细综述。     

医用钛合金材料表面改性对骨整合影响的研究进展

医用钛合金材料是临床应用中较为常见的骨科植入物材料之一,作为一种具备良好的生物相容性、耐腐蚀性以及机械强度的生物材料受到了学者的广泛关注.本文专注于PubMed和Web of Science数据库中的相关文献,着重论述4种不同的表面改性设计对医用钛合金材料骨整合性能的影响.在材料学结构设计不断创新和深入研究的背景下,针...     

金属生物材料的微粗糙表面及其生物学效应(Ⅰ)─—金属生物材料的微粗糙表面

本文总结了金属生物材料做粗糙表面的制备技术，粗糙度的测量方法，粗糙度的衡量参数，简要论述了激粗糙表面的生物相容性．