Preliminary investigation of the effects of surface treatments on biological response to shape memory NiTi stents.

Nickel-titanium (NiTi) offers many advantages for the fabrication of coronary stents: shape memory, superelasticity, and radiopacity. However, many authors highlighted the selective dissolution of Ni from the alloy during the corrosion process that could lead to potential toxicity. The improvement of the NiTi stent's corrosion resistance by different surface treatments (electropolishing, heat treatment, and nitric acid passivation) was reported in a previous article. In the present study a comparative biocompatibility evaluation of such stents was performed through in vitro and in vivo assays. A cell proliferation test was completed to evaluate the cytotoxicity of surface treated NiTi using human fibroblasts. Then a stent implantation was performed in rabbit paramuscular muscle to study the inflammatory response generated by the same implants. Cell proliferation tests generally indicated an in vitro biocompatibility of our samples similar to the control group. An in vivo implantation study demonstrated the gradual overall reduction with time of the fibrocellular capsule thickness surrounding the implants. After a 12-week implantation period, the fibrous capsules surrounding the different implants tended toward the same value of 0.07 mm, which suggested that all surface treatments produced a similar biological response. This low value of the fibrocellular capsule indicated that our NiTi surface treated implants were relatively inert.     

Surface structure and properties of biomedical NiTi shape memory alloy after Fenton's oxidation

Fenton's oxidation is traditionally used to remove inorganic and organic pollutants from water in waster water treatment. It is an advanced oxidation process in which H2O2 is catalytically decomposed by ferrous irons into hydroxyl radicals (*OH) which have a higher oxidation potential (2.8V) than H2O2. In the work reported here, we for the first time use Fenton's oxidation to modify the surface of biomedical NiTi shape memory alloy (SMA). The influences of Fenton's oxidation on the surface microstructure, blood compatibility, leaching of harmful Ni ions and corrosion resistance in simulated body fluids is assessed using scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy, inductively coupled plasma mass spectrometry, electrochemical tests, hemolysis analysis and the blood platelet adhesion test. The mechanical stability of the surface titania film produced by Fenton's oxidation as well as their effects on the shape memory behavior of the SMA are studied by bending tests. Our results show that Fenton's oxidation produces a novel nanostructured titania gel film with a graded structure on the NiTi substrate without an intermediate Ni-rich layer that is typical of high-temperature oxidation. Moreover, there is a clear Ni-free zone near the top surface of the titania film. The surface structural changes introduced by Fenton's oxidation improve the electrochemical corrosion resistance and mitigate Ni release. The latter effects are comparable to those observed after oxygen plasma immersion ion implantation reported previously and better than those of high-temperature oxidation. Aging in boiling water improves the crystallinity of the titania film and further reduces Ni leaching. Blood platelet adhesion is remarkably reduced after Fenton's oxidation, suggesting that the treated SMA has improved thrombo resistance. Enhancement of blood compatibility is believed to stem from the improved hemolysis resistance, the surface wettability and the intrinsic electrical characteristics of the titania film. The titania film produced by Fenton's oxidation has good mechanical stability and does not adversely impact the shape memory behavior of NiTi. Our work suggests that Fenton's oxidation is a promising low-temperature, low-cost surface modification method for improving the surface properties of biomedical NiTi SMA.     

Surface mechanical properties, corrosion resistance, and cytocompatibility of nitrogen plasma-implanted nickel-titanium alloys: a comparative study with commonly used medical grade materials

Stainless steel and titanium alloys are the most common metallic orthopedic materials. Recently, nickel-titanium (NiTi) shape memory alloys have attracted much attention due to their shape memory effect and super-elasticity. However, this alloy consists of equal amounts of nickel and titanium, and nickel is a well known sensitizer to cause allergy or other deleterious effects in living tissues. Nickel ion leaching is correspondingly worse if the surface corrosion resistance deteriorates. We have therefore modified the NiTi surface by nitrogen plasma immersion ion implantation (PIII). The surface chemistry and corrosion resistance of the implanted samples were studied and compared with those of the untreated NiTi alloys, stainless steel, and Ti-6Al-4V alloy serving as controls. Immersion tests were carried out to investigate the extent of nickel leaching under simulated human body conditions and cytocompatibility tests were conducted using enhanced green fluorescent protein mice osteoblasts. The X-ray photoelectron spectroscopy results reveal that a thin titanium nitride (TiN) layer with higher hardness is formed on the surface after nitrogen PIII. The corrosion resistance of the implanted sample is also superior to that of the untreated NiTi and stainless steel and comparable to that of titanium alloy. The release of nickel ions is significantly reduced compared with the untreated NiTi. The sample with surface TiN exhibits the highest amount of cell proliferation whereas stainless steel fares the worst. Compared with coatings, the plasma-implanted structure does not delaminate as easily and nitrogen PIII is a viable way to improve the properties of NiTi orthopedic implants.     

A comparative study of the cytotoxicity and corrosion resistance of nickel-titanium and titanium-niobium shape memory alloys

Nickel-titanium (NiTi) shape memory alloys (SMAs) are commonly used in a range of biomedical applications. However, concerns exist regarding their use in certain biomedical scenarios due to the known toxicity of Ni and conflicting reports of NiTi corrosion resistance, particularly under dynamic loading. Titanium-niobium (TiNb) SMAs have recently been proposed as an alternative to NiTi SMAs due to the biocompatibility of both constituents, the ability of both Ti and Nb to form protective surface oxides, and their superior workability. However, several properties critical to the use of TiNb SMAs in biomedical applications have not been systematically explored in comparison with NiTi SMAs. These properties include cytocompatibility, corrosion resistance, and alterations in alloy surface composition in response to prolonged exposure to physiological solutions. Therefore, the goal of the present work was to comparatively investigate these aspects of NiTi (49.2 at.% Ti) and TiNb (26 at.% Nb) SMAs. The results from the current studies indicate that TiNb SMAs are less cytotoxic than NiTi SMAs, at least under static culture conditions. This increased TiNb cytocompatibility was correlated with reduced ion release as well as with increased corrosion resistance according to potentio-dynamic tests. Measurements of the surface composition of samples exposed to cell culture medium further supported the reduced ion release observed from TiNb relative to NiTi SMAs. Alloy composition depth profiles also suggested the formation of calcium phosphate deposits within the surface oxide layers of medium-exposed NiTi but not of TiNb. Collectively, the present results indicate that TiNb SMAs may be promising alternatives to NiTi for certain biomedical applications.     

Nickel release behavior, cytocompatibility, and superelasticity of oxidized porous single-phase NiTi

Porous NiTi shape memory alloys are one of the promising biomaterials for surgical implants because of their unique shape memory effects and porous structure with open pores. However, the complex surface morphology and larger area of porous NiTi compared to dense NiTi make it more vulnerable from the viewpoint of release of nickel, which can cause deleterious effects in the human body. It is also more difficult to modify the exposed surfaces of a porous structure using conventional surface modification technologies. In this work, oxidation in conjunction with postreaction heat treatment was used to modify the surfaces of porous single-phase NiTi prepared by capsule-free hot isostatic pressing to mitigate Ni leaching and enhance the surface properties. Differential scanning calorimetry thermal analysis, uniaxial compression tests, inductively-coupled plasma mass spectrometry, and cell cultures reveal that porous NiTi alloys oxidized at 450 degrees C for 1 h have an austenite transition temperature below 37 degrees C, excellent superelasticity, lower nickel release, and no cytotoxicity.     

New oxidation treatment of NiTi shape memory alloys to obtain Ni-free surfaces and to improve biocompatibility

Various oxidation treatments were applied to nearly equiatomic NiTi alloys so as to form a Ni-free protective oxide on the surface. Sample surfaces were analyzed by X-ray Photoelectron Spectroscopy, and NiTi transformation temperatures were determined by differential scanning calorimetry (DSC) before and after the surface treatment. An ion release experiment was carried out up to one month of immersion in SBF for both oxidized and untreated surfaces. The results show that oxidation treatment in a low-oxygen pressure atmosphere leads to a high surface Ti/Ni ratio, a very low Ni surface concentration and a thick oxide layer. This oxidation treatment does not significantly affect the shape memory properties of the alloy. Moreover, the oxide formed significantly decreases Ni release into exterior medium comparing with untreated surfaces. As a consequence, this new oxidation treatment could be of great interest for biomedical applications, as it could minimize sensitization and allergies and improve biocompatibility and corrosion resistance of NiTi shape memory alloys.     

The Corrosion Resistance of Composite Arch Wire Laser-Welded By NiTi Shape Memory Alloy and Stainless Steel Wires with Cu Interlayer in Artificial Saliva with Protein

In this paper, the corrosion resistance of laser-welded composite arch wire (CoAW) with Cu interlayer between NiTi shape memory alloy and stainless steel wire in artificial saliva with different concentrations of protein was studied. It was found that protein addition had a significant influence on the corrosion behavior of CoAW. Low concentration of protein caused the corrosion resistance of CoAW decrease in electrochemical corrosion and immersion corrosion tests. High concentration of protein could reduce this effect.     

Keratin hydrogels support the sustained release of bioactive ciprofloxacin

An in-situ nitriding method has been developed to modify the outer surface and the pore walls of both open and closed pores of porous NiTi shape memory alloys (SMAs) as part of their sintering process. XRD and XPS examinations revealed that the modified layer is mainly TiN. The biocompatibility of the in-situ nitrided sample has been characterized by its corrosion resistance, cell adherence, and implant surgery. The in-situ nitrided porous NiTi SMAs exhibit much better corrosion resistance, cell adherence, and bone tissue induced capability than the porous NiTi alloys without surface modification. Furthermore, the released Ni ion content in the blood of rabbit is reduced greatly by the in-situ nitriding. The excellent biocompatibility of in-situ nitrided sample is attributed to the formation of the TiN layer on all the pore walls including both open and closed pores.     

Bone healing and mineralization, implant corrosion, and trace metals after nickel-titanium shape memory metal intramedullary fixation.

Its shape memory effect, superelasticity, and good wear and damping properties make the NiTi shape memory alloy a material with fascinating potential for orthopedic surgery. It provides a possibility for making self-locking, self-expanding, and self-compressing implants. Problems, however, may arise because of its high nickel content. The purpose of this work was to determine the corrosion of NiTi in vivo and to evaluate the possible deleterious effects of NiTi on osteotomy healing, bone mineralization, and the remodeling response. Femoral osteotomies of 40 rats were fixed with either NiTi or stainless steel (StSt) intramedullary nails. The rats were killed at 2, 4, 8, 12, 26, and 60 weeks. Bone healing was examined with radiographs, peripheral quantitative computed tomography, (pQCT) and histologically. The corrosion of the retrieved implants was analyzed by electron microscopy (FESEM). Trace metals from several organs were determined by graphite furnace atomic absorption spectrometry (GF-AAS) or by inductively coupled plasma-atomic emission spectrometry (ICP-AES). There were more healed bone unions in the NiTi than in the StSt group at early (4 and 8 weeks) time points. Callus size was equal between the groups. The total and cortical bone mineral densities did not differ between the NiTi and StSt groups. Mineral density in both groups was lower in the osteotomy area than in the other areas along the nail. Density in the nail area was lower than in the proximal part of the operated femur or the contralateral femur. Bone contact to NiTi was close. A peri-implant lamellar bone sheet formed in the metaphyseal area after 8 weeks, indicating good tissue tolerance. The FESEM assessment showed surface corrosion changes to be more evident in the StSt implants. There were no statistically significant differences in nickel concentration between the NiTi and StSt groups in any of the organs. NiTi appears to be an appropriate material for further intramedullary use because it has good biocompatibility in bone tissue.Copyright 1999 John Wiley & Sons, Inc.     

Corrosion behavior of titanium nitride coated Ni-Ti shape memory surgical alloy

Nickel-titanium (NiTi, nitinol) shape memory alloy was nitrided using an original powder immersion reaction assisted coating (PIRAC) method in order to modify its surface properties. PIRAC nitriding method is based on annealing the samples in the atmosphere of highly reactive nitrogen supplied by decomposition of unstable nitride powders or, alternatively, by selective diffusion of the atmospheric nitrogen to the sample surface. Being a non-line-of-sight process, PIRAC nitriding allows uniform treatment of complex shape surgical implants. Hard two-layer titanium nitride (TiN)/Ti2, Ni coatings were obtained on NiTi surface after PIRAC anneals at 900 and 1000 degrees C. PIRAC coating procedure was found to considerably improve the corrosion behavior of NiTi alloy in Ringer's solution. In contrast to untreated nitinol, no pitting was observed in the samples PIRAC nitrided at 1000 degrees C, 1 h up to 1.1 V. The coated samples were also characterized by very low anodic currents in the passive region and by an exceedingly low metal ion release rate. The research results suggest that PIRAC nitriding procedure could improve the in vivo performance of NiTi alloys implanted into the human body.     

Microstructure,nickel suppression and mechanical characteristics of electropolished and photoelectrocatalytically oxidized biomedical nickel titanium shape memory alloy

A new surface modification protocol encompassing an electropolishing pretreatment (EP) and subsequent photoelectrocatalytic oxidation (PEO) has been developed to improve the surface properties of biomedical nickel titanium (NiTi) shape memory alloy (SMA). Electropolishing is a good way to improve the resistance to localized breakdown of NiTi SMA whereas PEO offers the synergistic effects of advanced oxidation and electrochemical oxidation. Our results indicate that PEO leads to the formation of a sturdy titania film on the EP NiTi substrate. There is an Ni-free zone near the top surface and a graded interface between the titania layer and NiTi substrate, which bodes well for both biocompatibility and mechanical stability. In addition, Ni ion release from the NiTi substrate is suppressed, as confirmed by the 10-week immersion test. The modulus and hardness of the modified NiTi surface increase with larger indentation depths, finally reaching plateau values of about 69 and 3.1 GPa, respectively, which are slightly higher than those of the NiTi substrate but much lower than those of a dense amorphous titania film. In comparison, after undergoing only EP, the mechanical properties of NiTi exhibit an inverse change with depth. The deformation mechanism is proposed and discussed. Our results indicate that surface modification by dual EP and PEO can notably suppress Ni ion release and improve the biocompatibility of NiTi SMA while the surface mechanical properties are not compromised, making the treated materials suitable for hard tissue replacements.     

Ion release from NiTi orthodontic wires in artificial saliva with various acidities

NiTi orthodontic wire products from different manufacturers would have different corrosion resistance. We assayed the corrosion resistance, in terms of ion release, of different NiTi orthodontic wires in artificial saliva with various acidities. Four types of as-received commercial NiTi orthodontic wires were immersed in artificial saliva (37 degrees C) at pH 2.5-6.25 for different periods (1-28d). The amount of Ni and Ti ions released from NiTi wires was determined using an atomic adsorption spectrophotometer. Surface morphology and roughness of wires were related to the corrosion resistance. Results showed that the manufacturer, pH value, and immersion period, respectively, had a significantly statistical influence on the release amount of Ni and Ti ions. The amount of Ni ions released in all test solutions was well below the critical value necessary to induce allergy and below daily dietary intake level. The amount of Ti ions released in pH>/=3.75 solution was mostly not detectable, representing that the TiO(2) film on NiTi wires exhibited a good protection against corrosion. Pre-existed surface defects on NiTi wires might be the preferred locations for corrosion. The NiTi wire with the highest release amount of metal ions had the maximal increase in surface roughness after immersion test, while a rougher surface did not correspond to a higher metal ion release.     

Surface characteristics, mechanical properties, and cytocompatibility of oxygen plasma-implanted porous nickel titanium shape memory alloy

Good surface properties and biocompatibility are crucial to porous NiTi shape memory alloys (SMA) used in medical implants, as possible nickel release from porous NiTi may cause deleterious effects in the human body. In this work, oxygen plasma immersion ion implantation (O-PIII) was used to reduce the amount of nickel leached from porous NiTi alloys with a porosity of 42% prepared by capsule-free hot isostatic pressing. The mechanical properties, surface properties, and biocompatibility were studied by compression tests, X-ray photoelectron spectroscopy (XPS), and cell culturing. The O-PIII porous NiTi SMAs have good mechanical properties and excellent superelasticity, and the amount of nickel leached from the O-PIII porous NiTi is much less than that from the untreated samples. XPS results indicate that a nickel-depleted surface layer predominantly composed of TiO(2) is produced by O-PIII and acts as a barrier against out-diffusion of nickel. The cell culturing tests reveal that both the O-PIII and untreated porous NiTi alloys have good biocompatibility.     

Surface characteristics, biocompatibility, and mechanical properties of nickel-titanium plasma-implanted with nitrogen at different implantation voltages

NiTi shape memory alloy is one of the promising orthopedic materials due to the unique shape memory effect and superelasticity. However, the large amount of Ni in the alloy may cause allergic reactions and toxic effects thereby limiting its applications. In this work, the surface of NiTi alloy was modified by nitrogen plasma immersion ion implantation (N-PIII) at various voltages. The materials were characterized by X-ray photoelectron spectroscopy (XPS). The topography and roughness before and after N-PIII were measured by atomic force microscope. The effects of the modified surfaces on nickel release and cytotoxicity were assessed by immersion tests and cell cultures. The XPS results reveal that near-surface Ni concentration is significantly reduced by PIII and the surface TiN layer suppresses nickel release and favors osteoblast proliferation, especially for samples implanted at higher voltages. The surfaces produced at higher voltages of 30 and 40 kV show better adhesion ability to osteoblasts compared to the unimplanted and 20 kV PIII samples. The effects of heating during PIII on the phase transformation behavior and cyclic deformation response of the materials were investigated by differential scanning calorimetry and three-point bending tests. Our results show that N-PIII conducted using the proper conditions improves the biocompatibility and mechanical properties of the NiTi alloy significantly.     

(Ti, O)/Ti and (Ti, O, N)/Ti composite coatings fabricated via PIIID for the medical application of NiTi shape memory alloy

In this investigation, the plasma immersion ion implantation and deposition (PIIID) technique was used to fabricate (Ti, O)/Ti or (Ti, O, N)/Ti coatings on a NiTi shape memory alloy (SMA, 50.8 at.% Ni) to improve its corrosion, wear resistance, and bioactivity. After coating fabrication, the structure and properties of composite coatings were studied, and the coated and uncoated NiTi SMA samples were compared with each other. Scanning electron microscopic (SEM) examination of coating surfaces and cross-sections showed that (Ti, O)/Ti and (Ti, O, N)/Ti composite coatings were dense and uniform, having thickness values of 1.16 ± 0.08 μm and 0.95 ± 0.06 μm, respectively. X-ray diffraction (XRD) results revealed that there were no diffraction peaks corresponding to TiO(2) or TiN for (Ti, O)/Ti and (Ti, O, N)/Ti composite coatings, suggesting that after the PIIID treatment, TiO(2) and TiN were amorphous or nanosized in the coatings. Energy dispersive X-ray (EDX) analysis indicated that the interface between the coating and NiTi SMA substrate was gradual rather than sharp. In addition, EDX elemental mapping of coating cross-sections showed that Ni was depleted from the surface. Differential scanning calorimetry (DSC) curves revealed that the shape memory ability of NiTi SMA was not degraded by the PIIID treatment. The width of wear tracks on (Ti, O, N)/Ti coated NiTi SMA samples was reduced 6.5-fold, in comparison with that on uncoated samples. The corrosion potential (E(corr) ) was improved from -466.20 ± 37.82 mV for uncoated samples to 125.50 ± 21.49 mV and -185.40 ± 37.05 mV for (Ti, O)/Ti coated and (Ti, O, N)/Ti coated samples, respectively. Both types of coatings facilitated bone-like apatite formation on the surface of NiTi SMA in simulated body fluid (SBF), indicating their in vitro bioactivity.     

Surface oxidation of NiTi shape memory alloy

Mechanically polished NiTi alloy (50 at% Ni) was subjected to heat treatment in air in the temperature range 300–800°C and characterised by scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy and Raman spectroscopy. Thermogravimetry measurements were carried out to investigate the kinetics of oxidation. The results of thermodynamic calculations were compared to the experimental observations. It was found that NiTi alloy exhibits different oxidation behaviour at temperatures below and above 500°C. A Ni-free zone was found in the oxide layer for oxidation temperatures of 500°C and 600°C. The oxidation at 500°C produces a smooth protective nickel-free oxide layer with a relatively small amount of Ni species at the air/oxide interface, which is in favour of good biocompatibility of NiTi implants. The oxidation mechanism for the NiTi shape memory alloy is discussed.     

Porous NiTi for bone implants: a review

NiTi foams are unique among biocompatible porous metals because of their high recovery strain (due to the shape-memory or superelastic effects) and their low stiffness facilitating integration with bone structures. To optimize NiTi foams for bone implant applications, two key areas are under active study: synthesis of foams with optimal architectures, microstructure and mechanical properties; and tailoring of biological interactions through modifications of pore surfaces. This article reviews recent research on NiTi foams for bone replacement, focusing on three specific topics: (i) surface modifications designed to create bio-inert porous NiTi surfaces with low Ni release and corrosion, as well as bioactive surfaces to enhance and accelerate biological activity; (ii) in vitro and in vivo biocompatibility studies to confirm the long-term safety of porous NiTi implants; and (iii) biological evaluations for specific applications, such as in intervertebral fusion devices and bone tissue scaffolds. Possible future directions for bio-performance and processing studies are discussed that could lead to optimized porous NiTi implants.     

Investigation of nickel suppression and cytocompatibility of surface-treated nickel-titanium shape memory alloys by using plasma immersion ion implantation

Nickel-titanium (NiTi) shape memory alloys are increasingly being used in orthopedic applications. However, there is a concern that Ni is harmful to the human body. We have recently investigated the use of nitrogen, or oxygen plasma immersion ion implantation to mitigate this deleterious effect. Our results reveal that the near-surface Ni concentration in all the treated samples is significantly suppressed. In addition, our in vitro tests show that the plasma-treated surfaces are cytologically compatible allowing the attachment and proliferation of osteoblasts. Among the two types of samples, the best biological effects are found on the samples with nitrogen implantation.     

Surface, corrosion and biocompatibility aspects of Nitinol as an implant material

The present review surveys studies on physical-chemical properties and biological response of living tissues to NiTi (Nitinol) carried out recently, aiming at an understanding of the place of this material among the implant alloys in use. Advantages of shape memory and superelasticity are analyzed in respect to functionality of implants in the body. Various approaches to surface treatment, sterilization procedures, and resulting surface conditions are analyzed. A review of corrosion studies conducted both on wrought and as-cast alloys using potentiodynamic and potentiostatic techniques in various corrosive media and in actual body fluids is also given. The parameters of localized and galvanic corrosion are presented. The corrosion behavior is analyzed with respect to alloy composition, phase state, surface treatment, and strain and compared to that of conventional implant alloys. Biocompatibility of porous Nitinol, Ni release and its effect on living cells are analyzed based on understanding of the surface conditions and corrosion behavior. Additionally, the paper offers a brief overview of the comparative toxicity of metals, components of commonly used medical alloys, indicating that the biocompatibility profile of Nitinol is conducive to present in vivo applications.     

Corrosion resistance of a laser spot-welded joint of NiTi wire in simulated human body fluids

The purpose of this study was to investigate corrosion resistance of a laser spot-welded joint of NiTi alloy wires using potentiodynamic tests in Hank's solution at different PH values and the PH 7.4 NaCl solution for different Cl- concentrations. Scanning electron microscope observations were carried out before and after potentiodynamic tests. The composition of a laser spot-welded joint and base metal were characterized by using an electron probe microanalyzer. The results of potentiodynamic tests showed that corrosion resistance of a laser spot-welded joint of NiTi alloy wire was better than that of base metal, which exhibited a little higher breakdown potential and passive range, and a little lower passive current density. Corrosion resistances of a laser spot-welded joint and base metal decreased with increasing of the Cl- concentration and PH value. The improvement of corrosion resistance of the laser spot-welded joint was due to the decrease of the surface defects and the increase of the Ti/Ni ratio.