Geetha Manivasagam

Bacterial adherence and biofilm formation on medical implants : a review

Biofilms are a complex group of microbial cells that adhere to the exopolysaccharide matrix present on the surface of medical devices. Biofilm-associated infections in the medical devices pose a serious problem to the public health and adversely affect the function of the device. Medical implants used in oral and orthopedic surgery are fabricated using alloys such as stainless steel and titanium. The biological behavior, such as osseointegration and its antibacterial activity, essentially depends on both the chemical composition and the morphology of the surface of the device. Surface treatment of medical implants by various physical and chemical techniques are attempted in order to improve their surface properties so as to facilitate bio-integration and prevent bacterial adhesion. The potential source of infection of the surrounding tissue and antimicrobial strategies are from bacteria adherent to or in a biofilm on the implant which should prevent both biofilm formation and tissue colonization. This article provides an overview of bacterial biofilm formation and methods adopted for the inhibition of bacterial adhesion on medical implants

Corrosion and Microstructural Aspects of Titanium and its Alloys as Orthopaedic Devices

Titanium is a wonder metal, generally considered as one of the most biocompatible and corrosion resistant metals available for clinical applications. Since 1951, when Leventhal /1/ first published an article on the orthopaedic application of this metal, research activity and clinical experience resulted in new developments in the manufacturing and use of this metal and its varieties of alloys. Beginning with commercially pure titanium, and then to Ti-6A1-4V alloy, today the state of the art p-titanium alloys have been added to the list; there is a range of materials and devices based on titanium, which are available for a variety of medical applications. In this review article an attempt is made to bring out the various features of titanium as orthopaedic material, mainly focusing on the physical metallurgy, alloy development, microstructural aspects, and corrosion and wear resistances. An attempt is also made to highlight the role of surface modification in enhancing the corrosion resistance of titanium and its alloys.

Effect of Texture and Grain Size on Bio-Corrosion Response of Ultrafine-Grained Titanium

The bio-corrosion response of ultrafine-grained commercially pure titanium processed by different routes of equal-channel angular pressing has been studied in simulated body fluid. The results indicate that the samples processed through route Bc that involved rotation of the workpiece by 90 deg in the same sense between each pass exhibited higher corrosion resistance compared to the ones processed by other routes of equal-channel angular pressing, as well as the coarse-grained sample. For a similar grain size, the higher corrosion resistance of the samples exhibiting off-basal texture compared to shear texture indicates the major role of texture in corrosion behavior. It is postulated that an optimum combination of microstructure and crystallographic texture can lead to high strength and excellent corrosion resistance.

Preparation and evaluation of the cytotoxic nature of TiO2 nanoparticles by direct contact method.

The purpose of this study is to prepare and evaluate the effect of synthesized titanium dioxide (TiO2) nanoparticles for their biocompatibility on physiological body fluids and the effect of cell toxicity to produce osteointegration when used as implantable materials. For the past few decades, the number of researches done to understand the importance of the biocompatibility of bioceramics, metals, and polymers and their effect on clinical settings of biomedical devices has increased. Hence, the total concept of biocompatibility encourages researchers to actively engage in the investigation of the most compatible materials in living systems by analyzing them using suitable physical, chemical, and biological (bioassay) methods. The ceramic material nano TiO2 was prepared by sol-gel method and analyzed for its functional group and phase formation by Fourier transform infrared spectroscopy and powder X-ray diffraction. Furthermore, the particle size, shape, surface topography, and morphological behavior were analyzed by dynamic light scattering, zeta potential, scanning electron microscopy–energy dispersive X-ray analysis, and transmission electron microscopy analysis. In addition to this, the cytotoxicity and cytocompatibility were determined on MG63 cell lines with varying doses of concentrations such as 1 µg/mL, 10 µg/mL, 25 µg/mL, 50 µg/mL, and 100 µg/mL with different time periods such as 24 hours and 48 hours. The results have not shown any toxicity, whereas, it improved the cell viability/proliferation at various concentrations. Hence, these findings indicate that the nano TiO2 material acts as a good implantable material when used in the biomedical field as a prime surface-modifying agent.

Degradation mechanisms and future challenges of titanium and its alloys for dental implant applications in oral environment

OBJECTIVE For many decades the failure of titanium implants due to corrosion and wear were approached individually and their synergic effect was not considered. In recent past, developments and understanding of the tribocorrosion aspects have thrown deeper understanding on the failure of implants and this has been reviewed in this article extensively. METHODS Medline, google scholar and Embase search was conducted to identify studies published between 1993 and 2016 which were related to the analysis of degradation mechanism which the dental implants undergo after implantation. RESULTS In-vitro tests has been extensively carried out to evaluate the tribocorrosion behavior of titanium based dental implants. However, there is still a lack of knowledge about the tangible behavior of materials under in-vivo condition, because the in-vitro experiments are conducted using different testing protocols and conditions (solutions, pH, time, equipment, and testing parameters). Hence, there is an urgent need to perform round-robin test in different laboratories which will help to overcome the gap between in-vitro and in-vivo conditions. CONCLUSION Tribocorrosion has been identified as the major degradation mechanisms that result in the failure of dental implants. Hence, it is of utmost importance to improve the service period of dental implants by reducing the tribocorrosion effects through developing new dental implant materials using nobler alloying elements or through modifying the surface of the implants. In order to have a thorough understanding of tribocorrosion behavior and failure mechanisms, round robin test are to be conducted and new protocols/standards are to be developed for the testing of implants.

Suture materials — Current and emerging trends

Surgical sutures are used to facilitate closure and healing of surgical- or trauma-induced wounds by upholding tissues together to facilitate healing process. There is a wide range of suture materials for medical purpose and the main types include absorbable and nonabsorbable. Recently, there is a growth in the development of classes of suture materials based on their properties and capabilities to improve tissue approximation and wound closure. This review outlines and discusses the current and emerging trends in suture technology including knotless barbed sutures, antimicrobial sutures, bio-active sutures such as drug-eluting and stem cells seeded sutures, and smart sutures including elastic, and electronic sutures. These newer strategies expand the versatility of sutures from being used as just a physical entity approximating opposing tissues to a more biologically active component enabling delivery of drugs and cells to the desired site with immense application potential in both therapeutics and diagnostics.

Effect of non-ionic surfactant assisted modification of hexagonal boron nitride nanoplatelets on the mechanical and thermal properties of epoxy nanocomposites

Hexagonal boron nitride (hBN) nanoplatelets have attracted considerable interest recently. In this work, hBN nanoplatelets have been prepared using chemical exfoliation route. The exfoliation of hBN nanoplatelets takes place along the (0 0 2) plane without destroying the crystal structure. The hBN nanoplatelets are modified using polyvinylpyrrolidone (PVP), a non-ionic surfactant in order to achieve finer dispersion of hBN nanoplatelets in ethyl alcohol, and subsequently in the epoxy matrix. The enhanced dispersion of hBN nanoplatelets achieved using PVP is due to the adsorption of PVP over the hBN nanoplatelets, and PVP miscibility with epoxy resin in an uncured state. Due to the finer dispersion of hBN nanoplatelets in the epoxy matrix, the flexural properties are higher as compared to pure epoxy. PVP assisted dispersed hBN nanoplatelets reinforced with epoxy nanocomposites have higher flexural properties as compared to pure hBN nanoplatelets-reinforced epoxy nanocomposites. The enhanced dispersion of hBN nanoplatelets using PVA also limits the decrease in glass transition temperature (Tg). Further, thermal stability of the epoxy increase with an addition of PVP modified and unmodified hBN nanoplatelets in the epoxy matrix as compared to pure epoxy. Fractography studies reveal that addition of PVP modified and unmodified hBN nanoplatelets in the epoxy matrix depict rough surface with many small facets due to resistance offered by the dispersed nanoplatelets.

Comparison of TiAlN, AlCrN, and AlCrN/TiAlN coatings for cutting-tool applications

Monolayer and bilayer coatings of TiAlN, AlCrN, and AlCrN/TiAlN were deposited onto tungsten carbide inserts using the plasma enhanced physical vapor deposition process. The microstructures of the coatings were characterized using scanning electron microscopy (SEM) and atomic force microscopy (AFM). The SEM micrographs revealed that the AlCrN and AlCrN/TiAlN coatings were uniform and highly dense and contained only a limited number of microvoids. The TiAlN coating was non-uniform and highly porous and contained more micro droplets. The hardness and scratch resistance of the specimens were measured using a nanoindentation tester and scratch tester, respectively. Different phases formed in the coatings were analyzed by X-ray diffraction (XRD). The AlCrN/TiAlN coating exhibited a higher hardness (32.75 GPa), a higher Young’s modulus (561.97 GPa), and superior scratch resistance (LCN = 46 N) compared to conventional coatings such as TiAlN, AlCrN, and TiN.

Influence of Coating Parameter and Sintering Atmosphere on the Corrosion Resistance Behavior of Electrophoretically Deposited Composite Coatings

The purpose of this study is to synthesize and characterize nanosized titania (TiO2), zinc oxide (ZnO), and its composite coating on Ti–6Al–4V to enhance its corrosion protection behavior in Ringers solution. Nanosized powders of TiO2 and ZnO was characterized by Fourier transform infrared spectroscopy (FTIR), powder X-ray diffraction (XRD), and scanning electron microscopy - energy dispersive atomic spectroscopy (SEM-EDAX) analysis. As a result of antibacterial activity, both ZnO and TiO2/ZnO have produce remarkable inhibition zone on Escherichia coli. The antibacterial activity of composites are due to the combined effect of ZnO on TiO2. The adherence and surface uniformity of TiO2/ZnO composite film on titanium implant was examined by optical microscopy and Vickers microhardness test. Corrosion resistant behavior of the coating on titanium implant was investigated by tafel polarization and impedance analysis. The composite coatings on Ti–6Al–4V have produced improved corrosion resistance with a pronounced shift in the anodic corrosion potential (Ecorr) with a corresponding less corrosion current density (Icorr) compared to monophase coating. Similar results have been obtained for impedance analysis which indicated a reduction in double layer capacitance (Cdl) and with enhancement in charge transfer resistance (Rct). These observations suggest improved corrosion resistance property of TiO2/ZnO composite coating on Ti–6Al–4V.

Current advances in enhancement of wear and corrosion resistance of titanium alloys – a review

Titanium alloys have created a biomedical revolution in the past three decades and several research works are being carried out globally to combat the day to day challenges posed by the biomedical industries to meet the needs of a patient-friendly implant. Enhancement of corrosion and wear resistance of titanium alloys serve as the major treat for the stability of implant material after implantation. These problems could be overcome through various objectives, one among them being alloying titanium with non-toxic β-stabilizer elements to both increase the surface-related properties and improve biocompatibility. Other objectives include surface engineering methods such as coating, oxidation, nanograined surface and laser texturing. Overall, in this article an attempt has been made to bring out the current advances in the development of highly stable Ti-alloys with superior corrosion and wear resistance through various processes has been reviewed in detail.