Magnesium alloys are biodegradable metals receiving increasing attention, but the clinical applications of these materials are delayed by concerns over the rapid corrosion rate and gas formation. Unlike corrosion, which weakens mechanical properties, the gas formation issue has received little attention. Therefore, we evaluated the gas formation and biological effects for Mg implants through preclinical (immersed in Earle’s balanced salt solution and in vivo) and clinical studies. The immersion test examined the gas volume and composition. The in vivo study also examined gas volume and histological analysis. The clinical study examined the gas volume and safety after Mg screw metatarsal fixation. Gas was mainly composed of H₂, CO and CO₂. Maximum volumes of gas formed after 5 days for in vivo and 7 days in clinical study. Within the clinical examination, two superficial wound complications healed with local wound care. Osteolytic lesions in the surrounding metaphysis of the Mg screw insertion developed in all cases and union occurred at 3 months. Mg implants released gas with variable volumes and composition (H₂, CO, and CO₂), with no long-term toxic effects on the surrounding tissue. The implants enabled bone healing, although complications of wound breakdown and osteolytic lesions developed.

In the field of bone tissue, maintaining adequate mechanical strength and tissue volume is an important part. Recently, biphasic calcium phosphate (BCP) was fabricated to solve the shortcomings of hydroxyapatite (HA) and beta-tricalcium phosphate (β-TCP), and it is widely studied in the field of bone-tissue engineering. In this study, a composite hydrogel was fabricated by applying BCP to gelatin methacrylate (GelMA). It was tested by using a mechanical tester, to characterize the mechanical properties of the prepared composite hydrogel. The fabricated BCP was analyzed through FTIR and XRD. As a result, a different characteristic pattern from hydroxyapatite (HA) and beta-tricalcium phosphate (β-TCP) was observed, and it was confirmed that it was successfully bound to the hydrogel. Then, the proliferation and differentiation of preosteoblasts were checked to evaluate cell viability. The analysis results showed high cell viability and relatively high bone differentiation ability in the composite hydrogel to which BCP was applied. These features have been shown to be beneficial for bone regeneration by maintaining the volume and shape of the hydrogel. In addition, hydrogels can be advantageous for clinical use, as they can shape the structure of the material for custom applications.

Multi walled carbon nanotubes-hydroxyapatite (MWCNTs-HA) with various contents of MWCNTs was synthesized using the sol-gel method. MWCNTs-HA composites were characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM). HA particles were generated on the surface of MWCNT. Produced MWCNTs-HA nanocomposites were coated on pure titanium (PT). Characteristic of the titanium coated MWCNTs-HA was evaluated by field-emission scanning electron microscopy (FE-SEM) and XRD. The results show that the titanium surface was covered with MWCNTs-HA nanoparticles and MWCNTs help form the crystalized hydroxyapatite. Furthermore, the MWCNTs-HA coated titanium was investigated for in vitro cellular responses. Cell proliferation and differentiation were improved on the surface of MWCNT-HA coated titanium.

Guided bone regeneration is a therapeutic method that uses a barrier membrane to provide space available for new bone formation at sites with insufficient bone volume. Magnesium with excellent biocompatibility and mechanical properties has been considered as a promising biodegradable material for guided bone regeneration; however, the rapid degradation rate in the physiological environment is a problem to be solved. In this study, surface modification of pure magnesium mesh was conducted by plasma electrolytic oxidation and hydrothermal treatment to form a densely protective layer on the Mg substrate. The protective layer mainly consisted of Mg(OH)₂ with the amorphous calcium phosphate. Then, weight loss measurement and Micro-CT imaging were performed after an immersion test in a simulated body fluid. The effect of surface modification of the magnesium mesh on the guided bone regeneration was evaluated through an in vivo test using the rat calvarial defect model. The biodegradation of the magnesium mesh was identified to be significantly retarded. Additionally, the surface modification of Mg also can improve the bone volume and bone density of calvarial defect in comparison with that of the pristine Mg mesh.

Jang YS, et al. J Adv Prosthodont. 2019 Feb;11(1):7-15. https://doi.org/10.4047/jap.2019.11.1.7

The gingerols and shogaols derived from ginger have excellent antibacterial properties against oral bacteria. However, some researchers have noted their dose-dependent potential toxicity. The aim of this study was to enhance the biofunctionality and biocompatibility of the application of ginger to dental titanium screws. To increase the amount of coating of the n-hexane-fractionated ginger on the titanium surface and to control its release, ginger was loaded in different concentrations in a photo-crosslinkable GelMA hydrogel. To improve coating stability of the ginger hydrogel (GH), the wettability of the surface was modified by pre-calcification (TNC), then GH was applied on the surface. As a result, the ginger fraction, with a high content of phenolic compounds, was effective in the inhibition of the growth of S. mutans and P. gingivalis. The GH slowly released the main compounds of ginger and showed excellent antibacterial effects with the concentration. Although bone regeneration was slightly reduced with the ginger-loading concentration due to the increased contents of polyphenolic compounds, it was strongly supplemented through the promotion of osteosis formation by the hydrogel and TNC coating. Finally, we proved the biosafety and superior biofunctionalities the GH−TNC coating on a Ti implant. However, it is recommended to use an appropriate concentration, because an excessive concentration of ginger may affect the improved biocompatibility in clinical applications.