Advances in the superhydrophilicity-modified titanium surfaces with antibacterial and pro-osteogenesis properties: A review

Abstract

In recent years, the rate of implant failure has been increasing. Microbial infection was the primary cause, and the main stages included bacterial adhesion, biofilm formation, and severe inhibition of implant osseointegration. Various biomaterials and their preparation methods have emerged to produce specific implants with antimicrobial or bactericidal properties to reduce implant infection caused by bacterial adhesion and effectively promote bone and implant integration. In this study, we reviewed the research progress of bone integration promotion and antibacterial action of superhydrophilic surfaces based on titanium alloys. First, the adverse reactions caused by bacterial adhesion to the implant surface, including infection and bone integration deficiency, are briefly introduced. Several commonly used antibacterial methods of titanium alloys are introduced. Secondly, we discuss the antibacterial properties of superhydrophilic surfaces based on ultraviolet photo-functionalization and plasma treatment, in contrast to the antibacterial principle of superhydrophobic surface morphology. Thirdly, the osteogenic effects of superhydrophilic surfaces are described, according to the processes of osseointegration: osteogenic immunity, angiogenesis, and osteogenic related cells. Finally, we discuss the challenges and prospects for the development of this superhydrophilic surface in clinical applications, as well as the prominent strategies and directions for future research.

Cerium Ion-Incorporated Titanium Metal Implants of Enhanced Bioactivity for Biomedical Applications

“…Rapid adsorption of biological molecules is initiated at the beginning, soon after the implantation by the implant surface wetting property . The superhydrophilic nature of the implant surfaces is today’s trend in implantology Figure b shows the graph with the wettability profile of samples from water contact angle (WCA) measurements.…”

The progress in titanium alloys used as biomedical implants: From the view of reactive oxygen species

“…The plasma-treated Ti surface has a reduction potential, leading to oxidation of the surrounding environment. In addition, TiO 2 could be modified by ions, such as COOH − , OH − , NO − , N 3− and O 2after plasma treatment (Lee et al, 2019;Shao et al, 2022).…”

“…Reactive oxygen and nitrogen species are the main active components of non-thermal plasma, enabling titanium surface perform reductive potential which oxidize the surrounding material ( Lee et al, 2019 ; Shao et al, 2022 ). Monetta and Bellucci (2014) proposed that oxygen cold plasma treatment can increase the content of TiO 2 on the surface of titanium samples and promote the anatase formation.…”

“…The plasma-treated Ti surface has a reduction potential, leading to oxidation of the surrounding environment. In addition, TiO 2 could be modified by ions, such as COOH − , OH − , NO − , N 3− and O 2- after plasma treatment ( Lee et al, 2019 ; Shao et al, 2022 ). Unfortunately, this type of treatment has only a temporary effect on bacterial adhesion, as the ions remain on the surface only for a limited time ( Bencina et al, 2021 ).…”

In Vitro and In Vivo Studies of Hydrogenated Titanium Dioxide Nanotubes with Superhydrophilic Surfaces during Early Osseointegration

“…A previous study obtained superhydrophilic implant surface by atmospheric-pressure plasma treatment, and confirmed that the superhydrophilic implant can induce high hard-tissue differentiation in vivo [ 26 ]. In addition to promoting bone formation, superhydrophilic surfaces can inhibit bacterial adhesion and viability [ 27 ].…”