Physical characterization of different-roughness titanium surfaces, with and without hydroxyapatite coating, and their effect on human osteoblast-like cells

The aim of this study was to characterize and compare various titanium (Ti) and hydroxyapatite (HA) coatings on Ti6Al4V, in view of their application on noncemented orthopedic implants. Two innovative vacuum plasma sprayed (VPS) coatings, the first of ultrahigh rough and dense Ti (PG60, Ra=74 microm) and the second of ultrahigh rough and dense Ti coated with HA (HPG60, Ra=52 microm), have been developed, and the response of osteoblast-like cells (MG-63) seeded on these new coatings was evaluated in comparison to: a low roughness and sandblasted (Ti/SA, Ra=4 microm) Ti6Al4V surface; Ti medium (TI01, Ra=18 microm), and high (TI60, Ra=40 microm) roughness VPS coatings; and the relative Ti plus HA duplex coatings (HT01, Ra=12 microm and HT60, Ra=36 microm respectively), also obtained by VPS. PG60 coating presented no open porosity, making it dense and potentially intrinsically stronger. Cell adhesion and proliferation on PG60 was similar to those of the smoothest one (Ti/SA) and adhesion on ultrahigh roughness was lower than the medium- and high-roughness coatings, whereas cell proliferation on PG60 was lower than TI60. The HA coating determined significant increases in cell proliferation at medium and high roughness levels when compared to the relative Ti coating, but not compared to the ultrahigh one; all HA-coated surfaces showed a decrease in alkaline phosphatase activity and collagen I production. Surface morphology and the HA coating strongly affected cell behavior. However, ultrahigh values of roughness are not correctly seen by cells, and the presence of HA has no improving effects.     

Comparison of plasma-sprayed hydroxyapatite coatings and zirconia-reinforced hydroxyapatite composite coatings: in vivo study

The clinical use of plasma-sprayed hydroxyapatite (HA) coatings on metal implants has been widely adopted because the HA coating can achieve the firmly and directly biological fixation with the surrounding bone tissue. However, the long-term mechanical properties of HA coatings has been concern for the long-term clinical application. Previous research showed that the concept of adding ZrO2 as second phase to HA significantly increased the bonding strength of plasma-sprayed composite material. The present work aimed to explore the biological properties, including the histological responses and shear strength, between the plasma-sprayed HA and HA/ZrO2 coating, using the transcortical implant model in the femora of canines. After 6 and 12 weeks of implantation, the HA coating revealed the direct bone-to-coating contact by the backscattered electron images (BEIs) of scanning electron microscope (SEM), but the osseointegration was not observed at the surface of HA/ZrO2 coating. For new bone healing index (NBHI) and apposition index (AI), the values for HA implants were significantly higher than that for HA/ZrO2 coatings throughout all implant periods. After push-out test, the shear strength of HA-coated implants were statistically higher than HA/ZrO2 coated implants at 6- and 12-week implantation, and the failure mode of HA/ZrO2 coating was observed at the coating-bone interface by SEM. The results indicate that the firm fixation between bone and HA/ZrO2 has not been achieved even after 12-week implantation. Consequently, the addition of ZrO2 could improve the mechanical properties of coatings, while the biocompatibility was influenced by the different material characteristics of HA/ZrO2 coating compared to HA coatings.     

Effect of zinc ions on improving implant fixation in osteoporotic bone

Abstract

The application of titanium (Ti) and its alloys in tooth restoration and joint replacement for aged patients with unfavorable conditions is gaining popularity. Therefore, strategies aiming at improving the fixation of Ti-based implants are worth investigating. This study was designed to observe whether modification of Ti implants by zinc (Zn) could enhance the fixation capability in osteoporotic bone. Two kinds of implants, hydroxyapatite (HA) coated Ti and Zn-incorporated HA (ZnHA) coated Ti, were inserted into the femoral metaphysis longitudinally in ovariectomized (OVX) rats. Specimens were harvested and subjected to double fluorescence labeling examination at week 6 after surgery. At week 12, samples were evaluated with histomorphometry, micro-CT (μCT) analysis and biomechanical test. Compared to the HA coated implants, ZnHA coating improved mineral apposition rate (MAR) of peri-implant bone, which was revealed by double fluorescence labeling; bone area ratio (BA) and bone-to-implant contact (BIC) were also higher for the latter group by histomorphometry. μCT images suggested that more bone mass was formed around the ZnHA coated implants as compared to the HA coated implants. Biomechanical push-out test showed that the ZnHA coated implants demonstrated higher strength of osseointegration than the HA group. The current study suggested that Zn ions could enhance bone formation and improve implant fixation in OVX rats.     

Bone growth is enhanced by novel bioceramic coatings on Ti alloy implants

Calcium phosphate ceramics are widely used as coating materials to orthopedic implants and are found to enhance initial bony ingrowth by stimulating osseous apposition to the implant surface. In this study, two novel calcium orthophosphate materials were selected for coating onto the commonly used orthopedic implant material Ti-6Al- 4V. One was calcium alkali orthophosphate with the crystalline phase Ca10[K/Na](PO4)7 with a small addition of SiO2 (AW-Si) and the other was calcium orthophosphate composed of 70 mol % fluorapatite, Ca10(PO4)6F2 and 30 mol % CaZr4(PO4)6 (FA7Z). The coated implants were placed in cortical and cortico-cancellous bone of sheep femur for six weeks. Retrieved samples were tested for osseointegration and mechanical strength. It was found that both coatings produced enhanced bone/implant contact rate compared to the control when implanted in cortico-cancellous bone. This study demonstrates that the two coatings have the capability of encouraging bone growth, and hence the potential for being used as coating materials on Ti implants.     

钛合金表面新型生物玻璃/羟基磷灰石涂层的体内动物实验

目的为促进钛合金植入体与骨的结合,在其表面制备了生物玻璃/羟基磷灰石复合涂层,并植入兔子股骨内进行动物试验,采用等离子喷涂羟基磷灰石涂层和未涂层的Ti6Al4V合金作为对照。方法种植到期的植入体取出后进行组织学切片,采用品红-苦味酸染色后进行组织学观察,采用SEM高倍观察种植体与骨的结合界面,并对骨接触率和凹槽内骨长入量进行了统计分析和比较。结果三种植入体都具有良好的生物相容性。Ti6Al4V合金与骨之间是一种形态固定,而生物玻璃/羟基磷灰石涂层、等离子喷涂羟基磷灰石涂层可与骨形成骨键合。生物玻璃/羟基磷灰石涂层在植入期间与基体没有脱落,同时其与骨的接触率和凹槽内骨长入量要明显高于其余两个植入体,显示出促进骨生长的作用。结论由于具有良好的生物相容性和促进新骨生长的能力,生物玻璃/羟基磷灰石涂层可加快植入体与骨的愈合速度,在骨替代修复方面显示出优势和广阔的应用前景。     

Effects of bone morphogenetic protein-2 and hyaluronic acid on the osseointegration of hydroxyapatite-coated implants: an experimental study in sheep

Research efforts aim at enhancing early osseointegration of cementless implants to improve early fixation and, thus, reduce the risk of loosening. The aim of the present study was to investigate whether bone morphogenetic protein (BMP) 2 had a positive effect on the osseointegration of hydroxyapatite-coated implants. Hydroxyapatite (HA) implants (perforated hollow cylinders and solid rods) were coated with BMP-2 and hyaluronic acid (HY) as the carrier or with HY alone. Uncoated HA implants served as controls. The osseointegration of the implants was evaluated either by light microscopy or by pullout tests after 1, 2, and 4 weeks of unloaded implantation in the cancellous bone of 24 sheep. The BMP-2 coating significantly increased bone growth into the implant perforations compared with HA-coated implants at 2 and 4 weeks. Bone-implant contact and interface shear strength of BMP-2 implants were lower than HA implants at 2 weeks. At 4 weeks, there was no significant difference in bone-implant contact and shear strength between BMP-2 and HA-coated implants. The BMP-2 coating enhanced gap healing but had no positive or even an inhibitory effect (at 2 weeks) on bone-implant contact and interface shear strength. In the clinical situation, a perfect press-fit implantation cannot be achieved, and BMP-2 may be beneficial for enhancing bone growth into gaps around cementless implants.     

Strontium in the bone-implant interface

Total hip replacement surgery is being performed on an increasingly large part of the population and at increasingly younger age. Because we live and stay physically active longer, and since hip replacement surgery has become quite successful, the treatment is being offered to progressively more patients. Unfortunately, about 17% of hip replacement surgeries currently involve revisions. Consequently, the longevity of both the primary and revision implant is an issue and warrants further investigation. Implants undergoing early instability or even subsidence correlate with an increased risk of aseptic loosening, subsequently requiring revision. Thus, the goal is early fixation by osseointegration of the implant. For revision implants, this is an even greater challenge since an allograft is often needed during surgery to obtain immediate stability of the implant. Bone grafts are rapidly resorbed. Thus, instability of the prosthesis may develop before new bone formation is well established and can mechanically secure the prosthesis. Strontium is a dual action drug; being both bone anabolic and anti-catabolic. In the form of strontiumranelate, it is used in the treatment of osteoporosis. Strontium may potentially improve the early osseointegration and fixation of implants. This dissertation consists of three studies investigating the effect of strontium at the bone-implant interface. The questions were firstly, what is the optimal delivery method for strontium to the interface, and secondly, can strontium exercise its dual action at the interface? The studies were performed in a cementless, experimental gap model in canine. The effects of strontium were evaluated by histomorphometrical analysis of the osseointegration and mechanical push-out test of implant fixation. Different stereological methods were used for the histomorphometrical analysis of each study. The methods used were reviewed critically and found valid. Study I compared a 5% strontium-substituted hydroxyapatite (HA) coating with an HA coating after 4 weeks and 12 weeks observation time. We examined whether fixation of the implant was improved by the strontium substitution. It was found that fixation of the implant was not improved by the strontium substituted HA coating at any of the two time points. Study II compared a 5% strontium-doped HA bone graft extender with an HA bone graft extender. The bone graft extender was mixed with allograft and impacted around a titanium implant. The objective of this study was to determine whether strontium doping of the bone graft extender could protect the allograft from fast resorption and increase gap healing, leading to the improved fixation of the implant. We found that the strontium doping increased gap healing and protected the allograft, however, results of the mechanical test were inconclusive. The reason might have been that the increased gap healing had not yet reached the implant during the 4 weeks observation time, so ongrowth onto the implant was not improved. Study III investigated the effects of bioactive glass coating with a 0%, 10% or 50% strontium-substitution versus HA coating of grit-blasted titanium alloy implants. The goal was to determine whether fixation of the implant would be improved by the bioactive glass coating, and then further improved by the strontium-substitution of the coating in a dose-dependent manner. Unfortunately, the bioactive glass coating failed, presumably due to aluminum contamination originating from the grit-blasting powder. The HA coated implants were superior in all parameters of osseointegration and the mechanical fixation of the implants. These studies show the importance of performing further experimental investigation. Even when investigating a known agent for use in a new application. Strontium delivered as doping of an HA bone graft extender showed potential as a dual acting agent in the interface. However, delivery methods of strontium to the bone-implant interface clearly need further investigation.     

The effect of polyelectrolyte multilayer coated titanium alloy surfaces on implant anchorage in rats

Advances have been achieved in the design and biomechanical performance of orthopedic implants in the last decades. These include anatomically shaped and angle-stable implants for fracture fixation or improved biomaterials (e.g. ultra-high-molecular-weight polyethylene) in total joint arthroplasty. Future modifications need to address the biological function of implant surfaces. Functionalized surfaces can promote or reduce osseointegration, avoid implant-related infections or reduce osteoporotic bone loss. To this end, polyelectrolyte multilayer structures have been developed as functional coatings and intensively tested in vitro previously. Nevertheless, only a few studies address the effect of polyelectrolyte multilayer coatings of biomaterials in vivo. The aim of the present work is to evaluate the effect of polyelectrolyte coatings of titanium alloy implants on implant anchorage in an animal model. We test the hypotheses that (1) polyelectrolyte multilayers have an effect on osseointegration in vivo; (2) multilayers of chitosan/hyaluronic acid decrease osteoblast proliferation compared to native titanium alloy, and hence reduce osseointegration; (3) multilayers of chitosan/gelatine increase osteoblast proliferation compared to native titanium alloy, hence enhance osseointegration. Polyelectrolyte multilayers on titanium alloy implants were fabricated by a layer-by-layer self-assembly process. Titanium alloy (Ti) implants were alternately dipped into gelatine (Gel), hyaluronic acid (HA) and chitosan (Chi) solutions, thus assembling a Chi/Gel and a Chi/HA coating with a terminating layer of Gel or HA, respectively. A rat tibial model with bilateral placement of titanium alloy implants was employed to analyze the bones’ response to polyelectrolyte surfaces in vivo. 48 rats were randomly assigned to three groups of implants: (1) native titanium alloy (control), (2) Chi/Gel and (3) Chi/HA coating. Mechanical fixation, peri-implant bone area and bone contact were evaluated by pull-out tests and histology at 3 and 8 weeks. Shear strength at 8 weeks was statistically significantly increased (p < 0.05) in both Chi/Gel and Chi/HA groups compared to the titanium alloy control. No statistically significant difference (p > 0.05) in bone contact or bone area was found between all groups. No decrease of osseointegration of Chi/HA-coated implants compared to non-coated implants was found. The results of polyelectrolyte coatings in a rat model showed that the Chi/Gel and Chi/HA coatings have a positive effect on mechanical implant anchorage in normal bone.     

Osseointegration of hydroxyapatite-coated and noncoated Ti6Al4V implants in the presence of local infection: a comparative histomorphometrical study in rabbits

A study was designed to investigate the osseointegration of titanium implants, either noncoated or coated with hydroxyapatite (HA), into rabbit tibiae in the presence of local infection compared with osseointegration in the absence of local infection. HA-coated or noncoated Ti cylinders were implanted into both tibiae of 32 rabbits (New Zealand Whites). Before implantation the left tibia was contaminated with different quantities of Staphylococcus aureus (10(2)-10(5) CFU). Four weeks after surgery the tibiae were explanted and prepared for microbiological and histomorphometrical examination. Histomorphometrical data, as a representation of implant fixation, were obtained by measuring the percentage of bone around the implants (within a radius of 1 mm from the outer diameter of the implants) and the percentage of the circumference of the implant that was in direct contact with bone. Histomorphometry revealed, in particular for the HA implants, a relationship between the inoculum concentration and/or the presence or absence of infection with the bone contact at the distal implant side. This confirms a relationship between peri-implant infection and bone contact or remodeling. HA-coated implants developed, in the presence of bacteria, more easily a more severe infection than noncoated Ti implants, and we show in the present study that local infection will influence histomorphometrical parameters (bone-implant contact) that determine implant fixation. Precautions to prevent contamination (asepsis) and/or infection (perioperative antibiotics) are even more important for the highly biocompatible HA-coated implant.     

Mechanical stability of two-step chemically deposited hydroxyapatite coating on Ti substrate: effects of various surface pretreatments

The success of implants in orthopaedic and dental load-bearing applications crucially depends on the initial biological fixation of implants in surrounding bone tissues. Using hydroxyapatite (HA) coating on Ti implant as carrier for bone morphogenetic proteins (BMPs) may promote the osteointegration of implants; therefore, reduce the risk of implant failure. The goal of this study was to develop an HA coating method in conditions allowing the incorporation of protein-based drugs into the coating materials, while achieving a mechanical stable coating on Ti implant. HA coatings were deposited on six different groups of Ti surfaces: control (no pretreatment), pretreated with alkali, acid, heat at 800°C, grit blasted with Al?O?, and grit blasted followed by heat treatment. HA coating was prepared using a two-step procedure. First step was the chemical deposition of a monetite coating on Ti substrate in acidic condition at 75°C and the second step was the hydrolysis of the monetite coating to HA. Coatings were characterized by scanning electron microscope (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). The roughness of substrates and coatings was measured using profilometry technique. The mechanical stability of the coatings deposited on the pretreated substrates was assessed using scratch test. The coatings deposited on the grit-blasted Ti surface demonstrated superior adhesive properties with critical shearing stress 131.6 ± 0.2 MPa.     

Effects of gold coating on experimental implant fixation

Insertions of orthopedic implants are traumatic procedures that trigger an inflammatory response. Macrophages have been shown to liberate gold ions from metallic gold. Gold ions are known to act in an antiinflammatory manner by inhibiting cellular NF-kappaB-DNA binding and suppressing I-kappa B-kinase activation. The present study investigated whether gilding implant surfaces augmented early implant osseointegration and implant fixation by its modulatory effect on the local inflammatory response. Ion release was traced by autometallographic silver enhancement. Gold-coated cylindrical porous coated Ti6Al4V implants were inserted press-fit in the proximal part of tibiae in nine canines and control implants without gold inserted contralateral. Observation time was 4 weeks. Biomechanical push-out tests showed that implants with gold coating had approximately 50% decrease in mechanical strength and stiffness. Histomorphometrical analyses showed gold-coated implants had a decrease in overall total bone-to-implant contact of 35%. Autometallographic analysis revealed few cells loaded with gold close to the gilded implant surface. The findings demonstrate that gilding of implants negatively affects mechanical strength and osseointegration because of a significant effect of the released gold ions on the local inflammatory process around the implant. The possibility that a partial metallic gold coating could prolong the period of satisfactory mechanical strength, however, cannot be excluded.     

Comparison of plasma-sprayed hydroxyapatite coatings and hydroxyapatite/tricalcium phosphate composite coatings: in vivo study

This study aimed to compare biological properties, including osteoconduction, osseointegration, and shear strength, between plasma-sprayed hydroxyapatite (HA) and HA/tricalcium phosphate (TCP) coatings, using a transcortical implant model in the femora of canines. After 3 and 12 weeks of implantation, the implants with surrounding bone were assessed histologically in undecalcified sections in backscattered electron images (BEIs) under a scanning electron microscope (SEM). After short-term (3 week) follow-up, both coatings conducted new bone formation and revealed direct bone-to-coating contact. The HA/TCP coating could not enhance early host-to-coating responses. At 12 weeks, serious dissolution of the HA/TCP coatings evidently occurred. By the new bone healing index (NBHI) and apposition index (AI), we found no significant difference between HA/TCP-coated implants and HA-coated implants throughout all implant periods. At 12 weeks of implantation, some particles dissociated from the HA/TCP coating were found within the remodeling canal. After push-out measurements, the shear strength and failure mode of HA/TCP-coated implants were similar to those of HA-coated implants, and no statistical differences were found between either coating. Consequently, this study indicates that HA/TCP coatings have excellent biological response and may be considered suitable bioactive ceramic coatings for short-term clinical use.     

Osseointegration of loaded dental implant with KrF laser hydroxylapatite films on Ti6Al4V alloy by minipigs

This study was performed with the objective of evaluating osseointegration of titanium alloy Ti6Al4V dental implants coated with hydroxylapatite (HA) deposited by a KrF laser. For this a KrF excimer laser and stainless-steel deposition chamber were used. The thickness of the HA films was approximately 1 microm. In this investigation experimental animals minipigs were used; the implants were placed vertically into the lower jaw. After 14 weeks of unloaded osseointegration, metal-ceramic crowns were inserted and, at the same time, fluorescent solution was injected into the experimental animals. Six months after insertion of crowns the animals were sacrificed. The vertical position of the implants was checked by a radiograph. Microscopic sections were cut and ground, and the sections were examined under polarized and fluorescent light using a microscope with a charge coupled device camera. The six month long osseointegration in the lower jaw has confirmed the presence of newly formed bone around all the implants. In the experimental group, which had a laser-deposited coating, the layer of fibrous connective tissue was seen only randomly. In the control group (titanium implant without a cover) the fibrous connective tissue between the implant and the newly formed bone was observed more frequently, but this difference was not significant.     

Different patterns of bone fixation with hydroxyapatite and resorbable CaP coatings in the rabbit tibia at 6, 12, and 52 weeks

Applying bioactive coatings on orthopedic implants can increase the fixation and long-term implant survival. In our study, we compared a resorbable electrochemically deposited calcium phosphate coating (Bonit?) to a thin (40 μm) plasma-sprayed hydroxyapatite (HA) coating, applied on grit-blasted screw-shaped Ti-6Al-4V implants in the cortical region of rabbit tibia, implanted for 6, 12, and 52 weeks. The removal torque results demonstrated stronger bone-to-implant fixation for the HA than Bonit-coated screws at 6 and 12 weeks. After 52 weeks, the fixation was in favor of the Bonit-coated screws, but the difference was statistically insignificant. Coat flaking and delamination of the HA with multinucleated giant cell activity and bone resorption observed histologically seemed to preclude any significant increase in fixation comparing the HA implants at 6 versus 12 weeks and 12 versus 52 weeks. The Bonit-coated implants exhibited increasing fixation from 6 to 12 weeks and from 12 to 52 weeks, and the coat was resorbed within 6 weeks, with minimal activity of multinucleated giant cells or bone resorption. A different fixation pattern was observed for the two coatings with a sharper but time limited increase in fixation for the HA-coated screws, and a slower but more steadily increasing fixation pattern for the Bonit-coated screws. The side effects were more serious for the HA coating and limiting the expected increase in fixation with time.     

In vivo behavior and mechanical stability of surface-modified titanium implants by plasma spray coating and chemical treatments

The geometric design and chemical compositions of an implant surface may have an important part in affecting early implant stabilization and influencing tissue healing. In this study, in vivo behavior and mechanical stability in implants of three surface designs, which were smooth surface (SS), rough titanium (Ti) surface by plasma spray coating (PSC), and alkali- and heat-treated (AHT) Ti surface after plasma spray coating, were compared by histological and mechanical analyses. Surface morphologies of the implants were observed by optical microscopy and scanning electron microscopy. Chemical compositional surface changes were investigated by energy dispersive spectroscopy. The implants were inserted transversely in a dog thighbone and evaluated at 4 weeks of healing. At 4 weeks of healing after implantation in bone, the healing tissue was more extensively integrated with an AHT implant than with the implants of smooth (SS) and/or rough Ti surfaces (PSC). The bone bonding strength (pull-out force) between living bone and implant was observed by a universal testing machine. At 4 weeks' healing after implant placement in bone, the pull-out forces of the SS, PSC, and AHT implants were 235 (+/-34.25), 710 (+/-142.25), and 823 (+/-152.22) N, respectively. Histological and mechanical data demonstrate that appropriate surface design selection can improve early bone growth and induce an acceleration of the healing response, thereby improving the potential for implant osseointegration.     

A mechanical investigation of fluorapatite, magnesiumwhitlockite, and hydroxylapatite plasma-sprayed coatings in goats.

Ceramic coatings of fluorapatite (FA), magnesiumwhitlockite (MW), and hydroxylapatite (HA), and noncoated Ti-6Al-4V alloy (Ti) implants were evaluated before and after implantation in an animal study. Cylindrical plugs were coated by plasma-spraying with FA, MW, and HA. X-ray-diffraction patterns showed for FA and HA a crystalline and for MW an amorphous-crystalline coating structure. The plugs were implanted into the right femora and left humeri of 16 adult goats. Follow-up periods were 12 and 25 weeks. The in vivo results were evaluated using push-out tests and scanning electron microscopy. There were significant differences in push-out strengths between femur and humerus. The FA and HA implants showed significantly higher push-out strengths than the MW and Ti alloy implants, especially for the 12 week follow-up period. Furthermore, at 12 weeks, MW showed significantly lower push-out strengths than Ti alloy. SEM-investigation of the interfaces revealed that FA did not degrade while both MW and HA showed extensive degradation at 12 and 25 weeks. In addition, the interface after push-out testing showed for the MW, HA, and Ti alloy implants to be fractured at the implant-tissue interface and for the FA to be fractured at the coating-titanium interface.     

具有微弧氧化-硅烷-褪黑素复合膜层钛合金种植体的体内骨结合

BACKGROUND: Imperfect strength of titanium alloy implant-bone interface delays bone healing. OBJECTIVE: In order to further improve the early healing ability of titanium dental implants, to make the surface modification of titanium alloy implant and observe the osseointegration ability of the implant. METHODS: Titanium alloy implants were coated with micro-arc oxidation (group A), micro-arc oxidation-silane (group B), and micro-arc oxidation-silane-melatonin (group C) coatings, respectively. Three kinds of implants were placed into the mandible of New Zealand white rabbits, and 2, 4, 6 weeks after implantation, implant-bone interface osseointegration was observed using cone-beam CT, fluorescence microscopy, and torsion test. RESULTS AND CONCLUSION: (1) Cone-beam CT examination: 6 weeks after implantation, the osseointegration of the implant with the mandible achieved the best results in the group C, followed by group B and group A. (2) Fluorescence microscope observation: the implants in the three groups exhibited the strongest fluorescence at 4 weeks and slightly weakened at 6 weeks, and the fluorescence intensity was higher in the group C than the other two groups. (3) Torsion test: with implantation time prolonged, the implant-bone osseointegration activity gradually increased in the three groups, while it was still highest in the group C (P < 0.05). In summary, our results show that the titanium alloy implant coated with micro-arc oxidation-silane-melatonin composite coating has higher osseointegration activity and promotes bone formation.     

Loading improves anchorage of hydroxyapatite implants more than titanium implants

Roentgen Stereophotogrammetric Analysis (RSA) studies have shown that the quality of the early fixation of implants has a dominant effect on their long-term function. To evaluate methods to improve their fixation, we examined the influence of mechanical loading and surface coating on the quality of the bone-implant interface. We compared the fixation of a cylindrical, stable 6.0 mm implant initially surrounded by a 0.75 mm concentric gap, after 4 weeks of loaded or unloaded conditions. Two types of surfaces were analyzed: plasma sprayed hydroxyapatite (HA) and plasma sprayed titanium (Ti). The histomorphometric evaluation showed that HA implants had greater bone coverage than Ti implants, and this coverage was further increased under loaded conditions only for HA. Furthermore, loading reduced the fibrous tissue coverage for the HA implants, while it increased fibrous tissue coverage for Ti implants. These findings were in agreement with pushout results showing that HA implants had greater shear strength, stiffness, and energy than Ti implants, and (except for energy) these parameters were further increased under loaded conditions only for HA. In addition, because the two implant surfaces exhibited a different relative response to load, it is important to evaluate new surfaces under the more clinically relevant loaded condition.     

Characterization of hydroxyapatite and titanium coatings sputtered on Ti-6Al-4V substrate.

A series of thin (<10 microm), single-layered HA/Ti coatings were deposited on Ti-6Al-4V substrate using a radio frequency magnetron-assisted sputtering system. The adhesion strength, microstructure, and chemistry of the coatings were characterized. Experimental results showed that higher Ti contents in targets or coatings resulted in higher deposition rates. When Ti was added the highly crystalline structure of monolithic HA coating was largely disrupted and the coating became amorphous-like. The highly crystalline structure of the monolithic Ti coating was also disrupted by introducing small amounts of Ca, P, and O into the coating. The HA/Ti coatings had quite uniform thicknesses and appeared smooth, dense, and well bonded to the substrate. A scanning electron microscope with an energy dispersive spectroscopy system showed that monolithic HA, 95HA/5Ti, 25HA/75Ti, and 50HA/50Ti coatings had the lowest Ca/P ratios while the 75HA/25Ti coating had the highest. The adhesion strengths of all coatings were between 60 and 80 MPa.     

Improved bone anchorage of hydroxypatite coated implants compared with tricalcium-phosphate coated implants in trabecular bone in dogs

Tricalcium phosphate (TCP) and hydroxyapatite (HA) ceramic coatings are bioactive coatings that have been shown to stimulate bone apposition onto ceramic-coated implants. TCP and HA ceramics have well-documented differences in physical properties, but both types of ceramics are used for stimulation of bone ongrowth to cementless endo-prosthetic components clinically. However, little is known about the difference in osteoconductive properties between these coatings when inserted into trabecular bone in a controlled experimental situation. Unloaded cylindrical gritblasted titanium (Ti-6A1-4V) implants (6 x 10 mm) coated with either hydroxyapatite (HA) or tricalcium phosphate (TCP) ceramic were inserted into the proximal humerus of 20 skeletally mature dogs. The implants were initially surrounded by a 2 mm gap. Each animal received one HA-coated implant and one TCP-coated implant. All dogs were sacrificed 6 weeks after surgery. Results were evaluated by histomorphometry and mechanical push-out test. Push-out tests demonstrated that HA-coated implants were 10-fold stronger fixated in comparison to TCP-coated implant. Bone ongrowth was significantly higher for HA-coated implants compared to TCP-coated implants. Bone volume in the gap showed a tendency to less bone volume around HA-coated implants compared to TCP-coated implants but this difference was insignificant. As expected almost all of the TCP coating were resorbed after 6 weeks and almost none of the HA coating. HA-coated implants with a grit-blasted surface provide a favorable early mechanical implant anchorage most likely due to superior ceramic stability compared to TCP-coated implants.