Additive manufacturing technologies of porous metal implants

Biomedical metal materials with good corrosion resistance and mechanical properties are widely used in orthopedic surgery and dental implant materials,but they can easily cause stress shielding due to the significant difference in elastic modulus between the implant and human bones.The elastic modulus of porous metals is lower than that of dense metals.Therefore,it is possible to adjust the pore parameters to make the elastic modulus of porous metals match or be comparable with that of the bone tissue.At the same time,the open porous metals with pores connected to each other could provide the structural condition for bone ingrowth,which is helpful in strengthening the biological combination of bone tissue with the implants.Therefore,the preparation technologies of porous metal implants and related research have been drawing more and more attention due to the excellent features of porous metals.Selective laser melting(SLM)and electron beam melting technology(EBM)are important research fields of additive manufacturing.They have the advantages of directly forming arbitrarily complex shaped metal parts which are suitable for the preparation of porous metal implants with complex shape and fine structure.As new manufacturing technologies,the applications of SLM and EBM for porous metal implants have just begun.This paper aims to understand the technology status of SLM and EBM,the research progress of porous metal implants preparation by using SLM and EBM,and the biological compatibility of the materials,individual design and manufacturing requirements.The existing problems and future research directions for porous metal implants prepared by SLM and EBM methods are discussed in the last paragraph.

Porous metal implants: processing,properties, and challenges

Porous and functionally graded materials have seen extensive applications in modern biomedical devices—allowing for improved site-specific performance;their appreciable mechanical,corrosive,and biocompatible properties are highly sought after for lightweight and high-strength load-bearing orthopedic and dental implants.Examples of such porous materials are metals,ceramics,and polymers.Although,easy to manufacture and lightweight,porous polymers do not inherently exhibit the required mechanical strength for hard tissue repair or replacement.Alternatively,porous ceramics are brittle and do not possess the required fatigue resistance.On the other hand,porous biocompatible metals have shown tailorable strength,fatigue resistance,and toughness.Thereby,a significant interest in investigating the manufacturing challenges of porous metals has taken place in recent years.Past research has shown that once the advantages of porous metallic structures in the orthopedic implant industry have been realized,their biological and biomechanical compatibility—with the host bone—has been followed up with extensive methodical research.Various manufacturing methods for porous or functionally graded metals are discussed and compared in this review,specifically,how the manufacturing process influences microstructure,graded composition,porosity,biocompatibility,and mechanical properties.Most of the studies discussed in this review are related to porous structures for bone implant applications;however,the understanding of these investigations may also be extended to other devices beyond the biomedical field.

The Tissue Reactions and Changes of a Surface of Various Metal Implants after Their Introduction in a Bone Tissue in Experiment

Screw metal implants (3S, Israel) with rough or smooth polished surface were introduced in a tibial proximal condyle of not purebred rabbits. The condition of surrounding tissues in 2 and 6 months after implantation was compared by light microscopy and X-ray methods. Within 6 months after operation the considerable distinctions of radiological and morphological data were revealed not. 2 months later after introduction of implants with a rough surface the effort enclosed for its twisting is, much more, than for removal of the polished product. However, stability of fixing of implants was practically made even at 6 months. On remote rough implants there is a set of tissue scraps whereas on products with a smooth surface the tissue remains were much less. Surrounding tissues strongly join a rough surface, grow into cavities, and during removal of such products there is a considerable trauma of tissues round an implantation place. Smooth implants have the smaller area of contact with organism tissues, they are fixed due to bicortical implantation, during removal easily get out and don’t break off surrounding tissues. The signs of inflammation and formation of merged multinuclear macrophages were not found at all cases, which give evidence to the inertness of material of the mentioned articles for living organism. In some observations however and by implantation of the rough article and by introduction of polished implants, metal particles were found, but after use of the foreign body with grit-blasted treatment of surface metal was found more frequently, and its fragments had larger volume.

Analysis of Accumulating Ability of Heavy Metals in Lotus (Nelumbo nucifera) Improved by Ion Implantation

Heavy metals have seriously contaminated soil and water, and done harm to public health. Academician WANG Naiyan proposed that ion-implantation technique should be exploited for environmental bioremediation by mutating and breeding plants or microbes. By implanting N^＋ into Taikonglian No.l, we have selected and bred two lotus cultivars, Jingguang No.1 and Jingguang No.2. The present study aims at analyzing the feasibility that irradiation can be used for remediation of soil and water from heavy metals. Compared with parent Taikonglian No.l, the uptaking and accumulating ability of heavy metals in two mutated cultivars was obviously improved. So ion implantation technique can indeed be used in bioremediation of heavy metals in soil and water, but it is hard to select and breed a cultivar which can remedy the soil and water from all the heavy metals.

Surface metallization of PTFE and PTFE composites by ion implantation for low-background electronic substrates in rare-event detection experiments

Polytetrafluoroethylene(PTFE)is a low-background polymer that is applied to several applications in rare-event detection and underground low-background experiments.PTFE-based electronic substrates are important for reducing the detection limit of high-purity germanium detectors and scintillator calorimeters,which are widely applied in dark matter and 0υββdetection experiments.The traditional adhesive bonding method between PTFE and copper is not conducive to working in liquid nitrogen and extremely low-temperature environments.To avoid adhesive bonding,PTFE must be processed for surface metallization owing to the mismatch between the PTFE and copper conductive layer.Low-background PTFE matrix composites(m-PTFE)were selected to improve the electrical and mechanical properties of PTFE by introducing SiO_(2)/TiO_(2) particles.The microstructures,surface elements,and electrical properties of PTFE and m-PTFE were characterized and analyzed following ion implantation.PTFE and m-PTFE surfaces were found to be broken,degraded,and cross-linked by ion implantation,resulting in C=C conjugated double bonds,increased surface energy,and increased surface roughness.Comparably,the surface roughness,bond strength,and conjugated double bonds of m-PTFE were significantly more intense than those of PTFE.Moreover,the interface bonding theory between PTFE and the metal copper foil was analyzed using the direct metallization principle.Therefore,the peel strength of the optimized electronic substrates was higher than that of the industrial standard at extremely low temperatures,while maintaining excellent electrical properties.

The corrosion scenario in human body: Stainless steel 316L orthopaedic implants

As the world’s populations increase and age, there is a parallel increase in the number of medical procedures addressed to bone related injuries. It is estimated that approximately 1 million of orthopaedic implant surgeries in association with total joint replacements are needed every year. This number is expected to double between 1999 and 2025 as a result of increasing numbers of musculoskeletal injuries (i.e., due to routine activities such as work, sport, etc.) and musculoskeletal diseases (i.e., such as osteoporosis, arthritis and bursitis due to increase age). Consequently, the increase demand for better quality of life has necessarily led people to opt for high quality orthopaedic devices for early recovery and speedy resumption of their routine activities. Unfortunately in the present time, it has been found that the current used orthopaedic implants have the tendencies to fail after long period of usage, due to the corrosion issue of implant in the human body. Therefore, this paper provides a simple overview about the corrosion issue of stainless steel (SS) 316L as implants in human body. Electrophoretic deposition (EPD) of hydroxypaptite (HA) bioceramic was proposed as the approach to minimize the corrosion phenomena. Additionally, the corrosion testing of HA coated SS 316L in comparison to pristine SS 316L was also performed and discussed.

Investigation on the Tribology of Co Implanted Stainless Steel Using Metal Vapor Vacuum Arc Ion Source

AISI 304 stainless steel was ion implanted with Co, and the tribological property on the surface of the stainless steelwas investigated. The Co ion implantation was carried out using a metal vapor vacuum arc (Mevva) broad-beam ionsource with an extraction voltage of 40 kV, implantation doses of 3×10^(17)/cm^2 and 5×10^(17)/cm^2, and ion currentdensities of 13, 22 and 32μA/cm^2. The results showed that the near-surface hardness of Co-implanted stainless steelsample was increased by 50% or more, and it increased with increasing ion current density at first and then declined.The friction coefficient decreased from 0.74 to 0.20 after Co implantation. The wear rate after Co implantationreduced by 25% or more as compared to the unimplanted sample. The wear rate initially decreased with increasingion current density and then an increase was observed. Within the range of experimental parameters, there existsa critical ion current density for the Co-implanted stainless steel, at which the wear rate decreased with increasingretained dose, going through a minimum and then increased. The critical ion current density in this paper is about22μA/cm^2.

Porcelain fracture of metal-ceramic tooth-supported and implant-supported restorations: A review

Metal-ceramic restorations are widely used in dentistry with a high degree of general success. However, fracture of these restorations does occur and usually frustrates both the dentist and the patient. Objective: This literature review discusses the factors that may lead to the fracture of these restorations whether they are tooth-supported or implant-supported with the aim of making dentists and technicians aware of these factors to avoid them. Factors reviewed include: technical factors, dentist-related factors, inherent material properties, direction, magnitude and frequency of applied loads, environmental factors, screw-retained implant-supported restorations, and posterior cantilevered prostheses. Material and Methods: A netbased search in “Pubmed” was performed and combined with a manual search. The search was limited to articles written in English. Conclusions: the published literature revealed that the factors predisposing to fracture of metal-ceramic restorations may be related to the technician, dentist, patient, environment, design of the restoration, or to inherent structure of ceramics and others. However, if the dentist and technician understand these factors and respect the physical characteristics of the materials, most of those are avoidable.

Determination of activation energy of ion-implanted deuterium release from W–Y2O3

The retention and release of deuterium in W–2%Y2O3 composite materials and commercially pure tungsten after they have been implanted by deuterium plasma(flux ~ 3.71 × 1021 D/m2·s, energy ~ 25 eV, and fluence up to 1.3 × 1026D/m2)are studied. The results show that the total amount of deuterium released from W–2%Y2O3 is 5.23 × 1020 D/m2(2.5 K/min),about 2.5 times higher than that from the pure tungsten. Thermal desorption spectra(TDS) at different heating rates(2.5 K/min–20 K/min) reveal that both W and W–2%Y2O3 have two main deuterium trapped sites. For the low temperature trap, the deuterium desorption activation energy is 0.85 eV(grain boundary) in W, while for high temperature trap, the desorption activation energy is 1.57 eV(vacancy) in W and 1.73 eV(vacancy) in W–2%Y2O3.

Interaction pathways of implant metal localized corrosion and macrophage inflammatory reactions

Macrophages play a central role in immunological responses to metallic species associated with the localized corrosion of metallic implants,and mediating in peri-implant inflammations.Herein,the pathways of localized corrosion-macrophage interactions were systematically investigated on 316L stainless steel(SS)implant metals.Electrochemical monitoring under macrophage-mediated inflammatory conditions showed a decreased pitting corrosion resistance of 316L SSs in the presence of RAW264.7 cells as the cells would disrupt biomolecule adsorbed layer on the metal surface.The pitting potentials were furtherly decreased when the RAW264.7 cells were induced to the M1 pro-inflammatory phenotype by the addition of lipopolysaccharide(LPS),and pitting corrosion preferentially initiated at the peripheries of macrophages.The overproduction of aggressive ROS under inflammatory conditions would accelerate the localized corrosion of 316L SS around macrophages.Under pitting corrosion condition,the viability and pro-inflammatory polarization of RAW264.7 cells were region-dependent,lower viability and more remarkable morphology transformation of macrophages in the pitting corrosion region than the pitting-free region.The pitting corrosion of 316L SS induced high expression of CD86,TNF-α,IL-6 and high level of intracellular ROS in macrophages.Uneven release of metallic species(Fe^(2+),Cr^(3+),Ni^(2+),etc)and uneven distribution of surface overpotential stimulated macrophage inflammatory responses near the corrosion pits.A synergetic effect of localized corrosion and macrophages was revealed,which could furtherly promote localized corrosion of 316L SS and macrophage inflammatory reactions.Our results provided direct evidence of corrosion-macrophage interaction in metallic implants and disclosed the pathways of this mutual stimulation effect.

Absorbable implants in sport medicine and arthroscopic surgery:A narrative review of recent development

Over the past two decades,advances in arthroscopic and minimally invasive surgical techniques have led to significant growth in sports medicine surgery.Implants such as suture anchors,interference screws,and endo-buttons are commonly used in these procedures.However,traditional implants made of metal or inert materials are not absorbable,leading to complications that affect treatment outcomes.To address this issue,absorbable materials with excellent mechanical properties,good biocompatibility,and controlled degradation rates have been developed and applied in clinical practice.These materials include absorbable polymers,absorbable bioceramics,and absorbable metals.In this paper,we will provide a comprehensive summary of these absorbable materials from the perspective of clinicians,and discuss their clinical applications and related research in sport medicine.

Development and experimental study of large size composite plasma immersion ion implantation device

Plasma immersion ion implantation （PI） overcomes the direct exposure limit of traditional beam- line ion implantation, and is suitable for the treatment of complex work-piece with large size. Pm technology is often used for surface modification of metal, plastics and ceramics. Based on the requirement of surface modification of large size insulating material, a composite full-directional PHI device based on RF plasma source and metal plasma source is developed in this paper. This device can not only realize gas ion implantation, but also can realize metal ion implantation, and can also realize gas ion mixing with metal ions injection. This device has two metal plasma sources and each metal source contains three cathodes. Under the condition of keeping the vacuum unchanged, the cathode can be switched freely. The volume of the vacuum chamber is about 0.94 m3, and maximum vacuum degree is about 5 x10-4 Pa. The density of RF plasma in homogeneous region is about 109 cm-3, and plasma density in the ion implantation region is about 101x cm-3. This device can be used for large-size sample material PHI treatment, the maximum size of the sample diameter up to 400 mm. The experimental results show that the plasma discharge in the device is stable and can run for a long time. It is suitable for surface treatment of insulating materials.

Imaging characteristics of metallic interbody spacers: in vitro score evaluation of susceptibility artifacts considering different MRI sequences

Aim: Intervertebral spacers for anterior spine fusion are made of different materials, such as titanium, carbon or cobalt-chrome, which can affect the post- fusion MRI scans. Implant-related susceptibility artifacts can decrease the quality of MRI scans, thwar- ting proper evaluation. This cadaver study aimed to demonstrate the extent that implant-related MRI artifacting affects the post-fusion evaluation of intervertebral spacers. Methods: In a cadaveric porcine spine, we evaluated the post-implantation MRI scans of 2 metallic intervertebral spacers (TiAL6V4, CoCrMo) that differed in shape, material, surface qualities and implantation technique. A spacer made of human cortical bone was used as a control. The median sagittal MRI slice was divided into 12 regions of interest (ROI). Results: No significant differences were found on 15 different MRI sequences read independently by an interobserver-validated team of specialists (P>0.05). Artifact-affected image quality was rated on a score of 0-1-2. A maximum score of 24 points (100%) was possible. Turbo spin echo sequences produced the best scores for all spacers and the control. Only the control achieved a score of 100%. The titanium and cobalt-chrome spacers scored 62.5% and 50%, respectively. Conclusions: Our scoring system allowed us to create an implant-related rank- ing of MRI scan quality in reference to the control that was independent of artifact dimensions. Even with turbo spin echo sequences, the susceptibility artifacts produced by the metallic spacers showed a high degree of variability. Despite optimum sequen- cing, implant design and material are relevant factors in MRI artifacting.

MRI-Induced Tissue Heating at Metallic Sutures (Cerclages)

Magnetic resonance imaging (MRI) has become an important diagnostic tool with an ongoing dynamic development towards application of increasing static magnetic flux densities and consequently, exposures to electromagnetic fields (EMF) of increasing radio frequencies (RF). This raises particular concern metallic implants could lead to excess tissue heating and consequently, to thermal tissue damage. In thorax surgery the intersected sternum is reconnected by metallic sutures (cerclages). To investigate whether patients with such implants can be accepted for MRI and whether there may be limitations with regard to static magnetic fields, by numerical anatomical and thermal modelling MRI induced tissue heating was assessed for magnetic flux densities 1.5 T, 3 T, 4 T and 7 T. Results show that overall tissue temperature increased with increasing RF EMF frequency. However, even for setting MRI exposure parameters at maximum permissible level partial body heating remained marginally affected and even at local level the additional contribution of the presence of the metallic cerclage remained below 1°C. This allows concluding that from a heating point of view metallic sutures as used to fix the sternum after thorax surgery are no contraindication for MRI with static magnetic flux densities up to 7 T.

Aluminum ion beam surface modification of elastic metallic-plastic pads for improving tribological properties

Elastic metallic-plastic pads（EMP） were irradiated by low energy aluminum ion in a metal vapor vacuum arc（MEVVA） 80-10 implantation system. The samples were irradiated with 20keV Al ion with the influx from 1×1015 to 1×1016 Al/cm2. Then the as-irradiated samples were measured by ESCA, XRD, AFM/FFM and a nano-probe. It is found that the hardness of as-irradiated samples is 5-6 times as that of the pristine ones. The worn depth of sample implanted at ion influx of 1×1016 Al/cm2 is about one eighth of that of the pristine sample at the same load. The XRD results show that there are some Al2O3 and AlF3 intermingled with the phase of polytetrafluoroethylene（PTFE）. The experimental results reveal that the tribological properties of EMP can be significantly improved by the ion beam surface modification.

Characteristics of La_0.7Sr_0.3MnO₃Films Modified by Aluminum Ions Implantation and Post-Implantation Annealing

The magnetron sputtered La0.7Sr0.3MnO3 films were implanted with different doses (5 ′ 1015 ions×cm?2 and 5 ′ 1016 ions×cm-2) of Al ions at different negative pulsed voltages (30 kV and 50 kV) by plasma based ion implantation and then annealed at 973 K for 1 h in air. The microstructure, surface morphologies, surface roughness, metal-insulator transition and room temperature emittance properties of the post-implantation annealed films were investigated and compared with those of the La0.7Sr0.3MnO3 film annealed at 973 K for 1 h in air. The results indicate that the post- implantation annealed films show single perovskite phase and obvious (100) preferred orientation growth. The Mn-O bond length, surface roughness and metal-insulator transition temperature (TMI) of the films can be effectively adjusted by changing implantation voltage or implantation dose of Al ions. However, the change of implantation parameters just has a small effect on room temperature emittance of the films. Compared with the annealed film, the post-implantation annealed films have shorter Mn-O bond length and lower room temperature emittance. The TMI of the films implanted at low voltage is lower than that of the annealed film, which mainly results from the degradation of oxidization during annealing process and the part displacement of Mn3+-O2+- Mn4+ double exchange channels by Al3+-O2?-Mn4+. The post-implanted annealed film implanted at 50 kV/5 ′ 1016 ions×cm-2 has a higher TMI than the annealed film, which is 247 K. The increase of TMI of the film implanted with high dose of Al ions at high voltage can be attributed to the improvement of microstructure.

深度学习重建联合Smart去金属伪影算法在口腔金属植入物患者头颈CT血管成像中的应用

目的:探讨深度学习重建(DLR)联合Smart去金属伪影(MAR)算法在口腔金属植入物患者头颈CT血管成像(CTA)中的应用价值。方法:选择郑州大学第一附属医院2023年2月至6月口腔有不可拆卸金属植入物行头颈CTA的患者70例,采用以下3种方法重建图像:基于混合模型的自适应迭代重建(ASIR-V)50%算法(IR),ASIR-V50%联合Smart MAR算法(IR-S),高水平DLR联合Smart MAR算法(DLR-S)。测量不受伪影影响的颈内动脉C1段和头夹肌感兴趣区CT值的标准差(SD)2和SD4,作为图像噪声指标;计算颈内动脉C1段和舌部的金属伪影指数(AI)1和AI2;对颈内动脉C1段和口腔整体图像质量进行主观评分。结果:与IR组和IR-S组比较,DLR-S组SD2和SD4降低(P<0.05)。与IR组比较,IR-S组和DLR-S组AI1、AI2降低;与IR-S组比较,DLR-S组AI1、AT2降低(P<0.05)。与IR组比较,IR-S组和DLR-S组口腔整体和颈内动脉C1段图像质量主观评分均增高;与IR-S组比较,DLR-S组图像质量主观评分增高(P<0.05),9例患者舌部可见新的伪影。结论:Smart MAR联合DLR可减少口腔植入物造成的金属伪影,提高头颈CTA图像质量。但Smart MAR可能引入新的伪影,需联合未加入Smart MAR的图像进行分析。

A tantalum-containing zirconium-based metallic glass with superior endosseous implant relevant properties

Zirconium-based metallic glasses(Zr-MGs)are demonstrated to exhibit high mechanical strength,low elastic modulus and excellent biocompatibility,making them promising materials for endosseous implants.Meanwhile,tantalum(Ta)is also well known for its ideal corrosion resistance and biological effects.However,the metal has an elastic modulus as high as 186 GPa which is not comparable to the natural bone(10–30 GPa),and it also has a relative high cost.Here,to fully exploit the advantages of Ta as endosseous implants,a small amount of Ta(as low as 3 at.%)was successfully added into a Zr-MG to generate an advanced functional endosseous implant,Zr58Cu25Al14Ta3 MG,with superior comprehensive properties.Upon carefully dissecting the atomic structure and surface chemistry,the results show that amorphization of Ta enables the uniform distribution in material surface,leading to a significantly improved chemical stability and extensive material-cell contact regulation.Systematical analyses on the immunological,angiogenesis and osteogenesis capability of the material are carried out utilizing the next-generation sequencing,revealing that Zr_(58)Cu_(25)Al_(14)Ta_(3)MG can regulate angiogenesis through VEGF signaling pathway and osteogenesis via BMP signaling pathway.Animal experiment further confirms a sound osseointegration of Zr_(58)Cu_(25)Al_(14)Ta_(3)MG in achieving better bone-implant-contact and inducing faster periimplant bone formation.

微弧氧化对金属植入物抗菌和抗炎能力的调节效应

背景:微弧氧化技术能够有效地将生物活性元素掺杂到金属表面,提高生物医用金属材料的抗菌性能和抗炎性能,因此该技术已成为生物医用材料的研究热点之一。目的:重点介绍微弧氧化技术及其与其他表面改性技术联合应用制备植入物表面涂层的抗菌性能和抗炎性能。方法:以“微弧氧化,抗炎性能,抗菌性能,金属植入物”为中文检索词检索中国知网和万方数据库,以“micro-arc oxidation、antibacterial properties,anti-inflammatory properties,metal implants”为英文检索词检索PubMed数据库,检索时间范围为1996年1月至2022年12月,根据纳入和排除标准初筛后,最后保留89篇文献进行归纳总结。结果与结论:微弧氧化陶瓷层提高了钛、镁等合金的抗菌性能和抗炎性能,联合其他表面改性技术有效解决了孔隙对合金表面性能的影响,进一步提高了氧化膜的生物学性能,在骨科和牙科等领域有着广泛的应用前景。目前研究多局限于金属涂层,而且大部分研究集中在银、铜等具有良好抗菌性能的金属元素,仅有少数研究提到氧化石墨烯、羟基磷灰石和壳聚糖等非金属涂层,未来可以对无机物涂层和高分子涂层进行广泛研究,也可采取更多种不同生物活性元素的组合来提高抗菌性能。目前微弧氧化技术所制备的植入体涂层炎症研究多局限于免疫系统,且集中在巨噬细胞,而其对于中性粒细胞、血小板等的研究稀缺,未来需联合应用多种先进技术手段探究微弧氧化涂层对其他免疫细胞和炎症细胞的具体影响。

离子注入诱导成核外延高质量AlN

超宽禁带AlN材料具有禁带宽度大、击穿电场高、热导率高、直接带隙等优势,被广泛应用于光电子器件和电力电子器件等领域.AlN材料的质量影响着AlN基器件的性能,为此研究人员提出了多种方法来提高异质外延AlN晶体的质量,但是这些方法工艺复杂且成本高昂.因此,本文提出了诱导成核的新方法来获得高质量的AlN材料.首先,对纳米图案化的蓝宝石衬底注入不同剂量的N离子进行预处理,随后基于该衬底用金属有机化学气相沉积法外延AlN基板,并在其上生长多量子阱结构,最后基于此多量子阱结构制备紫外发光二极管.研究结果表明,在注入N离子剂量为1×10^(13) cm^(-2)的衬底上外延获得的AlN基板,其表面粗糙度最小且位错密度最低.由此可见,适当剂量的N离子注入促进了AlN异质外延过程中的横向生长与合并过程;这可能是因为N离子的注入,抑制了初期成核过程中形成的扭曲的镶嵌结构,有效地降低了AlN的螺位错以及刃位错密度.此外,基于该基板制备的多量子阱结构,其残余应力最小,光致发光强度提高到无注入样品的152%.此外,紫外发光二极管的光电性能大幅提高,当注入电流为100 mA时,光输出功率和电光转换效率分别提高了63.8%和61.7%.