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In vitro corrosion of Ti-6Al-4V and type 316L stainless steel when galvanically coupled with carbon.

In vitro corrosion experiments were conducted employing potentiostatic polarization techniques, a saline environment and candidate biomaterial alloy/carbon combinations. Corrosion currents and potentials of carbon/metal couples were predicted by mixed-potential theory utilizing the polarization curves generated. The alloys examined were annealed ELI grade Ti-6A1-4V and cold-worked 316L stainless steel while the types of carbon examined were LTI pyrolytic carbon and vapor-deposited carbon. It was determined that galvanic couples of carbon to cold-worked 316L stainless steel with carbon/metal area ratios of 10:1 to 100:1 produced coupled corrosion potentials in the range of the observed breakdown potential of the stainless steel. It was therefore predicted that localized corrosion in the form of pitting could occur on the cold-worked stainless steel when coupled to carbon with area ratios of 10:1 or greater. The titanium alloy did not exhibit a breakdown potential up to a potential of 1.2 V. Therefore, accelerated corrosion was not predicted for the titanium alloy to carbon galvanic couples under these experimental conditions. Direct carbon/alloy coupling experiments were conducted to verify the corrosion currents and potentials predicted from mixed-potential theory and polarization curve analysis. The experimental and theoretical values showed good agreement.

Alloys↗

[Fabrication of custom-made artificial semi-knee joint based on rapid prototyping technique: computer-assisted design and manufacturing].

OBJECTIVE: To design a new custom-made artificial semi-knee joint based on rapid prototyping(RP) technique and to explore a method to solve necroses of allocartilage in hemi-joint allotransplantation. METHODS: Based on the extracted 3D contour image of the articular cartilage of femoral condyle, the custom-made artificial semi-knee joint was designed with Surfacer 9.0 image processing software. The artificial semi-knee joint design used the femoral condylar 3D contour of the patient as the outer face and the subchondral bone 3D contour of allograft bone as inner face. One dado for medullary nail and two for special designing cages which were used to fix the cartilage into the allograft were added on the inner face. After being converted into RP data format, the computer-assisted design was imported into the LPS600 rapid prototyping machine, and the prototype was achieved. Furthermore, the prototype could be modified by hand according to the design. Then the RP model was used as a positive mould to build up a silica gel negative mould, and the negative mould was sent to the factory to manufacture Ti-6A1-4V alloy articular cartilage through ordinary mould-melted founding process. Finally, the whole metal cartilage was completed after melting two special cages on it and polishing it. RESULTS: A new custom-made artificial semi-knee joint was made and used to treat a 14-year old patient. The custom-made artificial semi-knee joint and the subchondral bone were a perfect match. The operative result was satisfactory. The patient could walk 5 weeks after operation. The bone healing of the auto-bone and allo-bone was achieved 6 months later. A follow-up period lasting 1 year showed that the knee joint played a good function. CONCLUSION: The artificial semi-knee joint is a good match for the allograft bone and a good idea to solve necroses of allocartilage in hemi-joint allotransplantation.

Adolescent↗

Pull-out strength and stiffness of meniscal repair using absorbable arrows or Ti-Cron vertical and horizontal loop sutures.

We tested pull-out strength and linear stiffness of meniscal repair using bioabsorbable arrows and vertical and horizontal loop sutures in fresh-frozen bovine lateral menisci. In phase I, menisci repaired either with 2-0 Ti-Cron vertical or horizontal loop suture, or 10-, 13-, or 16-mm Meniscus Arrows were loaded to failure at 12.5 mm/sec. In phase II, we examined the number of barbs engaged and angle of insertion using 10- and 13-mm arrows. Pull-out strengths of both suture repair groups were significantly higher than those of the arrow groups. Vertical loop sutures were significantly stiffer than horizontal sutures and 10-mm arrows. In phase II, the mean ultimate load to failure for the 10-mm arrows was 35.1 N, significantly stronger than in phase I (18.5 N); however, stiffness remained low (7.9 N/mm). Five arrows in the 13-mm group were inserted parallel to the tibial surface and showed no significant difference from phase I. Five arrows were inserted at more than a 30 degrees angle. This group was significantly weaker than in phase I. Single vertical loop suture showed the highest overall pull-out strength. Although weaker than sutures, arrows should provide sufficient stability for meniscal healing. The number of barbs engaged and angle of insertion are critical.

Absorbable Implants↗

[The biomechanical study of craniovertebral junction fixation with posterior transarticular screw].

OBJECTIVE: To evaluate the stability of biomechanics of occipitoatlantoaxial reconstruction with transarticular screw fixation. METHODS: Twelve fresh human cadaveric occipitocervical spine specimens were mounted in a custom-designed, spine-testing machine that applied pure moments while recording the three-dimensional angular movement at occiput (Oc)-C(1) and C(1 - 2) segments. The specimens were tested under seven different conditions: the intact (intact group), the occipitoatlantoaxial instability (Destabilized group), fixation with Ti-cable plus bone graft group (cable + graf group), fixation with the transarticular fixation (CTS group), fixation with SUMMIT occitocervical spinal fixation system (SUMMIT group), fixation with transarticular screw plus bone graft (CTS + graf group), and fixation with SMMIT system and plus graft group (SUMMIT + graf group). The data obtained were statistically analyzed. RESULTS: The CTS group reduced motion to well within the normal rang. In the Oc-C(1) segment, The CTS group and SUMMIT group allowed a very small rang of motion (ROM) and neutral zone (NZ) during lateral bending and axial rotation. The ROM and NZ during flexion and extension of the SUMMIT group, were significantly smaller than those of cable + graf group and CTS group (6.64 degrees +/- 0.59 degrees, 2.49 degrees +/- 0.26 degrees, 0.50 degrees +/- 0.03 degrees, 0.21 degrees +/- 0.01 degrees, 0.27 degrees +/- 0.07 degrees, 0.13 degrees +/- 0.01 degrees vs 10.01 degrees +/- 1.26 degrees, 3.80 degrees +/- 0.79 degrees, 7.93 degrees +/- 1.34 degrees, 3.18 degrees +/- 0.95 degrees, 9.54 degrees +/- 0.87 degrees, 5.93 degrees +/- 0.74 degrees, P < 0.05). In the C(1 - 2) segment, ROM and NZ in all directions of CTS group were smaller in rotation than SUMMIT group (1.64 degrees +/- 0.39 degrees, 0.61 degrees +/- 0.15 degrees, 0.14 degrees +/- 0.05 degrees, 0.02 degrees +/- 0.01 degrees, 0.32 degrees +/- 0.04 degrees, 0.08 degrees +/- 0.01 degrees, vs 0.21 degrees +/- 0.04 degrees, 0.07 degrees +/- 0.03 degrees, 0.21 degrees +/- 0.12 degrees, 0.10 degrees +/- 0.02 degrees, 2.92 degrees +/- 0.28 degrees, 1.27 degrees +/- 0.11 degrees, all P < 0.05). There was no significant difference in ROM and NZ in all directions between CTS + graf group and SUMMIT + Graf group (P > 0.05). CONCLUSION: In vivo biomechanics studies show that posterior occipitocervical transarticular fixation has unique features in reconstructing dynamic stability of the occipitoatlantoaxis, especially in controlling stability of rotation and lateral flexion, thus ensuring successful fusion of the implanted bone and allowing for clinical use of the technique.

Adult↗

Impact of polypropylene amount on functional outcome and quality of life after inguinal hernia repair by the TAPP procedure using pure, mixed, and titanium-coated meshes.

BACKGROUND: Laparoscopic inguinal hernia repair requires the use of prosthetic material. This prospective, single-center study was intended to investigate the impact of the amount of polypropylene (PP) mesh used in hernia repair on functional results and quality of life. METHODS: For this series, 672 consecutive patients with primary inguinal hernia undergoing transabdominal preperitoneal hernia repair (TAPP) using a heavyweight PP mesh (Prolene 10 x 15 cm, 1.5 g, group I, n = 232), a mixed PP- and Polyglactin mesh (Vypro II, 10 x 15 cm, 0.53 g, group II, n = 217), or a light-weight titanized PP mesh (Ti-Mesh, 10 x 15 cm, 0.24 g, group III, n = 223) were compared in terms of postoperative complications (seroma, wound healing disorders), quality of life score (pain development, physical condition, urologic disorders), and hernia recurrence. RESULTS: During a 12-month follow-up there were no significant differences in the recurrence rate (1.3%-1.7%). Patients with a pure PP mesh (group I) showed significantly more postoperative seromas (12.1% versus 4.1%/1.8%), foreign body sensations (9.1% versus 5.5%/3.5%), and sensitivity to weather changes (5.6% versus 3.2%/2.2%) compared to groups II and III. In all groups, the quality of life score was improved postoperatively. However, among those patients in our series with few preoperative complaints, the postoperative quality of life was worsened when heavy-weight PP meshes (group I+II) were used but significantly improved when light-weight titanized PP meshes were used. CONCLUSIONS: Comparable functional results, fewer postoperative complications, and improved quality of life can be achieved by reducing the amount of PP in meshes used for laparoscopic hernia repair by TAPP procedure.

Adult↗

Cyclo-(DfKRG) peptide grafting onto Ti-6Al-4V: physical characterization and interest towards human osteoprogenitor cells adhesion.

In the present paper, specific interest has been devoted to the design of new hybrid materials associating Ti-6Al-4V alloy and osteoprogenitor cells through the grafting of two RGD containing peptides displaying a different conformation (linear RGD and cyclo-DfKRG) onto titanium surface. Biomimetic modification was performed by means of a three-step reaction procedure: silanization with APTES, cross-linking with SMP and finally immobilization of peptides thanks to thiol bonding. The whole process was performed in anhydrous conditions to ensure homogeneous biomolecules layout as well as to guarantee a sufficient amount of biomolecules grafted onto surfaces. The efficiency of this new route for biomimetic modification of titanium surface was demonstrated by measuring the adhesion between 1 and 24 h of osteoprogenitor cells isolated from HBMSC. Benefits of the as-proposed method were related to the high concentration of peptides grafted onto the surface (around 20 pmol/mm(2)) as well as to the capacity of cyclo-DfKRG peptide to interact with integrin receptors. Moreover, High Resolution beta-imager (using [(35)S]-Cys) has exhibited the stability of peptides grafted onto the surface when treated in harsh conditions.

Alloys↗

Artificial lamina-assisted laminoplasty performed in seven cases.

OBJECT: The authors attempted to simplify the operative approach to severe multilevel cervical spondylotic myelopathy. Seven patients with progressive and severe myelopathy underwent modified double-door laminoplasty during a 5-month period. METHODS: The double-door laminoplasty procedure was modified by using two artificial titanium laminae obtained by simple surgical 0.5-mm Ti-mesh (rather than by bone graft or ceramic spacers). Preoperatively, gait disturbance was present in all patients with long-tract signs on neurological examination. In all cases the sagittal diameter of the cervical spinal canal was somewhat reduced (< 10 mm) by congenital stenosis, and further severe compression of the spinal cord resulted from osteophytic bars and calcified ligamenta flava at different levels. No abnormal alignment, pathological movements, or instability was present. Computerized tomography (CT) studies demonstrated severe multilevel cervical compression, and T2-weighted magnetic resonance (MR) imaging demonstrated pathological areas of hyperintensity within the spinal cord in all cases. In the initial follow-up study (range 8-12 months), the patients who underwent this procedure experienced marked improvement of gait disturbance without any significant incidence of morbidity or complications. Postoperative CT and MR imaging studies demonstrated complete spinal cord decompression and restoration of the patency of the subarachnoid spaces. CONCLUSIONS: The proposed procedure has the advantage of achieving both an immediate stabilization of the open laminae by means of a bridgelike mechanism and protection from the possible compression of the dural sac by paravertebral muscles.

Aged↗

Electrochemical study on microbiology-related corrosion of metallic dental materials.

Microbiology-related corrosion has been noted in industry for many years. It is widely recognized that microorganisms affect the corrosion of metal and alloys immersed in aqueous environments. Under similar conditions, the effect of bacteria in the oral environment on the corrosion of dental metallic materials remains unknown. The purpose of this study is to investigate the corrosion behavior of dental metallic materials in the presence of Streptococcus mutans and its growth byproducts. Samples were commercially pure titanium (CPT), Ti-6Al-4V (TAV), Ti-Ni (TN), Co-Cr-Mo alloy (CCM), 316L stainless steel (SSL), 17Cr-4Ni PH-type stainless steel (PH), and Ni-Cr alloy (NC). Using Gamry corrosion test system, surfaces were exposed to (1) sterilized Ringer's solution as a control for (2), (2) S. mutans mixed with sterilized Ringer's solution; (3) sterilized tryptic soy broth as a control for (4), and (4) byproducts of S. mutans mixed with sterilized tryptic soy broth. Corrosion parameters (EOCP, ECORR, ICORR, etc.) were corrected for all tested samples. Averaged values of these parameters were statistically analyzed by t-test to identify significant differences. It was concluded that (1) S. mutans reduced the EOCP of CPT, TAV, TN, and SSL, and the byproducts of S. mutans reduced the EOCP of TAV, TN, SSL, and PH. (2) S. mutans increased the ICORR of PH, and byproducts of S. mutans increased the ICORR of all the samples. (3) S. mutans reduced the ECORR of CPT, TAV and TN, and the byproducts of S. mutans reduced the ECORR of TN, SSL, PH, and NC. (4) S. mutans increased the IPASS of CPT, and the byproducts of S. mutans increased the IPASS of CPT, PH, and NC.

Corrosion↗

Modulation of the responses of human osteoblast-like cells to physiologic mechanical strains by biomaterial surfaces.

In a previous study we demonstrated that MG-63 cells cultured on Ti-6Al-4V discs covered by alumina ceramic and submitted to intermittent mechanical strain (IMS) presented morphological alteration associated with enhanced differentiation. Here we examine how the mechanical response of osteoblasts can be modulated by the nature of the substrate. MG-63 cells were cultured on four materials: polystyrene and Ti-6Al-4V (average roughness = 0.48 microm) as smooth substrates; Ti-6Al-4V (average roughness = 5.76 microm) and Ti-6Al-4V covered with alumina (average roughness = 5.21 microm) as rough substrates. Mechanical strains were applied for 15 min, three times a day for 1-5 days with a 600 microstrains magnitude and a 0.25 Hz frequency. IMS stimulated alkaline phosphatase activity by 25-35% on all substrates and had no effect on cell growth on either substrate. Fibronectin (FN) was chosen as representative of cell-matrix interaction. FN production was increased by 60% after 1 day of stretching only on alumina-coated discs. FN organization examined on smooth substrates was affected by 5 days of IMS, showing a thickening of the fibres. The same modifications induced by IMS were previously observed on alumina-covered discs. Vinculin expression was not affected by IMS whatever the substrate. Cell-cell interactions were determined by N-cadherin immunoblotting. N-cadherin expression was increased by IMS specifically on rough substrates. Our results suggest that the nature of the surface did not influence the up-regulation of alkaline phosphatase activity induced by IMS, but modulates specifically cell-substrate as well as cell-cell interactions in response to IMS.

Alloys↗

In vitro biocompatibility of titanium oxide for prosthetic devices nanostructured by low pressure metal-organic chemical vapor deposition.

Metal-Organic Chemical Vapor Deposition (MOCVD) has recently been proposed to coat orthopedic and dental prostheses with metal nanostructured oxide films through the decomposition of oxygenated compounds (single-source precursors) or the reaction of oxygen-free metal compounds with oxygenating agents. The present study was carried out to assess the in vitro biocompatibility in terms of cell proliferation and activation, of commercially pure Ti (control material: TI/MA) coated with nanostructured TiO2 film by MOCVD (Ti/MOCVD) using osteoblast-like cell cultures (MG-63). Evaluations were performed at 3, 7 and 14 days. Cell proliferation showed a similar trend for Ti/MA and TilMOCVD compared to polystyrene; cell number increased with time from seeding to day 7 (p < 0.005), and then decreased progressively until day 14 (ranging from -14% to -47%). The ALP level and OC production showed no significant differences between Ti/MOCVD and Ti/MA at each experimental time. Significantly higher ALP levels were found in Ti/MA at 3 days and in Ti/MOCVD at 7 and 14 days when compared to the polystyrene group. OC production decreased over time and the highest values were observed at 3 days, when it was significantly higher in the Ti/MA than in the polystyrene group (50%, p < 0.05). CICP synthesis was positively affected by the presence of Ti/MOCVD and was higher in Ti/MOCVD than in the polystyrene group. No significant differences were found between Ti/MOCVD and Ti/MA in terms of IL-6 and TGF-beta1 synthesis at any experimental time. In conclusion, the current findings demonstrate that the nanostructured TiO2 coating positively affects the osteoblast-like cell behavior in terms of cell proliferation and activity, thus confirming its high level of in vitro biocompatibility in accordance with expectations.

Biocompatible Materials↗

Effect of spark plasma sintering on the microstructure and in vitro behavior of plasma sprayed HA coatings.

The crystalline phases and degree of crystallinity in plasma sprayed calcium phosphate coatings on Ti substrates are crucial factors that influence the biological interactions of the materials in vivo. In this study, plasma sprayed hydroxyapatite (HA) coatings underwent post-spray treatment by the spark plasma sintering (SPS) technique at 500 degrees C, 600 degrees C, and 700 degrees C for duration of 5 and 30 min. The activity of the HA coatings before and after SPS are evaluated in vitro in a simulated body fluid. The surface microstructure, crystallinity, and phase composition of each coating is characterized by scanning electron microscopy and X-ray diffractometry before, and after in vitro incubation. Results show that the plasma sprayed coatings treated for 5 min in SPS demonstrated increased proportion of beta-TCP phase with a preferred-orientation in the (214) plane, and the content of beta-TCP phase corresponded to SPS temperature, up to 700 degrees C. SPS treatment at 700 degrees C for 30 min enhanced the HA content in the plasma spray coating as well. The HA coatings treated in SPS for 5 min revealed rapid surface morphological changes during in vitro incubation (up to 12 days), indicating that the surface activity is enhanced by the SPS treatment. The thickest apatite layer was found in the coating treated by SPS at 700 degrees C for 5 min.

Biomimetic Materials↗

Stability of a cyclically loaded hydroxyapatite coating: effect of substrate material, surface preparation, and testing environment.

Cyclic loading of Ti-6-4 and Co-Cr-Mo (cast) test samples with grit-blasted or waffle-textured surfaces coated with a plasma-sprayed 50-mum HA layer was performed in air, Ringer's solution (5% dextrose), 0.9% NaCl (Tris buffer, pH 7.40), and balanced Hank's solution. Maximum interfacial stresses in bending of 40 ksi (280 MPa) and 20 ksi (140 MPa) were utilized, and the specimens tested to 10 6 cycles at 5 Hz with a MTS servohydraulic machine. Tested samples were examined by optical microscopy to determine coating integrity and thickness and by scanning electron microscopy (electron backscatter mode and EDAX) to determine surface morphology and chemical changes. The following observations were made: (1) Samples cyclically tested in solutions showed a general thinning of the coating, accentuated in the higher-stressed regions. (2) Samples tested with an equivalent static load in the solutions did not show this centralization. (3) Bare metal interface surfaces were noted on most of the edges of highly stressed central specimen regions, in several entire central regions, and on the upper surfaces of some of the waffled samples. (4) The specimens tested in Ringer's solution (pH 4.70 initially) demonstrated the most dramatic coating deterioration. (5) The coatings on titanium appeared more stable than these on Co-Cr as tested in all solution environments for both surface types. The HA coating evaluated in this experiment demonstrated increased instability when cyclically loaded in in vitro solutions of lowered pH and depleted cations (Ca 2+) at stress levels of 280 MPa.(ABSTRACT TRUNCATED AT 250 WORDS)

Chromium↗