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Correlation between structural
          properties and in vivo
            biocompatibility of
      alumina/zirconia bioceramics


     Simona Cavalu
            Professor

   Preclinical Sciences Department
Faculty of Medicine and Pharmaceutics
       University of Oradea
             ROMANIA
Motivation
 There is a continuous input from bioengineering for
  reaching a high level of comfort, improving reliability,
  finding new applications.
 This development is also a response to the growing
  number of patients afflicted with traumatic or non-
  traumatic conditions: the number of implants is
  continuously growing, due to the increase in persons
  suffering of arthritis and joint problems.
 As the average age of population grows, the need for
  medical devices to replace damaged or worn tissues
  increases.
 As patients have become more and more demanding
  regarding esthetic and biocompatibility aspects of
  their dental restorations
Motivation
     Al2O3                               ZrO2
 Excellent hardness and        Was introduced to overcome
  wear properties.               the limitations of alumina.
 Fracture toughness values     When properly manufactured,
  are lower than those of        zirconia has a higher strength,
  the metals used in             but only 50% of aluminas
  orthopedic surgery.            hardness.
 Chemical and                  Unstable material. The
  hydrothermal stability.        tetragonal phase tends to
 It is a brittle material,      transform into the monoclinic
                                 phase. The addition of
  with low resistance to the     stabilizing materials
  propagation of cracks.         (Y2O3)during manufacture, can
                                 control the phase
                                 transformation of zirconia.

  Al2O3, ZrO2, TiO2 have been considered as bioinert ceramics
  since they cannot induce apatite formation in SBF. They do
  however support bone cell attachment, proliferation and
  differentiation.
The ideal ceramic is a high performance biocomposite that combines
the excellent material properties of alumina in terms of chemical
stability and low wear and of zirconia with its superior mechanical
strength and fracture toughness.



 Alumina/zirconia ceramics were successfully used in total
  hip/knee arthroplasty in the last decades.

 For dental application: root canal posts, orthodontic
  brackets, implant abutments and all- ceramic
  restaurations.
Goal

 An evaluation of the structural and
  biocompatibility properties of a new
  zirconia toughened alumina ceramics.
 The composition of proposed materials
  for this study:
    90%Al2O3-10%ZrO2 and
    90%Al2O3-10%ZrO2+5%TiO2
 prepared by using modern processing
  technologies  spark plasma sintering.
Methods
   Investigation of the structural changes induced by TiO2
    addition to Al2O3/ ZrO2 are made by FTIR spectroscopy and X-
    ray diffraction (XRD) analysis .

   Scanning Electron Microscopy (SEM) and EDX are used for
    microstructure and morphology investigation of the samples.

   In order to perform in vivo tests, the rat model has been applied
    for biocompatibility evaluation. The rat model has been accepted
    as a model for the effects of systemic disease on osseointegration.

   SEM micrographs are recorded on the rats femur along with the
    elemental composition of the sheared implant surfaces at
    different time intervals after the surgery.

   Histological examination of the connective tissue is performed
    to detect any immunological or inflammatory responses.
Results: XRD Spectroscopy
                                                                 XRD patterns of (a) 90Al2O310ZrO2 and
                                                                  (b) 90Al2O310ZrO2 + 5%TiO2 samples.

            1200
                                               Z
                                                    A
                                                                                                                                 The     TiO2   addition  slightly
                                                             A            Z                                                       modifies the relative intensities
            1000                                                                                                                  of XRD peaks. Both samples
                                       A                                               A                                          show similar peak positions,
                   800                                  A        Z
                                                                      A
                                                                                       A
                                                                                                                                  the slight change of relative
                                                                              Z
                                                                                  A                 A                             intensities of XRD peaks could
                                                                                                                                  be     attributed
                                                                                                                                         T
                                                                                                                                                        to    weak
Intensity (a.u.)




                                                                                  Z             A
                   600
                                               Z A           A            Z
                                                                                                                  (a)             differences in size and shape of
                                                                                                                                  the crystals in these samples
                   400
                                       A                                                   A
                                                                      A
                                                        A
                                                                                       A
                                                                                                                                 This    result   suggest    that
                   200                                           Z            A                                                   zirconia    present    in    the
                                           T
                                                                                   Z
                                                                                                    A
                                                                                                                                  composite      is,    therefore,
                    0
                                                                                                A
                                                                                                                  (b)             retained in the tetragonal form
                                                                                                                                  as alumina particles prevent
                         0   10   20           30       40       50           60           70           80   90         100
                                                                                                                                  the tetragonal to monoclinic
                                                    2 theta (degrees)
                                                                                                                                  transformation     by     matrix
                                                                                                                                  constraint.
FTIR Spectroscopy: (a) 90Al2O310ZrO2 and
                         (b) 90Al2O310ZrO2 + 5%TiO2 samples.
                                                                                                   The large bands around 1088
                                                                                                    cm-1 are assigned to stretching
                                                                                                    vibration of AlOAl bonds.
                                                                                                   The Al-O stretching vibrations of




                                                                                  465
                   0.6
                                  1088




                                                                                                    tetrahedral AlO4 groups are
                                                                     614
                                                              660
                                                                                                    related with the bands in the
                                                        780
                           1168




                                                                                                    region 900  750 cm-1 and
                                                                            564
                                                                           518
                                                     797




                   0.5
                                                                                                    bands in 650  460 cm-1 region
Intensity (a.u.)




                                                                                          (a)
                                                                                                    are associated with stretching
                                                                                                    modes of AlO6 octahedra.
                   0.4
                                                                                                   The absorption bands at 518 to
                                                                                                    564 cm-1 correspond to Zr-O
                                                                                                    vibrations in tetragonal ZrO2
                   0.3
                                                                                                    phase.
                                                                                          (b)      Upon TiO2 addition to alumina-
                                                                                                    zirconia matrix, the relative
                   0.2                                                                              intensity of 660/614 cm-1 band
                         1200            1000         800
                                                Wavenumber (cm )
                                                                    -1
                                                                         600            400
                                                                                                    is considerably modified, as a
                                                                                                    superposition of the
                                                                                                    characteristics absorption bands
                                                                                                    occurs in this region.
SEM: Irregular shape of 90%Al2O3-10%ZrO2(a)
     and 90%Al2O3-10%ZrO2+5%TiO2 (b) granules and
     their corresponding microstructure (c, d)




a)                   c)




b)                   d)
Biocompatibility evaluation: Animal model
   (Wistar rats)

 Surgical procedure
Surgical procedure: filling the critical size
      defect created in the femur




Collagen film
Monitoring the osseointegration process at
   different time intervals (3, 6 weeks).
   Radiographic images

90Al2O310ZrO2




90Al2O310ZrO2 + 5%TiO2
SEM images of the sheared implant surfaces:
                                       3 weeks



  90Al2O310ZrO2




90Al2O310ZrO2 + 5%TiO2
SEM images of the sheared implant surfaces:
                                    6 weeks



  90Al2O310ZrO2




90Al2O310ZrO2 + 5%TiO2
Haversian canal details
SEM Analysis reveals:
 Fibrinous and collagenous matrix extensively interdigitated
  with the three-dimensional interconnected porous structure
  after first 3 weeks.
 Distinct gaps between the implant and the bone were
  observed in a few locations.
 After 6 weeks, the matrix around the surface implanted
  area appeared more densely, well covered and extensively
  integrated into a mixture of mineralized tissue, osteoid and
  dense matrix.
 As revealed from the EDAX spectra, calcium/phosphate
  ratio is an indicative of the surface implant coverage for a
  successful osseointegration, varying from 1.5 (after 3
  weeks) to 1.9 (after 6 weeks).
 The results suggest that TiO2 presence in the samples favor
  the osseointegration process.
XRD spectrum of the femoral bone
                 900

                 800                 Z                                        AlZr Biocomposite
                 700                                     A
                                             A               Z       Z          A
                                A                                A       A     A
                                                 A
                                 T                                        Z
                 600

                 500                 Z                                              Bone/AlZr
      I (a.u.)




                                         B                   Z     Z
                                A                        A                     A
                 400                         A B                 A AZ

                 300                     *
                 200

                                                     *                                Bone
                 100

                  0

                       0   20                    40                  60                80         100
                                                         2 (deg)
Histological images: The connective tissue
     was also examined to detect any
     immunological or inflammatory responses

                 osteoblasts




A network of woven bony trabecular architecture with cellular infiltration
was observed
Conclusions
 Structural investigations of the proposed composites
  using XRD and FTIR spectroscopy confirms the
  stability of the microstructure upon TiO 2 addition to
  alumina/zirconia matrix.
 In vivo: both implanted materials in critical size
  defect of the femur were well integrated in the
  original bone defects and covered with a layer of soft
  tissue at 6 weeks after implantation, as demonstrated
  by SEM images.
 As revealed from the EDAX spectra, Ca/P ratio is an
  indicative of the surface implant coverage for a
  successful osseointegration, varying from 1.5 (after 3
  weeks) to 1.9 (after 6 weeks).
 No signs of inflammatory reactions, such as necrosis
  or reddening suggesting implant rejection, were found
  upon histological examination.
The team:
 Prof. dr. Gultekin Goller and dr. Ipek Akin, Istanbul
  Technical University, Materials Science Department.

 Prof. dr. Viorica Simon and dr. Oana Ponta Babes-Bolyai
  University, Faculty of Physics & Institute of Interdisciplinary
  Research in Bio-Nano-Sciences, Cluj-Napoca, Romania.
 Assoc. prof. Cristian Ratiu and dr. Ioan Oswald
  University of Oradea, Faculty of Medicine and Pharmaceutics,
  Oradea, Romania.

 Romania-Turkey Bilateral Cooperation project 385/2010.
Jerry and Jimmy
                  Linda




Thank you

More Related Content

SIMONA CAVALU_Correlation between structural properties and in vivo biocompatibility of alumina/zirconia bioceramics

  • 1. Correlation between structural properties and in vivo biocompatibility of alumina/zirconia bioceramics Simona Cavalu Professor Preclinical Sciences Department Faculty of Medicine and Pharmaceutics University of Oradea ROMANIA
  • 2. Motivation There is a continuous input from bioengineering for reaching a high level of comfort, improving reliability, finding new applications. This development is also a response to the growing number of patients afflicted with traumatic or non- traumatic conditions: the number of implants is continuously growing, due to the increase in persons suffering of arthritis and joint problems. As the average age of population grows, the need for medical devices to replace damaged or worn tissues increases. As patients have become more and more demanding regarding esthetic and biocompatibility aspects of their dental restorations
  • 3. Motivation Al2O3 ZrO2 Excellent hardness and Was introduced to overcome wear properties. the limitations of alumina. Fracture toughness values When properly manufactured, are lower than those of zirconia has a higher strength, the metals used in but only 50% of aluminas orthopedic surgery. hardness. Chemical and Unstable material. The hydrothermal stability. tetragonal phase tends to It is a brittle material, transform into the monoclinic phase. The addition of with low resistance to the stabilizing materials propagation of cracks. (Y2O3)during manufacture, can control the phase transformation of zirconia. Al2O3, ZrO2, TiO2 have been considered as bioinert ceramics since they cannot induce apatite formation in SBF. They do however support bone cell attachment, proliferation and differentiation.
  • 4. The ideal ceramic is a high performance biocomposite that combines the excellent material properties of alumina in terms of chemical stability and low wear and of zirconia with its superior mechanical strength and fracture toughness. Alumina/zirconia ceramics were successfully used in total hip/knee arthroplasty in the last decades. For dental application: root canal posts, orthodontic brackets, implant abutments and all- ceramic restaurations.
  • 5. Goal An evaluation of the structural and biocompatibility properties of a new zirconia toughened alumina ceramics. The composition of proposed materials for this study: 90%Al2O3-10%ZrO2 and 90%Al2O3-10%ZrO2+5%TiO2 prepared by using modern processing technologies spark plasma sintering.
  • 6. Methods Investigation of the structural changes induced by TiO2 addition to Al2O3/ ZrO2 are made by FTIR spectroscopy and X- ray diffraction (XRD) analysis . Scanning Electron Microscopy (SEM) and EDX are used for microstructure and morphology investigation of the samples. In order to perform in vivo tests, the rat model has been applied for biocompatibility evaluation. The rat model has been accepted as a model for the effects of systemic disease on osseointegration. SEM micrographs are recorded on the rats femur along with the elemental composition of the sheared implant surfaces at different time intervals after the surgery. Histological examination of the connective tissue is performed to detect any immunological or inflammatory responses.
  • 7. Results: XRD Spectroscopy XRD patterns of (a) 90Al2O310ZrO2 and (b) 90Al2O310ZrO2 + 5%TiO2 samples. 1200 Z A The TiO2 addition slightly A Z modifies the relative intensities 1000 of XRD peaks. Both samples A A show similar peak positions, 800 A Z A A the slight change of relative Z A A intensities of XRD peaks could be attributed T to weak Intensity (a.u.) Z A 600 Z A A Z (a) differences in size and shape of the crystals in these samples 400 A A A A A This result suggest that 200 Z A zirconia present in the T Z A composite is, therefore, 0 A (b) retained in the tetragonal form as alumina particles prevent 0 10 20 30 40 50 60 70 80 90 100 the tetragonal to monoclinic 2 theta (degrees) transformation by matrix constraint.
  • 8. FTIR Spectroscopy: (a) 90Al2O310ZrO2 and (b) 90Al2O310ZrO2 + 5%TiO2 samples. The large bands around 1088 cm-1 are assigned to stretching vibration of AlOAl bonds. The Al-O stretching vibrations of 465 0.6 1088 tetrahedral AlO4 groups are 614 660 related with the bands in the 780 1168 region 900 750 cm-1 and 564 518 797 0.5 bands in 650 460 cm-1 region Intensity (a.u.) (a) are associated with stretching modes of AlO6 octahedra. 0.4 The absorption bands at 518 to 564 cm-1 correspond to Zr-O vibrations in tetragonal ZrO2 0.3 phase. (b) Upon TiO2 addition to alumina- zirconia matrix, the relative 0.2 intensity of 660/614 cm-1 band 1200 1000 800 Wavenumber (cm ) -1 600 400 is considerably modified, as a superposition of the characteristics absorption bands occurs in this region.
  • 9. SEM: Irregular shape of 90%Al2O3-10%ZrO2(a) and 90%Al2O3-10%ZrO2+5%TiO2 (b) granules and their corresponding microstructure (c, d) a) c) b) d)
  • 10. Biocompatibility evaluation: Animal model (Wistar rats) Surgical procedure
  • 11. Surgical procedure: filling the critical size defect created in the femur Collagen film
  • 12. Monitoring the osseointegration process at different time intervals (3, 6 weeks). Radiographic images 90Al2O310ZrO2 90Al2O310ZrO2 + 5%TiO2
  • 13. SEM images of the sheared implant surfaces: 3 weeks 90Al2O310ZrO2 90Al2O310ZrO2 + 5%TiO2
  • 14. SEM images of the sheared implant surfaces: 6 weeks 90Al2O310ZrO2 90Al2O310ZrO2 + 5%TiO2
  • 16. SEM Analysis reveals: Fibrinous and collagenous matrix extensively interdigitated with the three-dimensional interconnected porous structure after first 3 weeks. Distinct gaps between the implant and the bone were observed in a few locations. After 6 weeks, the matrix around the surface implanted area appeared more densely, well covered and extensively integrated into a mixture of mineralized tissue, osteoid and dense matrix. As revealed from the EDAX spectra, calcium/phosphate ratio is an indicative of the surface implant coverage for a successful osseointegration, varying from 1.5 (after 3 weeks) to 1.9 (after 6 weeks). The results suggest that TiO2 presence in the samples favor the osseointegration process.
  • 17. XRD spectrum of the femoral bone 900 800 Z AlZr Biocomposite 700 A A Z Z A A A A A A T Z 600 500 Z Bone/AlZr I (a.u.) B Z Z A A A 400 A B A AZ 300 * 200 * Bone 100 0 0 20 40 60 80 100 2 (deg)
  • 18. Histological images: The connective tissue was also examined to detect any immunological or inflammatory responses osteoblasts A network of woven bony trabecular architecture with cellular infiltration was observed
  • 19. Conclusions Structural investigations of the proposed composites using XRD and FTIR spectroscopy confirms the stability of the microstructure upon TiO 2 addition to alumina/zirconia matrix. In vivo: both implanted materials in critical size defect of the femur were well integrated in the original bone defects and covered with a layer of soft tissue at 6 weeks after implantation, as demonstrated by SEM images. As revealed from the EDAX spectra, Ca/P ratio is an indicative of the surface implant coverage for a successful osseointegration, varying from 1.5 (after 3 weeks) to 1.9 (after 6 weeks). No signs of inflammatory reactions, such as necrosis or reddening suggesting implant rejection, were found upon histological examination.
  • 20. The team: Prof. dr. Gultekin Goller and dr. Ipek Akin, Istanbul Technical University, Materials Science Department. Prof. dr. Viorica Simon and dr. Oana Ponta Babes-Bolyai University, Faculty of Physics & Institute of Interdisciplinary Research in Bio-Nano-Sciences, Cluj-Napoca, Romania. Assoc. prof. Cristian Ratiu and dr. Ioan Oswald University of Oradea, Faculty of Medicine and Pharmaceutics, Oradea, Romania. Romania-Turkey Bilateral Cooperation project 385/2010.
  • 21. Jerry and Jimmy Linda Thank you

Editor's Notes

  • #2: The research of upgraded or new bioceramics is related to the crucial topic of the enhancement of life conditions.
  • #4: The two ceramic materials in clinical use today as bearing surfaces are aluminium oxide and zirconium oxide.
  • #5: So everybody is searching for the ideal bioceramic that combines the properties of both. Because of the extensively reported long term success in the orthopedic field (more than 20 years), it has been used in dentistry .
  • #6: In this context, we propose an evaluation of the structural properties and biocompatibility of new zirconia toughened alumina ceramics. The composition.. Materials were prepared in Biomaterials Research Center ITU by using spark plasma sintering.
  • #7: FTIR and XRD SEM and EDAX for microstructure and morphology. Grain size and densification degree as a result of TiO2 adition to alumina zirconia matrix. The rat model has been accepted as a model for the effects of systemic disease on osseointegration. -SEM Histo
  • #8: XRD spectra shows reflection lines occurring from crystallographic planes related to alpha alumina and tetragonal zirconia. The addition of TiO2 slightly modifies the relative intensities of the peaks.
  • #9: -The FTIR spectrum is dominated by the absorption lines arising from alumina phase. The stretching vibration of Al-O bonds are related to the tetrahedral or octahedral groups. Stretching vibration of Zr- O bonds in tetragonal phase. -TiO2 addition to alumina/zirconia matrix is reflected in relative intensity of the 660/614 as a superposition of the characteristics bands in this range.
  • #10: In order to perform in vivo tests, both materials were used as granular, irregular shaped, filling the defects created in in the femur of Wistar rats. The microstructure of the granules is presented, along with the EDAX spectrum for each sample.
  • #11: As a surgical procedure, a critical size defect was made in the femur, using a dental drill, under constant irrigation of cold saline to avoid thermal necrosis and to remove the debris.
  • #12: Upon filling the defects, a collagen thin film was placed on the top, and then muscle and skin were sutured in layers.
  • #13: In order to monitor the osseointegration process in vivo, radiographic images were recorded at different time intervals after the surgical procedure.
  • #14: The femur was harvested for SEM. The defects were microscopically evaluated with respect to filling of the defect with new bone. We can notice the contour/ the edge line of the implanted area and the details with different magnification. After 3 weeks, distinct gaps between the implanted area and the original bone were observed in a few locations. The defects are covered with a layer of soft tissue. A fibrinous and collagenous matrix extensively interdigitated in a three dimensional structure is observed. The details reveal that our material (grain) seems to be swallowed by the natural bone. Notice the Ca/P ratio in the EDAX spectrum=1.57
  • #15: After 6 weeks, the matrix around the implant area appeared more densely, well covered and extensively integrated into a mixture of mineralized tissue , osteoids and dense matrix. It seems that TiO2 addition to alumina/zirconia matrix is favorable to the oseointegration process, as the aspect of the implanted area is more uniform. Notice the Ca/P ratio = 1.9
  • #16: Up- image was taken from the original bone, unaffected by the surgical procedure. Below- image taken from the surface of the new bone covering the implanted area.
  • #17: SEM images reveals that the materials are well integrated in the original bone
  • #18: The XRD pattern of the harvested femur shows characteristic lines of the Al Zr and hydroxyapatite compared with the pattern of pure biocomposite and those of original bone unaffected by surgery.
  • #19: No signs of inflammatory reaction such as necrosis or reddening suggesting implant rejection were found upon histological examination. The periosteal regions were completely closed with new blood capillaries around the implant site. Osteoblast- like cells are the evidence of new bone formation.