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PubMedDate not supplied

Enhancing osseointegration by capacitively coupled electric field: a pilot study on early occlusal loading in the dog mandible.

Expeditious postoperative appositional growth of bone to dental implants is desired for clinically successful fixation of oral implants. The present study was performed to evaluate the effect of applying a capacitively coupled electric field (CCEF) followed by functional loading on peri-implant osteogenesis in the dog mandible. Nine adult beagles were used in this study. All premolars on both sides of the mandible were removed from each dog. A physio-odontlam implant (POI, Ti-6AI-4v) with 2 stages (3.7 mm in diameter and 8.0 mm in length), whose surface had been treated with anodic oxidation and sandblasted, was placed into each test site by self-tapping. Daily application of CCEF (8 hours per day) was initiated on the day following surgery and continued for 14 days or 21 days. After CCEF treatment was finished for each period, a prosthetic abutment and a straight post were placed on each implant. Four days after placement of the post, implants were placed under functional loading for 30 days. The dogs were then sacrificed, and histologic and radiographic studies of the mandible were performed. Relatively well calcified, mature bone with a lamellar-like structure was observed by contact microradiography and histologic study (double staining with basic fuchsin-methylene blue) of the peri-implant region on the CCEF-treated samples. In contrast, poorly calcified, immature bone without a lamellar structure was observed in control sites not treated with CCEF. The bone area ratios of the CCEF-treated sides were larger than those of control sides. These results suggest that the application of CCEF after implant placement may enhance peri-implant osteogenesis, even with functional loading.

Animals↗

PubMed1996

In vitro backscattering from implant materials during radiotherapy.

It is a certainty that many of the patients now receiving dental implants will one day require radiotherapy if they have head and neck cancer. The purpose of this study was to examine the dose enhancement form backscattered radiation at implant/bone interfaces irradiated with high-energy 6 MV and 10 MV x-rays. Three commonly used implant materials, pure titanium, Ti-6A1-4V alloy, and a high gold content implant material of various thicknesses, were used to measure the dose enhancement caused by backscattered radiation. The relative ionization charges at implant/bone interfaces were measured at distances of 0, 1, 2, and 3 mm away from the implant material by insertion of 0, 1, 2, and 3 mm thick bone substitute disks between the implant material and an ionization chamber. The results indicated that the highest dose enhancement occurred at a distance of 0 mm from the implant/bone interface for all the materials studied. The Au-Cu-Ag implant material had more average relative dose than pure titanium or Ti-6A1-4V alloy. The backscattered electrons decreased as the thickness of the bone substitute (distance between the implant material and the ionization chamber) increased.

Alloys↗

PubMed2004

The effect of different titanium and hydroxyapatite-coated dental implant surfaces on phenotypic expression of human bone-derived cells.

Roughened titanium (Ti) surfaces have been widely used for dental implants. In recent years, there has been the tendency to replace Ti plasma-sprayed surfaces by sandblasted and acid-etched surfaces in order to enhance osseous apposition. Another approach has been the utilization of hydroxyapatite (HA)-coated implants. This study examines the effect of two roughened Ti dental implant surfaces on the osteoblastic phenotype of human bone-derived cells (HBDC) and compares this behavior to that for cells on an HA-coated surface. Test materials were an acid-etched and sandblasted Ti surface (Ti-DPS), a porous Ti plasma-sprayed coating (Ti-TPS), and a plasma-sprayed porous HA coating (HA). Smooth Ti machined surfaces served as control (Ti-ma). HBDC were grown on the substrata for 3, 7, 14, and 21 days, counted and probed for various bone-related mRNAs and proteins (type I collagen, osteocalcin, osteopontin, osteonectin, alkaline phosphatase, and bone sialoprotein). All dental implant surfaces significantly affected cellular growth and the temporal expression of an array of bone-related genes and proteins. HA-coated Ti had the most effect on osteoblastic differentiation inducing a greater expression of an array of osteogenic markers than recorded for cells grown on Ti-DPS and Ti-TPS, thus suggesting that the HA-coated surface may possess a higher potency to enhance osteogenesis. Furthermore, Ti-DPS surfaces induced greater osteoblast proliferation and differentiation than Ti-TPS.

Adolescent↗

PubMed2002

Histological characterization of the early stages of bone morphogenetic protein-induced osteogenesis.

On the basis of currently available knowledge, we hypothesize that the initial bone formation, as induced by bone morphogenetic protein (BMP), is influenced by the chemical composition and three-dimensional spatial configuration of the used carrier material. Therefore, in the current study, the osteoinductive properties of porous titanium (Ti) fiber mesh with a calcium phosphate (Ca-P) coating (Ti-CaP), insoluble bone matrix (IBM), fibrous glass membrane (FGM), and porous particles of hydroxy apatite (PPHAP) loaded with rhBMP-2 were compared in a rat ectopic assay model at short implantation periods. Twelve Ti-CaP, 12 IBM, 12 FGM, and 12 PPHAP implants, loaded with rhBMP-2, were subcutaneously placed in 16 Wistar King rats. The rats were sacrificed at 3, 5, 7, and 9 days post-operative, and the implants were retrieved. Histological analysis demonstrated that IBM and Ti-CaP had induced ectopic cartilage and bone formation by 5 and 7 days, respectively. However, in PPHAP, bone formation and cartilage formation were seen together at 7 days. At 9 days, in Ti-CaP, IBM, and PPHAP, cartilage was seen together with trabecular bone. At 9 days, in FGM, only cartilage was observed. Quantitative rating of the tissue response, using a scoring system, demonstrated that the observed differences were statistically significant (Wilcoxon rank sum test, p < 0.05). We conclude that IBM, CaP-coated Ti mesh, FGM, and PPHAP provided with rhBMP-2 can indeed induce ectopic bone formation with a cartilaginous phase in a rat model at short implantation periods. Considering the different chemical composition and three-dimensional spatial configuration of the carrier materials used, these findings even suggest that endochondral ossification is present in rhBMP-2-induced osteogenesis, even though the amount of cartilage may differ.

Animals↗

PubMed2006

The influence of surface bioactivated modification on titanium percutaneous implants anchored in bone.

In order to achieve biological sealing and resist mechanical damage of load-bearing percutaneous devices, Ti with excellent mechanical properties was anodic-oxidized to be endowed with bioactivity, with plasma-sprayed hydroxyapatite coated Ti as control. Similar to previous works, hydroxyapatite coating could bond tightly with living tissues, resulting in implant stability for whole implantation periods. Meanwhile, when anodic-oxidized bioactivated Ti was implanted percutaneously in vivo, it could induce a layer of calcium phosphate at the interface of tissues/implant. This layer of Ca-P not only induced the fibrous tissue or collagen ingrowth in its structure, but also improved the osteointegration between the bone and the implant. There was no significant biological response difference for the anodic-oxidized Ti and HA coated Ti at different implantation period with histological statistical analysis (p>0.05). Accordingly, suitable bioactivated modified surface of Ti by anodic-oxidized method could not only obtain the same results as the HA coating, but also might avoid some drawbacks of plasma-sprayed HA coatings to achieve biological sealing for a long period in vivo.

Animals↗

PubMed2005

Ectopic bone formation in rats: the importance of the carrier.

Much research has been done to develop the ideal bone graft substitute (BGS). One approach to develop this ideal BGS is the use of growth factors, but for this approach osteoprogenitor cells are needed at the site of reconstruction. An alternative is a cell-based approach, where enough cells are provided to form bone in a carrier material. In previous studies of our group, titanium (Ti) carriers have been used, because of the excellent mechanical properties and the bone-compatibility of this material. On the other hand, calcium phosphate (CaP) ceramics are known for their excellent osteoconductivity. The aim of this study is to investigate the influence of the carrier in a cell-based bone regeneration approach, whereby we hypothesize that CaP-ceramic implants will induce more bone formation than Ti-fiber implants, in the same animal model as our previous experiment. Ti-fiber mesh implants and ceramic implants were seeded with rat bone marrow cells (RBM) and implanted subcutaneously. Histological analysis after one, three and six weeks showed differences in the way of bone formation in the two groups: bone appeared to grow from the center to the periphery of the implant in the titanium group, while bone formation in the ceramic group occurred through the whole implant. Histomorphometrical analysis after one week showed very limited bone formation for both the titanium and ceramic group. At three weeks, the amount of bone formation was increased till about 10% for the titanium group and 18% for the ceramic group. No significant difference between the two groups could be observed. In the six week group, the bone formation was 6% (Ti) and 23% (CaP), respectively (P < 0.001). Further, bone formation started earlier in the CaP-ceramic scaffolds than in the Ti scaffolds. Our hypothesis could be confirmed: ceramic implants induce more bone formation than titanium implants.

Animals↗

PubMed2001

Differential lymphocyte reactivity to serum-derived metal-protein complexes produced from cobalt-based and titanium-based implant alloy degradation.

The lymphocyte response to serum protein complexed with metal from implant alloy degradation was investigated in this in vitro study using primary human lymphocytes from healthy volunteers (n = 10). Cobalt chromium molybdenum alloy (Co-Cr-Mo, ASTM F-75) and titanium alloy (Ti-6Al-4V, ASTM F-136) beads (70 microm) were incubated in agitated human serum at 37 degrees C to simulate naturally occurring metal implant alloy degradation processes. Particulate free serum samples that had been incubated with metal were then separated into molecular weight based fractions. The amounts of soluble Cr and Ti within each serum fraction were measured and correlated with lymphocyte proliferation response to the individual serum fractions. Lymphocytes from each subject were cultured with 11 autologous molecular weight based serum fractions either with or without added metal. Two molecular weight ranges of human serum proteins were associated with the binding of Cr and Ti from Co-Cr-Mo and Ti implant alloy degradation (at <30 and 180-250 kDa). High molecular weight serum proteins ( approximately 180 kDa) demonstrated greater lymphocyte reactivity when complexed with Cr alloy and Ti alloy than low (5-30 kDa) and midrange (30-77 kDa) serum proteins. When the amount of lymphocyte stimulation was normalized to both the moles of metal and the moles of protein within each fraction (metal-protein complex reactivity index), Cr from Co-Cr-Mo alloy degradation demonstrated approximately 10-fold greater reactivity than Ti in the higher molecular weight serum proteins ( approximately 180 kDa). This in vitro study demonstrated a lymphocyte proliferative response to both Co-Cr-Mo and Ti alloy metalloprotein degradation products. This response was greatest when the metals were complexed with high molecular weight proteins, and with metal-protein complexes formed from Co-Cr-Mo alloy degradation.

Absorbable Implants↗

PubMed2005

Effects of titanium particle size on osteoblast functions in vitro and in vivo.

The formation of titanium (Ti)-wear particles during the lifetime of an implant is believed to be a major component of loosening due to debris-induced changes in bone cell function. Radiographic evidence indicates a loss of fixation at the implant-bone interface, and we believe that the accumulation of Ti particles may act on the bone-remodeling process and impact both long- and short-term implant-fixation strengths. To determine the effects of various sizes of the Ti particles on osteoblast function in vivo, we measured the loss of integration strength around Ti-pin implants inserted into a rat tibia in conjunction with Ti particles from one of four size-groups. Implant integration is mediated primarily by osteoblast adhesion/focal contact pattern, viability, proliferation and differentiation, and osteoclast recruitment at the implant site in vivo. This study demonstrates the significant attenuation of osteoblast function concurrent with increased expression of receptor activator of nuclear factor kappaB ligand (RANKL), a dominant signal for osteoclast recruitment, which is regulated differentially, depending on the size of the Ti particle. Zymography studies have also demonstrated increased activities of matrix metalloproteinases (MMP) 2 and 9 in cells exposed to larger Ti particles. In summary, all particles have adverse effects on osteoblast function, resulting in decreased bone formation and integration, but different mechanisms are elicited by particles of different sizes.

Animals↗

PubMed2001

Orthopaedic implant related metal toxicity in terms of human lymphocyte reactivity to metal-protein complexes produced from cobalt-base and titanium-base implant alloy degradation.

Metal toxicity from sources such as orthopaedic implants was investigated in terms of immune system hyper-reactivity to metal implant alloy degradation products. Lymphocyte response to serum protein complexed with metal from implant alloy degradation was investigated in this in vitro study using primary human lymphocytes from healthy volunteers (n = 10). Cobalt chromium molybdenum alloy (Co-Cr-Mo, ASTM F-75) and titanium alloy (Ti-6Al-4V, ASTM F-136) beads (70 microm) were incubated in agitated human serum at 37 degrees Celsius to simulate naturally occurring metal implant alloy degradation processes. Particulate free serum samples, which were incubated with metal, were then separated into molecular weight based fractions. The amounts of soluble Cr and Ti within each serum fraction were measured and correlated with lymphocyte proliferation response to the individual serum fractions. Lymphocytes from each subject were cultured with 11 autologous molecular weight based serum fractions either with or without added metal. Two molecular weight ranges of human serum proteins were associated with the binding of Cr and Ti from Co-Cr-Mo and Ti implant alloy degradation (at < 30 and 180-330 kDa). High molecular weight serum proteins (approximately 180 kDa) demonstrated greater lymphocyte reactivity when complexed with metal released from Co-Cr-Mo alloy and Ti alloy than with low (5-30 kDa) and midrange (30-77 kDa) serum proteins. When the amount of lymphocyte stimulation was normalized to both the moles of metal and the moles of protein within each fraction (Metal-Protein Complex Reactivity Index, MPCRI), Cr from Co-Cr-Mo alloy degradation demonstrated approximately 10 fold greater reactivity than Ti in the higher molecular weight serum proteins (approximately 180-250 kDa). This in vitro study demonstrated a lymphocyte proliferative response to both Co-Cr-Mo and Ti alloy metalloprotein degradation products. This response was greatest when the metals were complexed with high molecular weight proteins, and with metal-protein complexes formed from Co-Cr-Mo alloy degradation.

Adult↗

PubMed2006

The optimal SAM surface functional group for producing a biomimetic HA coating on Ti.

Commercial interest is growing in biomimetic methods that employ self assembled mono-layers (SAMs) to produce biocompatible HA coatings on Ti-based orthopedic implants. Recently, separate studies have considered HA formation for various SAM surface functional groups. However, these have often neglected to verify crystallinity of the HA coating, which is essential for optimal bioactivity. Furthermore, differing experimental and analytical methods make performance comparisons difficult. This article investigates and evaluates HA formation for four of the most promising surface functional groups: --OH, --SO(3)H, --PO(4)H(2) and --COOH. All of them successfully formed a HA coating at Ca/P ratios between 1.49 and 1.62. However, only the --SO(3)H and --COOH end groups produced a predominantly crystalline HA. Furthermore, the --COOH end group yielded the thickest layer and possessed crystalline characteristics very similar to that of the human bone. The --COOH end group appears to provide the optimal SAM surface interface for nucleation and growth of biomimetic crystalline HA. Intriguingly, this finding may lend support to explanations elsewhere of why human bone sialoprotein is such a potent nucleator of HA and is attributed to the protein's glutamic acid-rich sequences.

Coated Materials, Biocompatible↗

PubMed2006

The effects of titanium and polymethylmethacrylate particles on osteoblast phenotypic stability.

Wear particles generated following total joint arthroplasty interact with cells at the periprosthetic margin and induce an inflammatory response that contributes to osteolysis, aseptic loosening, and implant failure. This study examined the long-term effects of particles from two commonly implanted materials, titanium (Ti) and polymethylmethacrylate (PMMA), on cell viability and metabolism over a 21-day time course, using the human osteoblast-like cell line MG-63. Addition of particles was not associated with increased cell death or nitric oxide production at the particle concentration chosen. Collagen production was increased with exposure to titanium particles, whereas alkaline phosphatase and osteocalcin expression remained unchanged following exposure to both types of particles. The data show that titanium but not PMMA particles shifts bone cell metabolism to preferentially produce fibrous tissue rather than bone.

Biocompatible Materials↗

PubMed2005

Reactions of glutaric acid on the TiO2(001) single crystal. Effect of surface reduction on the reaction pathway.

The detailed reaction of glutaric acid (a C(5) dicarboxylic acid) has been studied by temperature programmed desorption (TPD) and X-ray photoelectron spectroscopy (XPS). Upon adsorption at 300 K, both carboxylic acid functions are deprotonated to give adsorbed glutarate species. The reaction of these species differs significantly on the oxidized surface from that on the reduced surface. On the oxidized surface, two competing reactions are seen: (i) decomposition to two molecules of CO and one molecule of propene and (ii) dehydration to ketene. Upon sputtering with hydrogen ions (reducing the surface states of Ti ions and implanting hydrogen atoms in the lattice), the main observed reaction is reduction to the dialdehyde and the dialcohol. The yield of these two products, not seen on the oxidized surface, reaches 80% on the highly reduced surface. Another compound is seen on the reduced surface with m/z = 70. The analysis of its fragmentation pattern tends to assign it to cyclopentane that is formed by an intramolecular reductive coupling reaction on the O-defect sites.

Journal Article↗

PubMed2006

Failure of the uncoated titanium ProxiLock femoral hip prosthesis.

UNLABELLED: New prostheses should be evaluated for stability and clinical performance. In a prospective randomized clinical trial, we implanted 22 titanium (Ti) and 20 hydroxyapatite-coated (HA) ProxiLock femoral hip prostheses during total hip arthroplasty in 42 patients. The patients were followed for 24 months with clinical, radiographic and radiostereometric analysis. Full weightbearing was allowed immediately postoperatively. One patient with a titanium stem was lost to followup. During the first two months, 34 of the 41 stems subsided and/or rotated towards retroversion, regardless of stem type. At the 24-month followup 35 of the 41 prostheses were either fully stabilized (16 HA and 11 Ti stems) or had clinical irrelevant migration (four HA and four Ti stems). Six Ti prostheses showed continuous migrations with maximums of 4.7 mm translation and 12.2 degrees retroversion; four of these were revised, the other two had no clinical complaints. CLINICAL RELEVANCE: The migration pattern we found indicates insufficient primary fixation of the ProxiLock stem in an immediate full weightbearing protocol. The HA coating improves the secondary stability of the prosthesis compared to the uncoated stem. Early migration is associated with an increased risk of possible future loosening and revision, and therefore we discontinued the use of this prosthesis. LEVEL OF EVIDENCE: Therapeutic Level I. See Guidelines for Authors for a complete description of levels of evidence.

Adult↗

PubMed2003

Inhibition of Ni release from NiTi alloy by hydroxyapatite, alumina, and titanium sputtered coatings.

To alleviate the effects of Ni allergy from NiTi alloy implants, hydroxyapatite (Ca10(PO4)6(OH)2; HA), alumina (Al2O3), or titanium (Ti) was coated onto NiTi alloy plates to form 1-microm thick films using radio frequency magnetron sputtering. The coatings on the plates were characterized using XRD. After the plates had been immersed in physiological saline for periods of one, four, or eight weeks, the concentration of Ni ions released in each solution was detected using a microwave induced plasma mass spectrometer. After eight weeks, the concentration of Ni ions released from the non-coated, the Ti-coated, the HA-coated, and the alumina-coated plates were 238, 19.7, 183, and 106 ppb, respectively. The bonding strength of the Ti film, the HA film, and the alumina film to the NiTi substrate were 3.8 +/- 1.2, 2.6 +/- 0.7, and 3.1 +/- 1.2 MPa, respectively. The non-coated, the HA-coated, the alumina-coated, and the Ti-coated plates were implanted into the femurs of a dog for four weeks for histological observation. In case of the non-coated plates, connective tissue more than 300 microm thick was observed, whereas for the coated plates the thickness of the connective tissue was around 100 microm.

Aluminum Oxide↗

PubMed1995

Histological and mechanical comparison of hydroxyapatite-coated cobalt-chrome and titanium implants in the rabbit femur.

The purpose of this study was to compare hydroxyapatite (HA)-coated titanium (Ti) and HA-coated cobalt-chrome (CoCr) implants in the distal femur of the rabbit by evaluating bone apposition and interfacial shear strength. Bilateral cylindrical implants with a plasma sprayed 50-microns thick HA coating were press-fit into the metaphyseal cancellous bone of the lateral femoral condyles in a transverse fashion, and the animals were sacrificed at 2, 4, and 8 weeks postimplantation. Mechanical strength of the interface between HA and bone was measured using the pushout method. For histologic analysis, the fractional linear extent of bone apposition was quantitated. No differences were found in the interfacial shear strength between the Ti and CoCr at any time period. The amount of bone apposition increased significantly at each time interval for both substrate metals, but there were no significant differences between the two substrates at any of the time periods studied. The HA-coated CoCr implants performed in a similar manner to the HA-coated Ti implants, both mechanically and histologically, suggesting that HA-coated CoCr implants deserve further study as a viable alternative to Ti for the biological fixation of total joint components in orthopaedic surgery.

Animals↗

PubMed2004

Mechanics considerations for microporous titanium as an orthopedic implant material.

This article investigates mechanics issues related to potential use of a recently developed porous titanium (Ti) material for load-bearing implants. This material may have advantages over solid Ti of enhancing the bone-implant interface strength by promoting bone and soft tissue ingrowth and of reducing the bone-implant modulus mismatch, which can lead to stress shielding. Experimental data from ultrasound experiments and uniaxial compression testing on microporous Ti are presented. Analytic models to predict its elastic modulus and Poisson's ratio are discussed, including "structural" approaches (Gibson and Ashby's cellular solids) and a "composite material" approach (Mori-Tanaka). Finally, two-dimensional finite element models based on optical micrographs of the material are presented. Simulations were performed for different conditions and levels of approximation. Results demonstrate that simple analytic models provide good estimates of the elastic properties of the porous Ti and that the moduli can be significantly reduced to decrease the mismatch between solid Ti and bone. The finite element simulations show that bone ingrowth will dramatically reduce stress concentrations around the pores.

Biomechanical Phenomena↗

PubMed2004

[Application of enzyme histochemistry in evaluation of in vitro and in vivo biocompatibility of HA/TCP].

In order to explore the possibility of applying enzyme histochemistry in biocompatibility evaluation, we investigated the effect of biomaterials on the activities of intracellular enzymes in this experiment. It was found that there was no obvious difference in morphology between osteoblasts co-cultured with HA/TCP and with Ti-alloy. However, transient down-regulation of NADH, SDH, LDH and CCO of the osteoblasts co-cultured with HA/TCP was detected by enzyme histochemistry, but these enzymes of osteoblasts the co-cultured with Ti-alloy were not down-regulated. It was indicated that something extracted from HA/TCP injured the co-cultured osteoblasts slightly. Similar early acute inflammatory reactions were observed after HA/TCP and Ti-alloy were separately implanted into the dorsal muscle of rabbit. There was also no obvious difference between the tissue response to HA/TCP and that to Ti-alloy. Activities of enzymes in tissues around implanted materials were down-regulated at the early injury period and recovered gradually within 30 days post-operation. But the mild toxicity of extracts from HA/TCP was demonstrated by the fact that the recovery period of HA/TCP group was longer than that of Ti-alloy group. It was proved that enzyme histochemistry is more sensitive than tissue morphology analysis in detecting the cell or tissue responses to biomaterials. Therefore, it is possible to use enzyme histochemistry in biocompatibility evaluation.

Alloys↗

PubMed2002

TOF-SIMS and XPS-investigations of ion implanted single crystal 1b-diamonds.

Near surface zones of (48)Ti- and (52)Cr-implanted single crystal diamonds (1b-MCD) were characterized by XPS, TOF-SIMS and white light interference microscopy (WLI). By the combination of WLI and TOF-SIMS it was possible to calibrate the depth scale of TOF-SIMS and XPS depth profiles quantitatively. The adjustment of TOF-SIMS and XPS elemental depth profiles in the implantation maximum increases the quantitative detection limit of the implanted elements by more than two orders of magnitude and enables the interpretation of results from wear simulation experiments. Peak fits of XPS C(1s)-photolines indicate the fraction and chemical nature of carbide-like structures in the implantation zone. Qualitative hints on carbide compounds are possibly included in the reconstructed TOF-SIMS spectra but this information can presently only be extracted with the aid of XPS analyses.

Journal Article↗