Biocompatibility of anodic titanium oxide: an experimental research

doi:10.3969/j.issn.2095-4344.1636

Abstract

Abstract:

BACKGROUND: Studies have confirmed that titanium dioxide coating can improve the adhesion of implant surface, promote osteoblast proliferation and other cell functions, and improve the bone integration ability between the surrounding bone and implant. But little has been done in the use of titanium dioxide coating as a coating for internal and external fixation to prevent screw loosening.

OBJECTIVE: To prepare titanium dioxide coated titanium screws and to observe the effect of titanium dioxide coated titanium screws used for bone fixation to reduce screw loosening.

METHODS: Titanium dioxide coating was prepared on the surface of titanium screw by anodic oxidation. Thirty male New Zealand white rabbits (provided by the Central Laboratory of Shanghai Putuo District Central Hospital in China) were randomly divided into two groups (n=15 per group). Titanium dioxide coated screws were implanted in the right tibia of the rabbits in the experimental group, and ordinary titanium screws were implanted in the right tibia of the rabbits in the control group. Bone tissue around the screw canal was taken at 1 day, 1 and 4 weeks after implantation, and levels of platelet-derived growth factor and vascular endothelial growth factor genes were detected using RT-PCR. Four weeks after implantation, bone tissue around the nail canal was taken for hematoxylin-eosin staining.

RESULTS AND CONCLUSION: (1) The results of hematoxylin-eosin staining showed that inflammatory cell infiltration was seen in the screw canal of the control group, and some screw canal threads were destroyed and absorbed. In the experimental group, the screw threads were clear and had no damage or absorption; inflammatory cells in the screw canal were less exuded. (2) RT-PCR analysis revealed no significant difference in the expression of platelet-derived growth factor and vascular endothelial growth factor gene between the two groups at 1 day after implantation (P > 0.05), while the expression of platelet-derived growth factor and vascular endothelial growth factor gene in the experimental group was significantly higher than that in the control group at 1 and 4 weeks after implantation (P < 0.05 or P < 0.01). Therefore, titanium dioxide coated titanium screws are more biocompatible than common titanium screws and can effectively prevent screw loosening when used for internal fixation.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Bone Nails, Biocompatible Materials, Tissue Engineering

CLC Number:

R459.9

R318.08

Liu Shaoyang, Zou Hanlin . Biocompatibility of anodic titanium oxide: an experimental research[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(10): 1575-1580.

Figures/Tables 4

References

[1] Moroni A, Vannini F, Mosca M, et al.State of the art review: techniques to avoid pin loosening and infection in external fixation. J Orthop Trauma.2002;16(3):189-195.

[2] Mutsuzaki H, Sogo Y, Oyane A, et al.Improved bonding of partially osteomyelitic bone to titanium pins owing to biomimetic coating of apatite.Int J Mol Sci. 2013;14(12): 24366-14379.

[3] Pieske O, Kaltenhauser F, Pichlmaier L, et al.Clinical benefit of hydroxyapatite-coated pins compared with stainless steel pins in external fixation at the wrist: A randomised prospective study. Injury. 2010;41(10):1031-1036.

[4] Holt J, Hertzberg B, Weinhold P, et al.Decreasing bacterial colonization of external fixation pins through nitric oxide release coatings.J Orthop Trauma. 2011;25(7):432-437.

[5] Guo C, Wang K, Hou S, et al. H2O2 and/or TiO2 photocatalysis under UV irradiation for the removal of antibiotic resistant bacteria and their antibiotic resistance genes. J Hazard Mater. 2017; 323(Pt B):710-718.

[6] Jimenez-Tototzintle M, Ferreira IJ, Da Silva Duque S, et al. Removal of contaminants of emerging concern (CECs) and antibiotic resistant bacteria in urban wastewater using UVA/TiO2/H2O2 photocatalysis. Chemosphere. 2018;210: 449-457.

[7] Moreira NFF, Narciso-Da-Rocha C, Polo-Lopez MI, et al.Solar treatment (H2O2, TiO2-P25 and GO-TiO2 photocatalysis, photo-Fenton) of organic micropollutants, human pathogen indicators, antibiotic resistant bacteria and related genes in urban wastewater. Water Res.2018;135:195-206.

[8] Esfandiari N, Simchi A, Bagheri R.Size tuning of Ag-decorated TiO(2) nanotube arrays for improved bactericidal capacity of orthopedic implants. J Biomed Mater Res A.2014;102(8):2625-2635.

[9] Zhang H,Sun Y,Tian A,et al.Improved antibacterial activity and biocompatibility on vancomycin-loaded TiO2 nanotubes: in vivo and in vitro studies. Int J Nanomedicine. 2013;8: 4379-4389.

[10] Maurer TB, Ochsner PE, Schwarzer G, et al.Increased loosening of cemented straight stem prostheses made from titanium alloys. An analysis and comparison with prostheses made of cobalt-chromium-nickel alloy.Int Orthop. 2001;25(2): 77-80.

[11] Shim J, Seo YS, Oh BT, et al. Microbial inactivation kinetics and mechanisms of carbon-doped TiO 2 (C-TiO 2) under visible light. J Hazard Mater. 2016;306:133-139.

[12] Gao A, Hang R, Huang X, et al.The effects of titania nanotubes with embedded silver oxide nanoparticles on bacteria and osteoblasts. Biomaterials. 2014;35(13): 4223-4235.

[13] Leitner L, Malaj I, Sadoghi P, et al.Pedicle screw loosening is correlated to chronic subclinical deep implant infection: a retrospective database analysis. Eur Spine J. 2018; 27(10): 2529-2535.

[14] Agrawal A. Pedicle screw nut loosening: potentially avoidable causes of spine instrumentation failure. Asian Spine J. 2014; 8(2): 224-226.

[15] Lawes TJ, Scott JC, Goodship AE.Increased insertion torque delays pin-bone interface loosening in external fixation with tapered bone screws. J Orthop Trauma.2004;18(9):617-622.

[16] Hee HT, Khan MS, Goh JC, et al.Insertion torque profile during pedicle screw insertion of the thoracic spine with and without violation of the pedicle wall: comparison between cylindrical and conical designs. Spine (Phila Pa 1976). 2006; 31(22):E840-846.

[17] Chatzistergos PE, Magnissalis EA, Kourkoulis SK.Numerical simulation of bone screw induced pretension: the cases of under-tapping and conical profile. Med Eng Phys. 2014;36(3): 378-386.

[18] Pettine KA, Chao EY, Kelly PJ. Analysis of the external fixator pin-bone interface. Clin Orthop Relat Res. 1993;(293):18-27.

[19] Siamos G, Winkler S, Boberick KG. Relationship between implant preload and screw loosening on implant-supported prostheses.J Oral Implantol.2002;28(2): 67-73.

[20] 姚珍松,唐永超,陈康,等.骨水泥螺钉强化固定伴骨质疏松腰椎滑脱症的稳定性及椎间融合[J].中国组织工程研究, 2016,20(4): 517-521.

[21] Partale K, Klein P, Schell H, et al.Poly(D,L-lactide) coating is capable of enhancing osseous integration of Schanz screws in the absence of infection. J Biomed Mater Res B Appl Biomater. 2005; 74(1):608-616.

[22] Rammelt S, Illert T, Bierbaum S, et al.Coating of titanium implants with collagen, RGD peptide and chondroitin sulfate. Biomaterials.2006;27(32):5561-5571.

[23] 韩建业,于振涛,周廉.羟基磷灰石/TiO2生物活性复合涂层的研究进展[C].第六届中国功能材料及其应用学术会议论文集, 2007:1808-1812.

[24] Brammer KS, Oh S, Cobb CJ, et al.Improved bone-forming functionality on diameter-controlled TiO2 nanotube surface. Acta Biomaterialia. 2009;5(8):3215-3223.

[25] Ercan B, Webster TJ. The effect of biphasic electrical stimulation on osteoblast function at anodized nanotubular titanium surfaces. Biomaterials. 2010;31(13):3684-3693.

[26] Uhm SH, Song DH, Kwon JS, et al.Tailoring of antibacterial Ag nanostructures on TiO2 nanotube layers by magnetron sputtering.J Biomed Mater Res B Appl Biomater. 2014; 102(3):592-603.

[27] Singh AV, Vyas V, Patil R, et al. Quantitative characterization of the influence of the nanoscale morphology of nanostructured surfaces on bacterial adhesion and biofilm formation. PLoS One.2011;6(9): e25029.

[28] Gunasekaran T, Nigusse T, Dhanaraju MD. Silver nanoparticles as real topical bullets for wound healing. J Am Coll Clin Wound Spec. 2011;3(4):82-96.

[29] Franchini A, Ottaviani E. Repair of molluscan tissue injury: role of PDGF and TGF-beta1. Tissue Cell. 2000;32(4): 312-321.

[30] Si HP, Lu ZH, Lin YL, et al. Transfect bone marrow stromal cells with pcDNA3.1-VEGF to construct tissue engineered bone in defect repair. Chin Med J (Engl). 2012;125(5): 906-911.

[31] Eming SA, Krieg T. Molecular mechanisms of VEGF-A action during tissue repair. J Investig Dermatol Symp Proc. 2006; 11(1):79-86.

[32] Hong YK, Lange-Asschenfeldt B,Velasco P, et al. VEGF-A promotes tissue repair-associated lymphatic vessel formation via VEGFR-2 and the alpha1beta1 and alpha2beta1 integrins. FASEB J. 2004; 18(10): 1111-1113.

[33] Mutsuzaki H,Ito A,Sakane M,et al. Fibroblast growth factor-2-apatite composite layers on titanium screw to reduce pin tract infection rate. J Biomed Mater Res B Appl Biomater. 2008;86(2):365-374.

[34] Mutsuzaki H, Ito A, Sakane M, et al. Calcium phosphate coating formed in infusion fluid mixture to enhance fixation strength of titanium screws. J Mater Sci Mater Med. 2007; 18(9):1799-1808.