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PubMed1992

Comparative cell culture effects of shape memory metal (Nitinol), nickel and titanium: a biocompatibility estimation.

Nitinol is an equiatomic alloy of nickel and titanium which has been attracting increasing interest in the field of biomedical engineering. To quantify toxicity as a preliminary evaluation of biocompatibility, inhibition of mitosis in human fibroblasts in tissue cultures exposed to test materials is an accepted screening method, although a dose-effect relationship had never been investigated. In this experiment, the effect of an increasing dose exposure to Nitinol, nickel or titanium on human fibroblasts in cell cultures was tested in subgroups in comparison with a control group. The results showed that nickel induces a significant (p < or = 0.05) inhibition of mitosis in human fibroblasts, whereas no significant effects of this kind were found for titanium or Nitinol. According to the results of these studies, Nitinol is to be considered in this respect biocompatible and comparable to titanium, which would seem to justify application as a surgical implant.

Alloys↗
PubMed1995

Improved defibrillation threshold with a new epicardial carbon electrode compared with a standard epicardial titanium patch.

BACKGROUND: Recent studies show that depending on the type of shock morphology used, 5% to 15% of patients requiring implantable defibrillators cannot be treated with a nonthoracotomy system. In these cases, an epicardial patch-based system becomes necessary. In this study, we investigated a newly developed epicardial carbon electrode as an alternative to a standard epicardial titanium patch. METHODS AND RESULTS: A tubular epicardial braided carbon electrode of 7F diameter and 14-cm length applied in a U-shape to the epicardium was compared with a standard left ventricular epicardial 15-cm2 titanium mesh patch (CPI Inc). As cathode, a CPI endocardial lead, a Medtronic lead, or a carbon-platinum-iridium prototype electrode was used. Ventricular fibrillation was induced with a 60-Hz generator and allowed to continue for 10 seconds before a shock was given. Two different biphasic shock waveforms (3.2/2- and 6/6-millisecond) were delivered by the six electrode configurations. Eight dogs (weight, 24.5 +/- 1.3 kg) underwent an up-down defibrillation protocol. The order of testing the epicardial electrodes, the endocardial cathodes, and the waveform was randomized. With the epicardial carbon electrode, the mean defibrillation threshold (DFT) energy decreased 39% to 56% and the voltage decreased 24% to 35% compared with the titanium patch: from 8.3 +/- 2.5 to 4.9 +/- 3.6 J with the CPI lead and the 3.2/2-millisecond waveform, from 6.2 +/- 2.5 to 2.9 +/- 2.1 J with the carbon-platinum-iridium prototype, and from 6.4 +/- 3.4 J to 3.5 +/- 2.6 J with the Medtronic lead (P < or = .05). The DFT determinations with the 6/6-millisecond biphasic waveform showed a similar trend with slightly higher values. CONCLUSIONS: Compared with a titanium patch, the new braided epicardial electrode significantly decreases the defibrillation energy requirements. This effect can be maximized by using an endocardial carbon-platinum-iridium prototype as cathode and a short duration biphasic waveform.

Animals↗
PubMed1999

Titanium vocal fold medializing implant: introducing a novel implant system for external vocal fold medialization.

With the increasing worldwide spread of the Isshiki technique for external vocal fold medialization, some disadvantages and limitations have also emerged. and an increasing demand for a ready-made and standardized implant system can be observed. For this reason. I started experimental and clinical investigations with the goal of replacing the silicone with a safer material, and also simplifying and standardizing the surgical procedure. In particular, the danger of implant dislocation should be excluded with greater certainty. As a result, I have developed an implant made of medical-grade titanium. My surgical experiences in 20 patients with this newly developed titanium vocal fold medializing implant revealed that vocal fold medialization could be performed easily and that no perioperative complications occurred in any case. The major advantage was a significant reduction of operative time due to the preformed implant. This is not only more convenient for both the surgeon and the patient, but is also critical for obtaining optimal results due to the reduced intralaryngeal swelling and hematoma. The reduction of the glottic gap by the operation was statistically significant. Significant improvement of all voice parameters was achieved and demonstrated by a statistically significant reduction of the voice dysfunction index. Compared to the current techniques and implant systems, I see the following additional advantages: 1) titanium is a relatively safe implant material with excellent biocompatibility: 2) the design of the implant ensures optimal fixation and stabilization: 3) the implantation technique and handling is simple and time-saving; 4) the titanium sheet is easy to shape and adapt to the individual situation: and 5) only 2 sizes of implants, and no expensive instruments, are required.

Adult↗
PubMed1989

Dental casting of titanium and Ni-Ti alloys by a new casting machine.

The purpose of this study was to develop a new casting machine for titanium and Ni-Ti alloys. Properties of cast pure titanium and Ni-Ti alloys were studied by means of the tensile and casting tests. As gas in the mold was removed by the mold being heated under a high vacuum, the reaction between the molten metal and the mold decreased. The new control system and the two types of crucibles developed proved very useful for prevention of internal macro-defects in castings and for improvement of castability. Mechanical properties and castability of pure titanium were improved. Ni-Ti alloys could be cast without loss of their shape-memory effect or super-elasticity characteristics. The new casting machine is thought to be promising for the casting of titanium and Ni-Ti alloys. Furthermore, we can cast these alloys using conventional techniques and investments.

Dental Alloys↗
PubMed1990

Oxide adherence and porcelain bonding to titanium and Ti-6Al-4V alloy.

The bonding of an experimental low-fusing porcelain to titanium and Ti-6Al-4V was evaluated by an x-ray spectrometric technique that measures the area that remains covered with porcelain following a controlled deformation of the metallic substrate. Oxide adherence strength values for titanium and Ti-6Al-4V oxidized at 750 degrees and 1000 degrees C were measured in tension with use of high-strength adhesives. The effect of further oxidation that would occur during porcelain firing was evaluated via simulated porcelain firings without actual porcelain application. Interface cross-sections of the titanium-porcelain and Ti-6Al-4V-porcelain bonds were examined in a scanning electron microscope (SEM). The porcelain was found to delaminate completely from the metal substrate, leaving less than 1% of the surface covered with porcelain. The oxide adherence of the specimens oxidized at 750 degrees C was good, but those oxidized at 1000 degrees C exhibited significantly lower oxide adherence (p = 0.001). The simulated porcelain-firing oxidation treatments also produced a significant decrease in oxide adherence (p = 0.004). The 750 degrees C oxidation treatments produced oxide films too thin to be visualized in the SEM, whereas the 1000 degrees C oxidation treatments produced oxide films approximately 1 micron thick. The lower oxide adherence of the 1-micron-thick oxide films is consistent with reports in the titanium literature of oxide delamination when the oxide film reaches 1 micron in thickness.

Alloys↗
PubMed1993

The effects of titanium and hydroxyapatite on osteoblastic expression and proliferation in rat parietal bone cultures.

Titanium and hydroxyapatite are used for the fabrication of dental and orthopedic implants. The longevity of these implants depends on the amount and rate of bone formation that occurs around their surfaces. In the present study, the effects of titanium, hydroxyapatite, and polystyrene (control) on the proliferation of rat calvarial cells, and on their capacity to express alkaline phosphatase and respond to parathyroid hormone (PTH) stimulation, were studied. The nature of the substrate did not affect the DNA and protein contents of experimental and control cultures throughout the experimental period. Alkaline phosphatase expression and PTH response, as assessed by DNA synthesis and adenylate cyclase activity, were higher in cultures grown on hydroxyapatite and polystyrene than in those grown on titanium. These results indicate that hydroxyapatite was a more favorable substrate than titanium for the growth and differentiation of osteoblast-like cells in vitro.

Alkaline Phosphatase↗
PubMed1996

Trial production of titanium orthodontic brackets fabricated by metal injection molding (MIM) with sintering.

Safety and esthetics are two indispensable factors to consider when fabricating orthodontic brackets. However, these factors are not easily achieved when conventional techniques (including forging and casting) are used in the mass production of titanium brackets, albeit the brackets exhibit excellent biocompatibility. In the present study, orthodontic brackets were manufactured by metal powder injection molding with sintering. Brackets with three different base designs were made and subjected to compression shear tests for evaluation of their bonding strength to enamel substrate. The shapes given to the dimple of the base were spherical, oval, and grooved. The maximum shear forces for each type were 11.1 kgf, 7.6 kgf, and 18.5 kgf, respectively. The bonding strengths of the titanium bracket were equivalent to those obtained with conventional stainless steel brackets. Moreover, uniform distribution of Vickers hardness values (average, 240 +/- 40 Hv) measured at three locations indicated that the titanium bracket was uniformly sintered. Accordingly, titanium brackets thus fabricated exhibit a potential for clinical application.

Analysis of Variance↗
PubMed1993

Early failure of titanium alloy femoral components: a quantitative radiological analysis of osteolytic and granulomatous change.

Shot blasted titanium alloy femoral components with a coarse finish were withdrawn from use in 1987 following reports of early component failure. We reviewed all coarse titanium femoral stems used in primary total hip arthroplasty in our institution between 1985 and 1987 and compared them to a similar stem made of vitallium which was also used over the same period. We found that, at an average of 5.2 years following implantation, over two-thirds of titanium components were associated with endosteal lysis. In many of the cases the early lytic changes were asymptomatic with significant bone loss occurring prior to presentation. We discuss our findings in relation to revision surgery. We advocate that all those with coarse stem titanium components should be positively reviewed to detect early lytic change before extensive bone destruction occurs.

Aged↗
PubMed2003

Blood compatibility of titanium oxides with various crystal structure and element doping.

BACKGROUND: Titanium oxides are known to be good hemocompatible, therefore they are suggested as coatings for blood contacting implants. But little is known about the influence of physical characteristics like crystal structure, roughness and electronic state on the activation of blood platelets and the blood clotting cascade. METHODS: Titanium oxide films were produced by metal plasma deposition and implantation in the form of rutile, crystalline and nanocrystalline anatase + brookite and amorphous TiO2. The redox potential was reduced by implantation of chromium ions, the Fermi level of the semiconductive oxide was shifted by ion implantation of the electron donor phosphorous. Hemocompatibility was determined by measuring the adhesion of blood platelets, their P-selectine expression, and of the blood clotting time on these samples. RESULTS: The crystalline titanium oxides had a slightly higher activation of the clotting cascade but lower platelet adhesion than nanocrystalline and amorphous titanium oxides. The surface roughness below 50 nm had no obvious effect. Both, implantation of phosphorous or chromium ions, strongly reduced the activation of the clotting cascade, but only the phosphorous implanted surface also showed a reduced platelet activation, whereas platelet adhesion and activation was strongly increased on the chromium implanted surfaces. CONCLUSION: Phosphorous doping of rutile TiO2 can increase its hemocompatibility, both concerning blood platelets and blood clotting cascade, but the biochemical mechanism has to be worked out.

Biocompatible Materials↗
PubMed2002

Anode glow discharge plasma treatment enhances calcium phosphate adsorption onto titanium plates.

Glow discharge plasma (GDP) supplied to a cathode (GDP-) has been applied for cleaning, surface activating, and sterilizing biomaterials, because the kinetic energy in the case of the GDP- is larger than that supplied to the anode (GDP+). However, no comparison between GDP+ and GDP- has been reported. In this study, a titanium surface pre-treated with GDP+ and GDP- was characterized by x-ray photoelectron spectroscopy (XPS). In addition, the wettability of the titanium surface was measured with and without GDP. Furthermore, XPS characterized the adsorption of inorganic ions on titanium surfaces with and without GDP and immersed in an electrolyte solution. The findings suggested that GDP+ enhances calcium phosphate nucleation, due to the accumulation of electrons. In addition, calcium phosphate was not nucleated on the specimen with GDP-. We conclude that GDP+ is more suitable for biomineralization on titanium.

Adsorption↗
PubMed2003

Behavior of SaOS-2 cells cultured on different titanium surfaces.

Surface properties may affect the clinical outcome of titanium dental implants. The aim of the present study was to investigate the effects of 3 different titanium surfaces-smooth (S), sandblasted (SB), and titanium plasma-sprayed (TPS)-on proliferation, differentiation, and apoptosis of human osteoblast-like cells, SaOS-2. Cell proliferation was significantly (p < 0.05) higher on the S surface, and synthesis of extracellular matrix proteins was more abundant on TPS and SB than on S surfaces. Analysis of integrin receptors showed a higher expression of alpha2, alpha5, alphaVbeta3, and ss1 on TPS as compared with SB and S surfaces. An increase in alkaline phosphatase activity was detected only on SB and TPS surfaces. Analysis of cell apoptosis did not demonstrate any significant difference among the 3 different surfaces. The results indicate that titanium surface topography affects proliferation and differentiation of osteoblast-like SaOS-2 cells, suggesting that surface properties might be important for bone response around dental implants in vivo.

Alkaline Phosphatase↗
PubMed2005

Anode glow discharge plasma treatment of titanium plates facilitates adsorption of extracellular matrix proteins to the plates.

Glow discharge plasma (GDP) supplied to an anode (GDP+) promotes calcium phosphate adsorption onto titanium better than that supplied to a cathode (GDP-). However, the adsorption of extracellular matrix (ECM) proteins is crucial for cell adhesion to titanium. Since GDP+ induced both inorganic adsorption and cell adhesion, we hypothesized that the inorganic adsorption in a culture medium might affect the adsorption of the ECM proteins. In this study, ECM proteins adsorbed on titanium with and without GDP were examined by x-ray photoelectron spectroscopy. After 1 hr of incubation, increasing sodium adsorption on GDP+ specimens induced adsorption of ECM proteins as shown by NH(+) and COO(-) signals without calcium adsorption. In contrast, since no specific adsorption of sodium on GDP-specimens was detected, GDP-did not contribute to the adsorption of ECM proteins. Thus, promotion of sodium adsorption of GDP+ was effective, at least in the initial ECM protein adsorption on a titanium surface.

Adsorption↗
PubMed2006

Harder and stiffer bone osseointegrated to roughened titanium.

Mechanisms underlying the beneficial anchorage of roughened titanium implants have not been identified. We hypothesized that the implant surface roughness alters intrinsic biomechanical properties of bone integrated to titanium. Nano-indentation performed on two- and four-week post-implantation bone specimens of rats revealed that bone integrated to acid-etched titanium was approximately 3 times harder than that integrated to the machined titanium, both at the osseointegration interface and at the inner area of the peri-implant bone. The hardness of the acid-etched surface-associated bone was equivalent to that of untreated cortical bone at week 4, while the bone hardness around the machined surface was equivalent to that of the untreated trabecular bone. The elastic modulus of the integrated bone was 1.5 to 2.5 times greater around the acid-etched surface than around the machined surface. Analysis of the data suggests that the implant surface roughness affects the biomechanical quality of osseo-integrated bone, and that the bone integrated to the acid-etched surface is harder and stiffer than the bone integrated to the machined surface.

Acid Etching, Dental↗
PubMed2025

Cross-talk between NLRP3 and AIM2 inflammasomes in macrophage activation by LPS and titanium ions.

BACKGROUND: Periodontitis and peri-implantitis are chronic inflammatory diseases that contribute to tissue destruction and bone loss. Periodontitis is triggered by pathogenic bacteria, while peri-implantitis also involves metallic particles, which increase the inflammatory response. Both conditions are linked to the activation of inflammasomes, such as NLRP3 and AIM2, which facilitate the release of pro-inflammatory cytokines like IL-1&#x3b2; and IL-18 and induce pyroptosis. This study aims to investigate the activation of NLRP3 and AIM2 inflammasomes in macrophages exposed to bacterial and metallic components, as well as to explore the potential interplay between these two signaling pathways. METHODS: Human THP-1-derived macrophages were treated with bacterial lipopolysaccharide (LPS) and titanium ions to evaluate inflammasome activation. IL-1&#x3b2; secretion, ROS production, mitochondrial DNA release and pyroptosis were assessed. Additionally, macrophages deficient in NLRP3 and AIM2 were used to examine the roles of these inflammasomes in inflammatory responses. RESULTS: LPS and titanium ions synergistically activated NLRP3, resulting in increased IL-1&#x3b2; secretion, ROS production, and pyroptosis. Under these conditions, AIM2 was indirectly activated, as indicated by elevated mitochondrial DNA release. Notably, AIM2 expression was reduced in wild-type macrophages treated with LPS and titanium ions compared to LPS alone, however, in NLRP3-deficient cells, AIM2 expression was increased following LPS and titanium ions treatment. This upregulation of AIM2 in NLRP3-deficient cells was further reduced by ROS inhibition, which decreased mitochondrial DNA release. Additionally, NLRP3 knockout had a more pronounced effect on reducing IL-1&#x3b2; secretion and pyroptosis compared to AIM2 knockout, indicating a greater role of NLRP3 in these inflammatory responses. CONCLUSIONS: This study demonstrates that bacterial and metallic components drive the activation of both NLRP3 and AIM2 inflammasomes in macrophages, highlighting their roles in the inflammatory responses associated with periodontitis and peri-implantitis. The findings reveal a regulatory relationship between NLRP3 and AIM2, where the absence of one inflammasome can enhance the activity of the other. These results provide new insights into the mechanisms underlying inflammasome-mediated inflammation and suggest potential therapeutic targets for managing inflammatory diseases.

NLR Family, Pyrin Domain-Containing 3 Protein↗
PubMed2002

Medical image based, preformed titanium membranes for bone reconstructions: design study and first clinical.

The currently used intralesional or marginal surgical treatment of a bone tumour in the extremities shows some shortcomings in providing a restoration of the mechanical strength of the bone and the containment of the used filling materials. The use of a medical image based, preformed and custom-made titanium membrane screwed onto the periosteal side of the bone is introduced. This study looks in detail into the design process and the biomechanical evaluation of such a membrane. The buckling strength of the membrane, the strength at the perforation holes and the strength of the screw-bone fixation are tested experimentally. The two latter experiments are performed with different screw types. From the performed tests it appears that a titanium membrane without a wave pattern, of 0.3 mm thickness, fixed to the bone with seven trabecular bone screws (4 mm diameter and 28 mm length) is capable of carrying the anticipated mechanical loads on the reconstructed tibia. The medical image based design methodology and the first clinical application of such a preformed and custom-made titanium membrane are reported and discussed. The feasibility of preformed titanium membranes for bone reconstruction in tumour surgery is demonstrated.

Biocompatible Materials↗
PubMed1996

Effect of counterface material on the characteristics of retrieved uncemented cobalt-chromium and titanium alloy total hip replacements.

A number of total hip components explanted at revision with bearing surfaces in either cobalt-chromium-molybdenum alloy or titanium-6% aluminium-4% vanadium alloy were examined and compared to contemporaneously manufactured but unused items; particular attention was paid to the bearing surfaces which were examined visually, by low-power microscopy, scanning electron microscopy (SEM), confocal microscopy, white light interferometry, laser profilometry and conventional stylus profilometry. The cobalt alloy heads maintained their surface finish well over periods up to 12 years. The titanium implants became badly damaged over much shorter periods although even badly scratched heads continued to meet the current standards for titanium alloy heads. Analysis showed that the damage to the titanium alloy heads was not a random but a well-defined process of scarring of a consistent size created by abrasion with small particles of bone. These damaged heads had the potential to wear the matching UHMWPE components rapidly creating large amounts of polymer debris. The finding that measurement of these damaged heads is within current standards raises concerns as to whether current standards incorporate fully the requirements for clinical performance.

Alloys↗
PubMed2004

[Titanium as an implant material for rods of transpedicular instrumentation of the lumbar spine].

BACKGROUND AND AIM: Titanium alloys are increasingly being used as an implant material in orthopaedics and for spinal instrumentation. In this study a metallographic analysis and mechanical testing were performed to evaluate the resistance of rods of Ti-A16-V4 in particular to tensile forces. METHOD: The surface texture of unprepared Ti-A16-V4 and a rod of the same material for spinal instrumentation were evaluated in a metallographic analysis using light microscopy and electron microscopy. Tensile strength measurements were performed on 2 rods, and the strength of the connection between rod and pedicle screws was tested in 9 cases. An electron microscopic analysis of surface changes of the connections between rod and pedicle screws after loading was performed. RESULTS: The titanium alloy Ti-A16-V4 has a mill-annealed appearance, which has a high resistance to tearing under stress. Titanium rods show high tensile strength before failure under loading. The connection between rod and pedicle screws also as high resistance to tensile loads (> 27 kN) with only little deformation of the connecting surface and no tearing. CONCLUSION: The titanium alloy Ti-A16-V4 is an appropriate material for dorsal spinal instrumentation rods because of its low weight, high biocompability and high tensile strength.

Alloys↗
PubMed1995

[Animal experiment study of titanium with surface coatings of (Ti,Nb)ON and (Ti,Zr)O].

Titanium is considered to be biocompatible as long as the passive layer of TiO2 which is formed within the body, is not destroyed mechanically by the shearing forces acting on implants during function. Mechanically stable hard coatings on the basis of the so-called refractory metals render titanium wear-and-tear-resistant, with the added advantage for its biocompatibility of keeping its the physical and electrochemical properties constant, even in the event of relative movement against hard or soft tissue. Biological testing of coated and uncoated titanium in experimental animals shows that the deposition of new bone on (Ti,Zr)O or (Ti,Nb)ON surfaces takes place in the same way as on the surface of titanium.

Alloys↗