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Bond strength, compositional, and structural properties of hydroxyapatite coating on Ti, ZrO2-coated Ti, and TPS-coated Ti substrate.

The effect of titanium plasma-sprayed (TPS) and zirconia (ZrO(2))-coated titanium (Ti) substrates on the adhesive, compositional, and structural properties of plasma-sprayed hydroxyapatite (HA) coatings were evaluated. X-ray diffraction, Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy, energy dispersive spectroscopy, surface roughness, and adhesive strength were used to characterize the coatings. Apatite-type and alpha-tricalcium phosphate phases were observed for all HA coatings. A structural change due to the absence of a 960 cm(-1) peak during FTIR analysis was observed for all HA coatings. The coating surfaces appeared rough and melted, with surface roughness correlating to the size of the starting powder. No significant difference in the Ca/P ratio of HA on Ti and TPS-coated Ti substrates was observed. However, the Ca/P ratio of HA on ZrO(2)-coated Ti substrate was significantly increased. Interfaces between all coatings and substrates were observed to be dense and tightly bound, except for HA coatings on TPS-coated Ti substrate interface. However, an intermediate TPS or ZrO(2) layer between the HA and Ti substrate resulted in a lower adhesive strength as compared to HA on Ti substrate.

Adhesiveness↗

Electromyographic study of the trapezius muscle in free movements of the shoulder.

The objective of this study is to analyze the simultaneity of the actions of the three portions of the trapezius (superior portion = TS; middle portion = TM and inferior portion = TI) in elevation, lowering, retraction and protraction of the shoulders. The electromyographic tests were carried out in 20 volunteers using a 4-channel TECA TE 2-7 electromyograph and surface and single coaxial needle electrodes. The electromyographs, obtained with the two types of electrodes, show that in elevation and lowering of the shoulders, TS and TM present increasing and decreasing activity, respectively, from the beginning until the end of these movements. In retraction of the shoulders, TM and TI present increasing activity from the beginning to the end of the movement. In protraction, TS, TM and TI do not show any activity.

Action Potentials↗

[Surface characterisation of shot peened implants with glas beads in total hip arthroplasty].

UNLABELLED: Alumina-blasting is used to create a rougher surface of Titanium implants in cementless total hip arthroplasty to achieve a better bony ingrowth. An increasing number of publications in maxillofacial surgery and orthopaedic surgery show that there is a significant contamination in Alumina blasted surfaces. Latest research published an effect of contaminant particles on early loosening of endoprostheses associated with third body wear. Due to our knowledge no previous study analysed surface contamination of hip endoprostheses with glass beads. Aim of our work was to evaluate the percentage of contaminated surface of hip endoprostheses with glass beads. MATERIAL AND METHOD: The surface of 5 Ti-VPS sprayed Phoenix cups and 5 morse-taper-junctions of the MRP-Titan revision stem (Peter Brehm, Chirurgie Mechanik, Weisendorf) were analysed with respect to glass particles. Shot peening was performed with glass beads "BALLOTINI" MGL, Fa. Würth Strahlmittel. A field emission scanning electron microscopy (LEO 1525) was used for the detection of the glass-particles on the implant surface with a backscattered electron detector. The particle covering position was calculated by means of an imaging analyze software (analySIS, Soft Imaging System GmbH). RESULTS: The surface of the Ti-VPS sprayed Phoenix cups showed a contaminated area at a mean of 9.2 +/- 1.3 %, morse-taper-junctions of the MRP-Titan stem at a mean of 9.6 +/- 2.1 % with glass particle contact. DISCUSSION: The results of this study clearly show that there is a contamination of shot pinned Titanium surfaces with glass particles in a significant percentage. With respect to third body wear in total hip arthroplasty further studies are necessary to minimize contamination.

Equipment Contamination↗

Adherent endotoxin on orthopedic wear particles stimulates cytokine production and osteoclast differentiation.

Aseptic loosening of orthopedic implants is thought to be caused primarily by osteoclast differentiation induced by bone resorptive cytokines produced in response to phagocytosis of implant-derived wear particles. This study examined whether adherent endotoxin on the wear particles is responsible for inducing osteoclast differentiation as well as production of interleukin-1beta (IL-1beta), IL-6, and tumor necrosis factor a (TNF-alpha). Removal of adherent endotoxin almost completely inhibited the responses to titanium (Ti) particles by both murine marrow cells and human peripheral blood monocytes. In vivo experiments showed that endotoxin removal reduced particle-induced osteolysis by 50-70%. Addition of lipopolysaccharide (LPS) to the "endotoxin-free" particles restored their ability to induce cytokine production and osteoclast differentiation in vitro. Moreover, marrow cells from mice that are hyporesponsive to endotoxin because of mutation of Toll-like receptor 4 induced significantly less cytokine production and osteoclast differentiation in response to Ti particles with adherent endotoxin than did marrow cells from normoresponsive mice. This mutation also resulted in significantly less particle-induced osteolysis in vivo. Taken together, these results show that adherent endotoxin is involved in many of the biological responses induced by orthopedic wear particles and should stimulate development of new approaches designed to reduce the activity of adherent endotoxin in patients with orthopedic implants.

Adhesiveness↗

Surface energy characterization of unalloyed titanium implants.

Osteointegration is dependent on a variety of biomechanical and biochemical factors. One factor is the wettability of an implant surface that is directly influenced by its surface energy. This investigation used the Zisman plot to determine critical surface tension as one representative measurement of surface energy. The effects of surface treatment, bulk grain size, and surface roughness on the critical surface tension of unalloyed titanium (Ti) were examined. Radio frequency glow discharge-treated Ti had the highest critical surface tension, followed by the passivated and heat-sterilized conditions. Titanium with no surface treatment had the lowest critical surface tension. The surface energy of Ti with an average grain size of 23 microns was not significantly different from that with a grain size of 70 microns. Surface roughness was shown to cause significant difference in measurements and definitely should be considered in studies of this kind.

Prostheses and Implants↗

Electropolymerization of pyrrole on titanium substrates for the future development of new biocompatible surfaces.

Titanium and its alloys are widely used in load-bearing implants as a result of their excellent mechanical properties and corrosion resistance. In order to improve their performances with respect to osseointegration, the use of bioactive coatings has been suggested. Polypyrrole (PPy) has been chosen as coating polymer because of its ability to be electrochemically grown directly onto metallic substrates, of any shape and dimension, leading to remarkably adherent overlayers. This polymer, in addition to protecting the metal implant against corrosion, could be surface modified with biologically active molecules able to stimulate positive interactions with bone tissue. In this work, PPy electrosynthesis on both titanium and Ti-Al-V substrates has been investigated. The chemical composition and the morphology of the polymeric films, deposited under different conditions, were evaluated by X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM), respectively.

Biocompatible Materials↗

PGE2 and IL-6 production by fibroblasts in response to titanium wear debris particles is mediated through a Cox-2 dependent pathway.

Aseptic loosening of orthopaedic implants is precipitated by wear debris-induced osteolysis. Central to this process are the pro-inflammatory mediators that are produced in response to wear by the fibroblastic cells, which comprise the majority of periprosthetic membranes. Since this pro-inflammatory cascade is mediated by a plethora of factors with redundant functions, it is imperative to establish a hierarchy. Two well-known fibroblast derived pro-inflammatory factors that stimulate wear debris-induced osteoclastic resorption are prostaglandin E2 (PGE2) and IL-6. However, their relationship to each other in this process is poorly defined. Here we show immunohistochemistry of retrieval membranes indicating that COX-2 is the principal cyclooxygenase responsible for PGE2 production in fibroblasts around failed implants. We also performed in vitro experiments with fibroblasts derived from wild-type (WT), COX-1 (-/-) and COX-2 (-/-) mice, which demonstrated that COX-2 is required for Ti wear debris-induced PGE2 production. Interestingly, COX-2 was also required for IL-6 production in these assays, which could be rescued by the addition of exogenous PGE2 (10(-6) M). Pharmacology studies that utilized the COX-1 selective inhibitor SC 560, the COX-2 selective inhibitor celecoxib, and the nonselective COX inhibitor indomethacin confirmed these results. Taken together, these results indicate that selective inhibition of prostaglandin signaling could favorably impact aseptic loosening beyond its direct effects on PGE2 synthesis, in that it inhibits downstream pro-inflammatory/pro-osteoclastic cytokine production.

Animals↗

Single blastomeres within human preimplantation embryos express different amounts of messenger ribonucleic acid for beta-actin and interleukin-1 receptor type I.

Gaining knowledge about the physiological timetable of gene expression during preimplantation embryo development is crucial, and a better understanding of cytokine and growth factor expression in early embryonic development could lead to improved in vitro culture conditions and enhance in vitro fertilization implantation rates. Our aim was to detect the patterns and levels of two messenger ribonucleic acids [mRNAs; beta-actin and interleukin-1 receptor type I (IL-1R tI)] in single human blastomeres by RT-nested PCR and to compare possible variations in the gene expression both between different embryos and in multiple blastomeres within the same embryo. Single blastomeres from nine human tripronucleic preimplantation embryos were examined by one round of RT and two rounds of nested competitive PCR. Beta-actin mRNA was detected in each blastomere, and IL-1R tI mRNA was found in 72% of the blastomeres examined. Beta-actin was expressed at a level of 511-12185 molecules of complementary DNA/blastomere, and IL-1R tI was expressed at a level of 2-290 molecules of complementary DNA/blastomere. Our results suggest that the mRNA pattern of an embryo cannot be reliably quantitated from the mRNA pattern of a single blastomere and therefore imply limitations for the use of this method for preimplantation diagnosis.

Actins↗

The influence of chronic cerebellar stimulation on respiratory muscle coordination in a patient with cerebral palsy.

The effect of chronic cerebellar stimulation on respiratory muscle coordination has been evaluated using a relatively simple and objective target breathing test on one patient. Seven normal subjects were used as controls. Magnetometer recordings were used to determine whether abdominal and rib cage expansion were in phase. Subjects were asked to match their breathing frequency to a metronome signal. Their ability to control respiratory timing voluntarily was assessed in terms of the coefficient of variation (CV) of inspiratory time (Ti) and of expiratory time (Te). The CV's of Ti and Te were much greater in the patient in the absence of cerebrellar stimulation than they were in normal subjects. Both at 3 weeks and 6 months after implantation of the stimulator, a significant improvement in the performance of the patient was demonstrable with the stimulator on, although normal values were never achieved. This demonstrable influence of chronic cerebellar stimulation on respiratory muscle coordination has important implications for both the avoidance of respiratory complications and the potential improvement of speech in patients with cerebral palsy.

Adolescent↗

Preparation of graded porous titanium coatings on titanium implant materials by plasma spraying.

Graded porous titanium coatings have been deposited on titanium substrates for dental implants by plasma spraying in an argon atmosphere. X-ray diffraction (XRD), scanning electron microscopy (SEM), surface roughness measurement, and tensile strength tests were performed on graded porous coatings. The results showed that Ti(3)O(5) was formed in the outermost surface of the porous coatings due to oxidation. The graded porous coatings consisted of three layers. The outer layer was full of macropores with a surface roughness of approximately 100 microm. The diameter of many macropores reached and even surpassed 150 microm, which could be beneficial for tissue to grow into the coating. The middle layer consisted of a mixture of micropores and macropores. The inner layer was a very dense and tight interface layer that included mechanical, physical, and metallurgical bonding. In tensile strength tests, testing bars peeled off the coatings, because the adhesive agent fractured, but the coatings remained intact.

Biocompatible Materials↗

The role of surface functional groups in calcium phosphate nucleation on titanium foil: a self-assembled monolayer technique.

Surface functional groups play important roles in nucleating calcium phosphate deposition on surgical titanium implants. In this study, various functional groups were introduced onto the surface of commercially pure titanium foils using a self-assembled monolayer (SAM) technique. An organic silane, 7-oct-1-enyltrichlorosilane (OETS) was used and -OH, -PO4H2, -COOH groups were derived from its unsaturated double bond. Ti foils were first oxidized in concentrated H2SO4/H2O2. ESCA and contact angle measurements were used to characterize the SAM surfaces and confirm the presence of various functional groups. A fast calcium phosphate deposition experiment was carried out by mixing Ca2+- and (PO4)(3-)-containing solutions in the presence of the surface-modified Ti samples at pH 7.4 at room temperature in order to verify the nucleating abilities of these functional groups. SEM, Raman spectroscopy, XRD and ATR-FTIR results showed that poorly crystallized hydroxyapatite (HA) can be deposited on the SAM surfaces with -PO4H2 and -COOH functional groups, but not onto the SAM with -CH=CH2 and -OH. -PO4H2 exhibited a stronger nucleating ability than that of -COOH. The oxidized Ti sample also showed some calcium phosphate deposition but to a lesser extent as compared to SAM surfaces with -PO4H2 and -COOH. The pre-deposited HA can rapidly induce biomimetic apatite layer formation after immersion in 1.5 SBF for 18 h regardless of the amount of pre-deposited HA. The results suggested that the pre-deposition of HA onto these functionalized SAM surfaces might be an effective and fast way to prepare biomimetic apatite coatings on surgical implants.

Biocompatible Materials↗

Postoperative inflammation: extracapsular cataract extraction versus phacoemulsification.

PURPOSE: To quantitatively compare postoperative inflammation after extracapsular cataract extraction (ECCE) with that after phacoemulsification in an Asian population. SETTING: Singapore National Eye Center, Singapore. METHODS: In this prospective, randomized, double-masked clinical trial, patients having cataract surgery were randomized to receive ECCE (n = 16) or phacoemulsification (n = 18). Diabetics were excluded. Two surgeons performed both types of surgery and implanted a 6.0 mm optic intraocular lens. Inflammation was assessed qualitatively by slitlamp grading of cells and flare and quantitatively using the Kowa flare meter. One independent postoperative investigator performed the slitlamp examination and laser flare meter readings. RESULTS: The ECCE and phacoemulsification groups were comparable (P > .05) in age, sex, ethnicity, and preoperative flare levels. The combined slitlamp inflammatory scores (anterior chamber cells and flare) and mean laser flare meter readings showed the ECCE group had significantly higher mean flare measurements than the phacoemulsification group at days 4 (P = .0012), 8 (P = .0013), 15 (P = .0013), 30 (P = .0004), and 60 (P = .0164). Flare levels in the ECCE group returned to preoperative values by the second month; the phacoemulsification group achieved preoperative levels by 1 month. The clinical inflammatory assessment score correlated closely to the flare level readings. CONCLUSION: Phacoemulsification induced less inflammation than ECCE, with the difference most marked in the first month after surgery.

Aged↗

Regulation of human osteoblast integrin expression by orthopedic implant materials.

Integrins are transmembrane proteins that mediate attachment to extracellular matrix (ECM) proteins. Integrins act as ECM receptors and are believed to play a role in signal transduction and gene regulation, potentially influencing several cellular functions, including differentiation, growth, and migration. Several integrins have previously been found in bone cells in vivo and in vitro. Because the biologic fixation of orthopedic implants depends on optimal cell interactions at the interface, we examined whether integrins are involved in the attachment of osteoblasts to implant materials. In this study, we have used immunohistochemistry to examine the expression of integrins in primary human osteoblasts cultured on tissue culture polystyrene (PS), and rough and polished disks of the orthopedic alloys titanium-aluminum-vanadium (Ti) and cobalt-chrome-molybdenum (CC). The integrin subunits, alpha 2, alpha 3, alpha 4, alpha 5, alpha v, alpha 6, beta 1 and beta 3, were expressed by primary human osteoblasts cultured on PS coated with various ECM molecules. However, alpha 5 and alpha 6 were notably absent in cells attached to the alloys. Also, alpha 3 was not present on rough Ti, polished CC, or rough CC, and beta 3 was not expressed by cells on rough CC. Thus, the nature of the metal alloy appeared to influence the expression of particular integrins. As a result, the ability of cells to adhere to and receive messages from the extracellular matrix may also be influenced by the substratum. These differences may explain previously observed differences in degree of cell attachment to these metals.

Alloys↗

Dose perturbation in the presence of metallic implants: treatment planning system versus Monte Carlo simulations.

An increasing number of patients receiving radiation therapy have metallic implants such as hip prostheses. Therefore, beams are normally set up to avoid irradiation through the implant; however, this cannot always be accomplished. In such situations, knowledge of the accuracy of the used treatment planning system (TPS) is required. Two algorithms, the pencil beam (PB) and the collapsed cone (CC), are implemented in the studied TPS. Comparisons are made with Monte Carlo simulations for 6 and 18 MV. The studied materials are steel, CoCrMo, Orthinox, TiAlV and Ti. Monte Carlo simulated depth dose curves and dose profiles are compared to CC and PB calculated data. The CC algorithm shows overall a better agreement with Monte Carlo than the PB algorithm. Thus, it is recommended to use the CC algorithm to get the most accurate dose calculation both for the planning target volume and for tissues adjacent to the implants when beams are set up to pass through implants.

Algorithms↗

[Corrosion behaviour, metal release and biocompatibility of implant materials coated by TiO2-sol gel chemistry].

Alloys based on titanium or cobalt have been used as implant materials for decades with good success. Because of their natural oxide layer these alloys reveal good corrosion behaviour. In contact with physiological solution metal release takes place, which can cause inflammation. Coatings can improve the corrosion behaviour. In this study Ti6Al4V and Co28Cr6Mo alloys, which are frequently used as implant materials, were tested. Polished discs of these alloys and polished discs, which were coated with TiO2-layers by sol-gel chemistry, were compared regarding their corrosion behaviour and metal ion releasing. The releasing of Al, V, Ti, Co, Cr and Mo was quantified by ICP-MS analysis. The TiO2-coating reduced the release of all ions except of the Al-ion. Both alloys showed a deviating kinetic of ion releasing. In addition, cell response (cell vitality, cell proliferation, endothelial marker CD31 and actin allocation) of osteoblasts and endothelial cells were investigated.

Cells, Cultured↗

Ti-6Al-7Nb promotes cell spreading and fibronectin and osteopontin synthesis in osteoblast-like cells.

The purpose of this study was to compare the early response of human osteoblast-like cells (SaOS-2) on commercially pure titanium (cpTi) and titanium-6-aluminium-7-niobium (Ti-6Al-7Nb) using glass slide as a control. In terms of cell attachment, no significance was observed when cells were seeded on the materials. However, morphological analysis by scanning electron microscope revealed that cells on Ti-6Al-7Nb showed better spreading after 4 hrs. After 48 hrs, both Western analysis and reverse transcription polymerase chain reaction analyses showed that cells cultured on Ti-6Al-7Nb synthesized a higher amount of fibronectin and osteopontin as compared to cells seeded on cpTi or on glass slide. These results suggest that Ti-6Al-7Nb possess a good potential to support SaOS-2 cells on spreading and fibronectin and osteopontin synthesis, therefore, this material may be one of a candidate material used in implant dentistry.

Alloys↗

Structure and mechanical properties of Cresco-Ti laser-welded joints and stress analyses using finite element models of fixed distal extension and fixed partial prosthetic designs.

STATEMENT OF PROBLEM: The Cresco-Ti System uses a laser-welded process that provides an efficient technique to achieve passive fit frameworks. However, mechanical behavior of the laser-welded joint under biomechanical stress factors has not been demonstrated. PURPOSE: This study describes the effect of Cresco-Ti laser-welding conditions on the material properties of the welded specimen and analyzes stresses on the weld joint through 3-dimensional finite element models (3-D FEM) of implant-supported fixed dentures with cantilever extensions and fixed partial denture designs. MATERIAL AND METHODS: Twenty Grade III (ASTM B348) commercially pure titanium specimens were machine-milled to the dimensions described in the EN10002-1 tensile test standard and divided into test (n = 10) and control (n = 10) groups. The test specimens were sectioned and laser-welded. All specimens were subjected to tensile testing to determine yield strength (YS), ultimate tensile strength (UTS), and percent elongation (PE). The Knoop micro-indentation test was performed to determine the hardness of all specimens. On welded specimens, the hardness test was performed at the welded surface. Data were analyzed with the Mann-Whitney U test and Student's t test (alpha=.05). Fracture surfaces were examined by scanning electron microscopy to characterize the mode of fracture and identify defects due to welding. Three-dimensional FEMs were created that simulated a fixed denture with cantilever extensions supported by 5 implants (M1) and a fixed partial denture supported by 2 implants (M2), 1 of which was angled 30 degrees mesio-axially. An oblique load of 400 N with 15 degrees lingual-axial inclinations was applied to both models at various locations. RESULTS: Test specimens fractured between the weld and the parent material. No porosities were observed on the fractured surfaces. Mean values for YS, UTS, PE, and Knoop hardness were 428 +/- 88 MPa, 574 +/- 113 MPa, 11.2 +/- 0.4%, 270 +/- 17 KHN, respectively, for the control group and 642 +/- 2 MPa, 772 +/- 72 MPa, 4.8 +/- 0.7%, 353 +/- 23 KHN, respectively, for the test group. The differences between the groups were significant for all mechanical properties ( P <.05). For both models, the FEA revealed that maximum principal stresses were concentrated at the framework-weld junction but did not exceed the UTS of the weld joint. CONCLUSION: Within the constraints of the finite element models, mechanical failure of the welded joint between the support and the framework may not be expected under biomechanical conditions simulated in this study.

Computer Simulation↗