3D-printed porous tantalum artificial bone scaffolds: fabrication, properties, and applications.

Porous tantalum scaffolds offer a high degree of biocompatibility and have a low friction coefficient. In addition, their biomimetic porous structure and mechanical properties, which closely resemble human bone tissue, make them a popular area of research in the field of bone defect repair. With the rapid advancement of additive manufacturing, 3D-printed porous tantalum scaffolds have increasingly emerged in recent years, offering exceptional design flexibility, as well as facilitating the fabrication of intricate geometries and complex pore structures that similar to human anatomy. This review provides a comprehensive description of the techniques, procedures, and specific parameters involved in the 3D printing of porous tantalum scaffolds. Concurrently, the review provides a summary of the mechanical properties, osteogenesis and antibacterial properties of porous tantalum scaffolds. The use of surface modification techniques and the drug carriers can enhance the characteristics of porous tantalum scaffolds. Accordingly, the review discusses the application of these porous tantalum materials in clinical settings. Multiple studies have demonstrated that 3D-printed porous tantalum scaffolds exhibit exceptional corrosion resistance, biocompatibility, and osteogenic properties. As a result, they are considered highly suitable biomaterials for repairing bone defects. Despite the rapid development of 3D-printed porous tantalum scaffolds, they still encounter challenges and issues when used as bone defect implants in clinical applications. Ultimately, a concise overview of the primary challenges faced by 3D-printed porous tantalum scaffolds is offered, and corresponding insights to promote further exploration and advancement in this domain are presented.

Preparation, modification, and clinical application of porous tantalum scaffolds.

Porous tantalum (Ta) implants have been developed and clinically applied as high-quality implant biomaterials in the orthopedics field because of their excellent corrosion resistance, biocompatibility, osteointegration, and bone conductivity. Porous Ta allows fine bone ingrowth and new bone formation through the inner space because of its high porosity and interconnected pore structure. It contributes to rapid bone integration and long-term stability of osseointegrated implants. Porous Ta has excellent wetting properties and high surface energy, which facilitate the adhesion, proliferation, and mineralization of osteoblasts. Moreover, porous Ta is superior to classical metallic materials in avoiding the stress shielding effect, minimizing the loss of marginal bone, and improving primary stability because of its low elastic modulus and high friction coefficient. Accordingly, the excellent biological and mechanical properties of porous Ta are primarily responsible for its rising clinical translation trend. Over the past 2 decades, advanced fabrication strategies such as emerging manufacturing technologies, surface modification techniques, and patient-oriented designs have remarkably influenced the microstructural characteristic, bioactive performance, and clinical indications of porous Ta scaffolds. The present review offers an overview of the fabrication methods, modification techniques, and orthopedic applications of porous Ta implants.

Characterization and cytocompatibility of hierarchical porous TiO2 coatings incorporated with calcium and strontium by one-step micro-arc oxidation.

Calcium (Ca) and strontium (Sr) are beneficial for bone reconstruction. This study incorporated Ca and Sr into the TiO2 coatings by one-step micro-arc oxidation (MAO) treatment with CaO and SrO added in tetraborate electrolytes. The structure, composition, hydrophilicity, ion release, and cytocompatibility of the coatings were studied. The coatings combine layered micron-scale pores in various sizes and nano-scaled pores, forming a hierarchical structure. This hierarchical structure is highly porous and super-hydrophilic. The coatings are composed of Ti, O, and B, as well as Ca or Sr. Ca and Sr mainly distribute in the outer layer of the coatings and exist in the forms of carbonates and oxides. The formation of the coatings was discussed. Ca and Sr incorporated into the coatings are readily released into aqueous solutions. The homogeneous surface structure of the coatings leads to an excellent and approximating performance in hydrophilicity, as well as the adhesion and spreading of the human bone marrow-derived mesenchymal stem cells (hBMSCs). The simultaneous incorporation of Ca and Sr incorporation exhibits superior facilitation in the proliferation of hBMSCs compared with single Ca or Sr incorporation. This study shows a promising method to incorporate bioactive elements into the MAO coatings on titanium surfaces.

Micro/nano-hierarchical structured TiO2 coating on titanium by micro-arc oxidation enhances osteoblast adhesion and differentiation.

Nano-structured and micro/nano-hierarchical structured TiO2 coatings were produced on polished titanium by the micro-arc oxidation (MAO) technique. This study was conducted to screen a suitable structured TiO2 coating for osteoblast adhesion and differentiation in dental implants. The formulation was characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD) and wettability testing. Adhesion, proliferation and osteogenic differentiation of MG63 cells were analysed by SEM, Cell Counting Kit-8 (CCK-8) and quantitative real-time PCR. The micro/nano-hierarchical structured TiO2 coating with both slots and pores showed the best morphology and wettability. XRD analysis revealed that rutile predominated along with a minor amount of anatase in both TiO2 coatings. Adhesion and extension of MG63 cells on the micro/nano-hierarchical structured TiO2 coating were the most favourable. MG63 cells showed higher growth rates on the micro/nano-hierarchical structured TiO2 coating at 1 and 3 days. Osteogenic-related gene expression was markedly increased in the micro/nano-hierarchical structured TiO2 coating group compared with the polished titanium group at 7, 14 and 21 days. These results revealed the micro/nano-hierarchical structured TiO2 coating as a promising surface modification and suitable biomaterial for use with dental implants.

Formation and in vitro/in vivo performance of "cortex-like" micro/nano-structured TiO2 coatings on titanium by micro-arc oxidation.

A novel "cortex-like" micro/nano dual-scale structured TiO2 coating was prepared on a titanium surface by micro-arc oxidation (MAO) with tetraborate electrolytes. This structure, which combines microslots with nanopores, exhibits super hydrophilicity. This coating modified the surface structure, chemistry, and hydrophilicity in a one-step treatment. Evolution of the coating together with its surface and structure properties was studied. We propose a forming mechanism of the dual-scale structure in which the oxides formed during the MAO discharge dissolve in the tetraborate electrolytes, leaving little or no deposition outside the discharge channels. We performed in vitro tests using human bone marrow-derived mesenchymal stem cells (hBMSCs) that compared this coating with a "volcano-like" MAO coating and a commercial sandblasted, large-grit and acid-etched (SLA) coating. The adhesion, morphology, proliferation, and differentiation of hBMSCs, together with the matrix mineralization, were investigated. Results suggest that the "cortex-like" structure significantly promotes the adhesion, spreading, and differentiation of cells and increases the matrix mineralization. In vivo tests with mongrel dogs showed an excellent osseointegration of the "cortex-like" coating. The combination of the dual-scale structure and the hydrophilicity of the "cortex-like" TiO2 coating synergistically resulted in an outstanding cytocompatibility and osseointegration, which may facilitate a higher level of implant success.

Early osseointegration of implants with cortex-like TiO2 coatings formed by micro-arc oxidation: A histomorphometric study in rabbits.

In our previous studies, a novel cortex-like TiO2 coating was prepared on Ti surface through micro-arc oxidation (MAO) by using sodium tetraborate as electrolyte, and the effects of the coating on cell attachment were testified. This study aimed to investigate the effects of this cortex-like MAO coating on osseointegration. A sand-blasting and acid-etching (SLA) coating that has been widely used in clinical practice served as control. Topographical and chemical characterizations were conducted by scanning electron microscopy, energy dispersive X-ray spectrometer, X-ray diffraction, contact angle meter, and step profiler. Results showed that the cortex-like coating had microslots and nanopores and it was superhydrophilic, whereas the SLA surface was hydrophobic. The roughness of MAO was similar to that of SLA. The MAO and SLA implants were implanted into the femoral condyles of New Zealand rabbits to evaluate their in-vivo performance through micro-CT, histological analysis, and fluorescent labeling at the bone-implant interface four weeks after surgery. The micro-CT showed that the bone volume ratio and mean trabecular thickness were similar between MAO and SLA groups four weeks after implantation. Histological analysis and fluorescent labeling showed no significant differences in the bone-implant contact between the MAO and SLA surfaces. It was suggested that with micro/nanostructure and superhydrophilicity, the cortex-like MAO coating causes excellent osseointegration, holding a promise of an application to implant modification.

Early Osseointegration of Implants with Cortex-like TiO2 Coatings Formed by Micro-arc Oxidation: A Histomorphometric Study in Rabbits / 华中科技大学学报（医学）（英德文版）

In our previous studies,a novel cortex-like TiO2 coating was prepared on Ti surface through micro-arc oxidation (MAO) by using sodium tetraborate as electrolyte,and the effects of the coating on cell attachment were testified.This study aimed to investigate the effects of this cortex-like MAO coating on osseointegration.A sand-blasting and acid-etching (SLA) coating that has been widely used in clinical practice served as control.Topographical and chemical characterizations were conducted by scanning electron microscopy,energy dispersive X-ray spectrometer,X-ray diffraction,contact angle meter,and step profiler.Results showed that the cortex-like coating had microslots and nanopores and it was superhydrophilic,whereas the SLA surface was hydrophobic.The roughness of MAO was similar to that of SLA.The MAO and SLA implants were implanted into the femoral condyles of New Zealand rabbits to evaluate their in-vivo performance through micro-CT,histological analysis,and fluorescent labeling at the bone-implant interface four weeks after surgery.The micro-CT showed that the bone volume ratio and mean trabecular thickness were similar between MAO and SLA groups four weeks after implantation.Histological analysis and fluorescent labeling showed no significant differences in the bone-implant contact between the MAO and SLA surfaces.It was suggested that with micro/nanostructure and superhydrophilicity,the cortex-like MAO coating causes excellent osseointegration,holding a promise of an application to implant modification.