Victor Manuel Villapun Puzas1, Luke N Carter1, Christian Schröder2, Paula E Colavita2, David A Hoey3,4, Mark A Webber5,6, Owen Addison7, Duncan E T Shepherd8, Moataz M Attallah9, Liam M Grover1, Sophie C Cox1. 1. School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT, U.K. 2. School of Chemistry, CRANN and AMBER Research Centres, Trinity College Dublin, College Green, Dublin 2 D02 PN4, Ireland. 3. Trinity Biomedical Sciences Institute, Trinity College, Trinity Centre for Biomedical Engineering, Dublin D02 R590, Ireland. 4. Department of Mechanical Manufacturing and Biomedical Engineering, School of Engineering, Trinity College, Dublin D02 DK07, Ireland. 5. Quadram Institute Bioscience, Norwich Research Park, Colney NR4 7UQ, U.K. 6. Norwich Medical School, University of East Anglia, Norwich Research Park, Colney NR4 7TJ, U.K. 7. Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London SE1 9RT, U.K. 8. School of Engineering, University of Birmingham, Edgbaston B15 2TT, U.K. 9. School of Materials and Metallurgy, University of Birmingham, Edgbaston B15 2TT, U.K.
Abstract
Additive manufacturing (AM) has emerged as a disruptive technique within healthcare because of its ability to provide personalized devices; however, printed metal parts still present surface and microstructural defects, which may compromise mechanical and biological interactions. This has made physical and/or chemical postprocessing techniques essential for metal AM devices, although limited fundamental knowledge is available on how alterations in physicochemical properties influence AM biological outcomes. For this purpose, herein, powder bed fusion Ti-6Al-4V samples were postprocessed with three industrially relevant techniques: polishing, passivation, and vibratory finishing. These surfaces were thoroughly characterized in terms of roughness, chemistry, wettability, surface free energy, and surface ζ-potential. A significant increase in Staphylococcus epidermidis colonization was observed on both polished and passivated samples, which was linked to high surface free energy donor γ- values in the acid-base, γAB component. Early osteoblast attachment and proliferation (24 h) were not influenced by these properties, although increased mineralization was observed for both these samples. In contrast, osteoblast differentiation on stainless steel was driven by a combination of roughness and chemistry. Collectively, this study highlights that surface free energy is a key driver between AM surfaces and cell interactions. In particular, while low acid-base components resulted in a desired reduction in S. epidermidis colonization, this was followed by reduced mineralization. Thus, while surface free energy can be used as a guide to AM device development, optimization of bacterial and mammalian cell interactions should be attained through a combination of different postprocessing techniques.
Additive manufacturing (AM) has emerged as a disruptive technique within healthcare because of its ability to provide personalized devices; however, printed metal parts still present surface and microstructural defects, which may compromise mechanical and biological interactions. This has made physical and/or chemical postprocessing techniques essential for metal AM devices, although limited fundamental knowledge is available on how alterations in physicochemical properties influence AM biological outcomes. For this purpose, herein, powder bed fusion Ti-6Al-4V samples were postprocessed with three industrially relevant techniques: polishing, passivation, and vibratory finishing. These surfaces were thoroughly characterized in terms of roughness, chemistry, wettability, surface free energy, and surface ζ-potential. A significant increase in Staphylococcus epidermidis colonization was observed on both polished and passivated samples, which was linked to high surface free energy donor γ- values in the acid-base, γAB component. Early osteoblast attachment and proliferation (24 h) were not influenced by these properties, although increased mineralization was observed for both these samples. In contrast, osteoblast differentiation on stainless steel was driven by a combination of roughness and chemistry. Collectively, this study highlights that surface free energy is a key driver between AM surfaces and cell interactions. In particular, while low acid-base components resulted in a desired reduction in S. epidermidis colonization, this was followed by reduced mineralization. Thus, while surface free energy can be used as a guide to AM device development, optimization of bacterial and mammalian cell interactions should be attained through a combination of different postprocessing techniques.
Entities:
Keywords:
additive manufacturing; biological interactions; medical devices; physicochemical characterization; powder bed fusion
Although the complication
rate in prosthetic joint replacements
is low, solely in the United States, the annual costs of revision
surgeries were estimated to be $1.62 billion in 2020.[1] As the population grows older, the number of orthopedic
interventions is expected to exceed 5 million worldwide by 2021.[2] As such, there is a critical need to develop
devices with minimal failure rates resulting from limited biocompatibility,
aseptic loosening, and infection.[3,4] To alleviate
and prevent such outcomes, implementation of novel materials and processes
has become crucial for which additive manufacturing (AM) has been
the lead disruptor in orthopedic device manufacture. Their ability
to produce bespoke implants[5] and versatility
to enable design modifications that may improve osseointegration,
reduce stress shielding, incorporate therapeutically loaded materials,
or reduce magnetic resonance imaging artifacts provide further rationale
to adopt these technologies in healthcare.[6−8] Despite the
great benefits brought by AM, a limited understanding of both eukaryotic
and prokaryotic cell–surface interactions poses a risk to their
successful implementation.Even though numerous materials can
be applied in healthcare, the
field of prosthetics has demonstrated a preference for titanium alloys
manufactured through laser powder bed fusion (PBF-LB).[5] In this technology, an energy source selectively melts
powdered particles allowing for structural control and customization
from the micro- (∼150 to 250 μm) to macroscales. Although
this layer-by-layer approach offers a flexible manufacturing process,
the localized melting and highly directional heat flow coupled with
surrounding powder results in heterogeneous microstructures and poor
surface finish for as-printed devices[9,10] which can
result in mechanical failure, cytotoxicity, and implant rejection.[11,12] These defects have historically been addressed through a combination
of process optimization and physicochemical treatments. Parametric
analyses have showed promise on limiting surface defects; nevertheless,
surface postprocessing in the form of polishing, passivation, vibratory
finish, or sand-blasting is still heavily used in the AM field.[5,13] The available literature on AM postprocessing aims to reduce poor
surface finish to enhance mechanical strength and fatigue performance.
In this regard, all aforementioned techniques have shown their ability
to improve the rough as-build surface, Ra > 13 μm to micron and submicron values, limiting crack
initiation
sites.[14] However, relatively few studies
have focused on their influence on subsequent eukaryotic cell and
microbial attachment of AM surfaces. Most of the available work aims
to compare some of these techniques in conventional titanium alloys.[15] This is surprising as, while polishing may solely
remove partially adhered particles, etching, blasting, and vibratory
finish alter the oxide layer of AM parts or may leave contaminants,
endangering the biological outcomes of the device.[5] Given the peculiarities of the AM process and surface finish,
the few available studies focused on AM have been able to demonstrate
the ability of microstructures obtained through postprocessing[16,17] or part orientation[18,19] to control biological outcomes.
However, our limited knowledge of cell–surface interactions
on AM devices indicates that a fundamental study is necessary.[20]The catastrophic effect of bacterial colonization,
biofilm formation,
and aseptic loosening on implantable devices has led to broad interest
in unraveling the mechanisms behind cell adhesion to biomaterials.[21,22] In the case of surface and bacterial interactions, cells are initially
guided to the surface by nonspecific long range, >50 nm, forces
(e.g.,
gravitational, van der Waals, and electrostatic and hydrophobic forces)
after which specific short-range, <5 nm, interactions (chemical,
ionic and dipole, and hydrophobic interactions) weakly bind them to
the substrate.[23−25] The reversible binding is then strengthened by adhesion
proteins and other surface polymeric structures resulting in permanent
adhesion.[21,23] On the other hand, mammalian cell adhesion
relies on the adsorbed layer of protein formed during the initial
contact between the bodily fluids and substrate.[26] Eukaryotic cells will be attracted and bonded by physicochemical
interactions; however, focal adhesion points will be formed through
the adsorbed protein layer. Cell spreading will then be achieved through
cytoskeleton filament contraction and secured by an equilibrium between
tension of microfilaments and compression of microtubules,[26,27] with subsequent migration, proliferation, and differentiation. Thus,
it is clear that both prokaryotic and eukaryotic adhesion processes
are heavily dependent on the physicochemical properties of both the
cells and surface, pushing forward the biomaterial community to unearth
correlations that can then be controlled to elucidate desirable device/tissue
interactions.Available literature can be found linking surface
topology, wettability,
or surface free energy of titanium surfaces to cell attachment with
idiosyncrasies between bacterial and mammalian cell behaviors reported.
Bacterial attachment is generally increased as the average surface
roughness (Ra) increases, although limited
colonization can be achieved in the 0.5–1.5 μm range.[28−30] On the other hand, previous studies have shown that the optimal Ra for mammalian and cell attachment may be around
1–1.5 μm;[31,32] however, limited adhesion may
be observed for higher Ra.(33) In contrast, other analyses seem to indicate
that both organisms have enhanced proliferation in hydrophilic/high
surface free energy[34,35] or positively charged[27,36] substrates. Nevertheless, the linkage between some of these fundamental
properties, such as topology and contact angle (CA),[37] and cellular responses has resulted in contradictory reports.[38−40] For example, as the surface roughness reaches the nanoscale, bacterial
adhesion would depend on both the cell membrane characteristics and
variations in topological features (i.e., height, spacing or diameter
of the main peaks).[41] To partly overcome
these difficulties, mathematical models have arisen, with particular
attention paid to bacterial-solid surface interfaces such as the Derjaguin–Landau–Verwey–Overbeek
(DLVO) and extended-DLVO (XDLVO) theories; however, the complexity
and specificity of such interactions still affect their applicability.[21,36]To support AM adoption, it is critical to understand the effect
of base materials and postprocessing methods on cell interactions
to encourage device longevity. The aim of this study was to establish
relationships between the physicochemical properties of selective
laser-melted Ti-6Al-4V samples on both bacterial and eukaryotic cell
attachment. For this purpose, coupons were manufactured and postprocessed
with high-degree polishing, passivation, and vibratory finish. Topology,
chemistry, wettability, and surface ζ-potential were correlated
with attachment and biofilm formation of Staphylococcus
epidermidis and adhesion, proliferation, and mineralization
of SAOS-2 osteosarcoma cells. These provide a new insight into the
physicochemical interactions between AM materials and biological matter
to drive the development of new custom devices.
Experimental Section
Sample Preparation
Circular coupons
10 mm in diameter and 3 mm in thickness were fabricated perpendicular
to the building plane using a laser powder bed fusion additive manufacture
system (RenAM 500 M, Renishaw PLC, United Kingdom). Ti-6Al-4V Grade
23 feedstock was supplied by Carpenter Additive (Carpenter Technology
Corporation, US) with the powder in the size range of 15–53
μm. The RenAM 500 M operates in a modulated system which substitutes
the scanning speed commonly defined in other systems through the exposure
time and point distance. Thus, a layer thickness of 30 μm, a
laser power of 200 W, a point distance of 55 μm, an exposure
time of 50 μs, a hatch distance of 0.105 mm, a spot size of
70–75 μm, and four contours were selected to control
the AM process. Samples were manually removed from the printing base,
and all supporting structures were detached manually avoiding damage
to the surface of study.As-built samples were sequentially
polished through a series of abrasive disks, MD-piano 120, 1200, 2000,
and 4000 (Struers, UK) with water cooling, followed by mirror polishing
with a hydrogen peroxide activated colloidal silica solution and an
MD-chem pad (Struers, UK). A set of polished samples was passivated
by immersion in a 10% HCl solution for 1 h. A second set was abraded
with a vibratory finish machine containing an abrasive bonded inorganic
ceramic media for the vibrofinishing process mixed with water and
SX-1L following the manufacturer’s guidelines (Sharmic Engineering
Ltd., UK) for 24 h. A rolled 316L stainless-steel sheet was used as
a control sample throughout the study. After each treatment, all samples
were cleaned in an ultrasonic bath with deionized water, acetone and,
finally, ethanol for 10 min each, followed by air drying.
Physicochemical Analysis
Surface Roughness and Chemical Evaluation
Surface finish was analyzed on the unsupported sides of the as-built
samples using a noncontact profilometer (Infinite Focus G5 Optimax,
Bruker Alicona, Austria) from an average of 10 measurements taken
perpendicularly to the build direction using a ×20 lens. During
profile acquisition, a Gaussian filter with cut off frequencies selected
with compliance to ISO 4288-1996[42] was
selected. Metrology was complemented through surface imaging and chemical
evaluation through a scanning electron microscope (JSM-6060, JEOL
Ltd., UK) equipped with an energy-dispersive X-ray spectroscopy system,
EDS (Inca 300, Oxford instruments, UK) unit.
Wettability and Surface Free Energy
The ability of a liquid to wet the selected surfaces was evaluated
through CA measurements using the sessile drop technique (OCA 25 Optical
CA system, DataPhysics, Germany). Two microliters of four different
liquids, namely, deionized water, ethylene glycol, glycerol, and dimethyl
sulfoxide (DMSO), were deposited onto the surfaces and, after 5 s
of contact, images were recorded. The resulting CA was calculated
as the average of three independent measurements for each sample.
Surface free energy was calculated using the Lifshitz–van der
Waals/Acid–Base (LW/AB) theory and surface tension of the specified
liquids obtained from the literature (Table ).[43]
Table 1
Components of the Surface Tension
Used in the Present Study (mJ/m2)a
liquid
γt
γLW
γAB
γ+
γ–
γAB/γLW
deionized water
72.8
21.8
51
25.5
25.5
2.3
ethylene glycol
48
29
19
1.92
47
0.7
DMSO
44
36
8
0.5
32
0.2
glycerol
64
34
30
3.92
57.4
0.9
Columns represent the total, γt, nonpolar or Lifshitz–van der Waals, γLW, polar or acid–base, γAB, electron acceptors,
γ+, donors, γ-, components,
and polarity γAB/γLW.
Columns represent the total, γt, nonpolar or Lifshitz–van der Waals, γLW, polar or acid–base, γAB, electron acceptors,
γ+, donors, γ-, components,
and polarity γAB/γLW.
ζ-Potential
To evaluate the
differences in SZP, suspensions of aliphatic amine latex beads (Life
Technologies) were prepared in phosphate buffer saline. This solution
contained 1.37 mM NaCl, 27 μM KCl, and a total phosphate concentration
of 100 μM at pH = 7.4. SZP determinations were carried out using
the tracer particle method,[44,45] through a SZP cell
(Malvern Instruments, UK). Briefly, the tracer particle mobility in
an alternate current field is probed at varying displacements from
the surface under study (250, 375, 500, and 1000 μm), yielding
determinations of the apparent SZP value of tracer particles at each
displacement. The greater the distance from the surface, the smaller
the effect of electro-osmotic flow, so that at a sufficiently large
distance the mobility is determined only by electrophoretic migration,
yielding the intrinsic SZP of the tracer particles. From the obtained
apparent SZP values, a linear extrapolation to the intercept at zero
displacement can be used to estimate the SZP of the surface using
the equation ζSurface = ζTracer –
intercept. These measurements were obtained through three independent
measurements.
Bacterial Proliferation and Imaging
Colonization of AM surfaces with a clinically relevant implant-infection
bacteria was studied by culturing S. epidermidis, ATCC 12228, biofilms following the protocol of Christensen et al.[46] Briefly, surfaces were degreased with acetone,
sterilized by autoclaving, then immersed in pure ethanol for 5 min,
dried under UV light for another 5 min, and kept sealed for more than
24 h before testing. The lamp emits predominantly 240 nm UV light,
and all samples were situated 100 mm from the source. An overnight
culture of S. epidermidis(47) in sterile Mueller Hinton broth was diluted
to ∼103 CFU/mL, and 1 mL was inoculated onto samples
placed in a 24 well plate. Plates were kept in an orbital incubator
for 24 h at 37 °C, washed gently three times with Dulbecco’s
phosphate buffered saline (DPBS), and fixed in a 2.5% glutaraldehyde
solution for 1 h. Crystal violet was used to estimate the bacterial
biomass formed on the surfaces similarly to the method used by O’Toole.[48] Briefly, each surface was covered with 200 μL
of a 0.5% crystal violet solution for 5 min. Excess staining was removed
by washing each sample in DPBS (Sigma-Aldrich, UK) and fully dried
in an incubator at 37 °C. Then, each sample was immersed in 1
mL of methylated spirit for 2 h, and absorbance was quantified at
590 nm wavelength using a TECAN Spark plate reader (Tecan Trading
AG, Switzerland). All experiments were repeated, and results are the
average of three independent measurements.To complement the
biomass analysis, one sample per condition was visualized using microscopy.
Each sample was washed gently three times with DPBS, fixed with 2.5%
glutaraldehyde in DPBS for 1 h, dehydrated with a series of ethanol
and deionized water dilutions (10 min sequentially each in 20, 30,
40, 50, 60, 70, 90, 95, and 100%), treated with hexamethyldisilazane,
and dried overnight. Before imaging, each sample was mounted on an
aluminum stub, gold-sputtered, and imaged using an acceleration voltage
of 15 kV in a Zeiss EVO M10 microscope (Carl Zeiss GmbH, Germany).
For confocal fluorescence imaging, one sample per condition was washed
gently three times with DPBS and stained with 200 μL of a DAPI
and fluorescein isothiocyanate-conjugated wheat germ agglutinin, WGA
(Vector laboratories, UK) solution and incubated for 30 min. Imaging
was carried out using a ZEISS LSM 710 confocal microscope (Carl Zeiss
GmbH, Germany) at ×10 magnification, and coverage was calculated
using ImageJ (National Institute of Health, version 1.53a).
DLVO and XDLVO Models
Physical interactions
caused by electrostatic, van der Waals, and Lewis acid–base
forces were estimated through the DLVO and XDLVO models, following
the method proposed by Wu et al.[49] All
calculations were performed in MATLAB R2021a version 9.10.0.1669831
(MathWorks Inc., USA).
Cell Culture
Cellular interactions
with the postprocessed samples were analyzed using a bone-forming
human osteosarcoma cell line (SAOS-2, P12). Before seeding, all samples
were degreased and disinfected following the protocol previously described
in Section . Samples
were inoculated with 2 × 104 osteoblastic cells and
incubated for 40 min (37 °C and 5% CO2) to allow initial
cell adhesion. Subsequently, 1 mL of Dulbecco’s modified Eagle’s
medium (10% fetal bovine serum, 12% l-glutamine, and 1% penicillin/streptomycin)
was added, and cells were cultured at 37 °C and 5% CO2. After 3 days of growth, media were exchanged with osteogenic media,
and basal media were modified with 50 μg/mL ascorbic acid, 10
mM β-glycerophosphate, and 100 nM dexamethasone (Sigma-Aldrich),
with further changes in media every two to three days for a total
of 28 days.Prior to confocal imaging, three samples per condition
and contact timeframe (2.5 and 24 h) were washed gently with DPBS,
fixed in a 4% solution of paraformaldehyde for 10 min, and incubated
at 37 °C and 5% CO2 for 10 min in 0.1% Triton (AnaSpec
Inc., US). Samples were then treated with 200 μL of a mixture
of Phalloidin 488 and DAPI in DPBS and further incubated for 20 min.
These were then moved into plastic confocal dishes and submerged in
DPBS, and images were taken using a Leica TSC SP8 (Leica Microsystems
Ltd., UK) with excitation and emission lines selected following the
manufacturer recommendations. Three large and three high-magnification
images per sample, condition, and timepoint were randomly taken at
the center of the sample where the initial cell seeding was performed.Coverage was calculated using ImageJ (National Institute of Health,
version 1.53a) by splitting the channel corresponding to the actin
dye and thresholding with Huang’s filter for the low-magnification
images. Illuminated and total pixels were counted to estimate cell
coverage with results being the average of nine images with standard
deviation reported. To analyze the morphology of high-magnification
images, a custom script was prepared in MATLAB R2021a. The green channel
was first split, and an approximate region containing the cell to
be analyzed was manually selected. The background was masked, brightness
maximized, and filled using the inbuilt Image Processing Toolbox,
and results were obtained from at least 100 cells. Circularity, aspect
ratio, and roundness were defined by eqs –3where A is
the area of the cell, P is the perimeter or the cell,
Majoraxis is the major axis of the best fit ellipse for
the measured cell, and Minoraxis is the minor axis of the
best fit ellipse for the measured cell.Metabolic activity was
assessed after 1, 3, 7, and 14 days of culture
by transferring the samples to a new 24-well plate, pouring 1 mL of
a 10% mixture of fresh media and Alamar Blue (Thermofisher scientific),
following incubation at 37 °C and 5% CO2 for 4 h.
One hundred microliters of the media and Alamar Blue mixture per sample
were recovered, and fluorescence was measured with 560 and 590 nm
excitation and emission wavelengths, respectively. Samples were washed
with DPBS, and fresh media were added.To estimate the initial
osteogenic potential of the treated surfaces,
alkaline phosphatase (ALP) content was measured using a SensoLyte
pNPP Alkaline Phosphatase Assay Kit (AnaSpec Inc., US) after 1, 3,
7, 14, 21, and 28 days of culture. Shortly, samples were washed in
1 mL of 1X buffer, treated with 1 mL of Triton-X solution, and incubated
for 1 h (37 °C, 5% CO2, 95% air). Lysation was carried
out by freezing and thawing all testing coupons from −80 to
37 °C three times and, after each thawing, samples were set in
an ultrasound bath for 20 min, and a pipette tip was used to scratch
each surface. Finally, 25 μL of the recovered lysate was diluted
with 25 μL of 1X buffer, treated with 50 μL of pNPP solution,
and incubated for 15 min (37 °C, 5% CO2, 95% air),
and absorbance was measured at 405 nm using a TECAN Spark plate reader
(Tecan Trading AG, Switzerland). ALP standards were prepared using
the ALP solution provided in the kit. Results were the average of
three independent measurements for each sample.To normalize
ALP content, DNA quantification was performed by taking
10 μL of the ALP lysate in a 96-well plate and adding 90 μL
of 1X TE buffer (Thermo Fisher scientific, USA). Then, 100 μL
of PicoGreen solution (Thermo Fisher scientific, USA) were added,
and plates were incubated for 5 min at room temperature protected
from light. Fluorescence was measured at 480 nm excitation and 520
nm emission wavelength, respectively, using a SPARK plate reader (Tecan
Trading AG, Switzerland). DNA standards were prepared with a preprepared
DNA standard solution (Thermo Fisher scientific, USA), and all results
were the average of three independent measurements for each sample.Calcium deposits were assessed after 7, 14, 21, and 28 days of
culture by fixing the surfaces in 4% paraformaldehyde for 30 min,
rinsing in 10 mM DPBS, and staining with a 2% alizarin red (AR) solution
for 20 min. Excess staining was removed by washing three times in
deionized water, and samples were moved to a new plate and left to
dry overnight. AR stain was recovered by immersion in a 10% cetylpyridinium
chloride (CPC) solution for 1 h at room temperature with samples protected
from light and set in a plate shaker at 40 rpm. Absorbance was measured
with a TECAN Spark plate reader (Tecan Trading AG, Switzerland) using
570 nm. Scanning electron microscopy (SEM) imaging was performed through
the same method previously discussed in Section . All results were calculated as the average
of three independent samples with standard deviation reported.Qualitative assessment of calcium and phosphate deposition was
performed using X-ray fluorescence (XRF). Briefly, samples treated
following SEM fixation and dehydration were carbon-coated and analyzed
in a M4 Tornado micro-XRF at 50 kV, 400 μA, with a spot distance
of 30 μm and 1 ms dwell time, in serpentine stage mode for five
cycles.To analyze the ability of the selected surfaces to adsorb
proteins,
sterilized samples were cultivated in Dulbecco’s modified Eagle’s
medium (10% fetal bovine serum, 12% l-glutamine, and 1% penicillin/streptomycin)
for 24 h. Samples were recovered, washed twice in DPBS, and further
analyzed using a Pierce BCA protein assay kit (Thermofisher scientific)
following the manufacturer’s guidelines. Shortly, each coupon
was placed in a 24-well plate and 1 mL of working solution (50:1 Reagent
A:B) and incubated at 37 °C for 30 min. After cooling to RT,
100 μL per sample were collected, and absorbance was measured
at 562 nm wavelength using a TECAN Spark plate reader (Tecan Trading
AG, Switzerland).Variations in extracellular matrix production
were assessed through
collagen staining with picrosirius red after 7, 14, and 21 days of
culture. Briefly, cultured samples were washed twice in PBS and fixed
in 4% paraformaldehyde for 30 min and stained with a Picro-Sirius
Red Solution (ScyTek Laboratories, Inc., USA) for 1 h at room temperature
and protected from light. Excess dye was removed by washing in 0.5
M acetic acid followed by distilled water and air-drying. Then, samples
were treated with 0.5 M sodium hydroxide to elute the bound dye, and
absorbance was read at 590 nm using a SPARK plate reader (Tecan Trading
AG, Switzerland).
Statistical Analysis
All statistical
analyses were performed with SPSS (IBM Corp. Released 2015. IBM SPSS
Statistics for Windows, Version 23.0). Prior to any test, the similarity
of variances between groups was studied through Levene’s test.
If similarity between variances could not be rejected, an ANOVA-I
test followed by Tukey’s post hoc with an alpha level of 0.05
was used. In contrast, a rejection of similarity between variances
resulted in a Welch’s test and Games-Howell’s post hoc
as suggested by Fiend and Miles.[50]
Results and Discussion
Postprocessing
of the AM titanium samples led to smooth surfaces (Figure a,b), with a mean surface roughness
(Ra) ranging between ∼40 and ∼50
nm. Both polished and passivated samples were characterized by the
limited presence of imperfections, suggesting a highly dense base
material. In contrast to the unblemished substrates, vibratory finishing
led to a visibly scratched surface as a consequence of the interaction
between the hard-ceramic media and AM surface. Despite these apparent
dissimilarities, topographical measurements indicate that no statistical
difference (p > 0.05) can be observed for the
average
and square root roughness (Rq) of the
titanium samples. More substantial variations in composition could
be observed through EDS analysis (Figure c). Passivation of the AM samples may have
resulted in a slight increase, ∼1.5%, in carbon content from
that displayed in the polished surface, but no substantial variation
in oxygen could be noticed. This was not the case for the vibratory
finished samples which exhibited 13.8 ± 0.9% of O alongside small
traces, 0.5%, of silicon possibly resulting from abrasive media cross
contamination.[51] Compared to these alloys,
the 316L stainless-steel is dominated by large grains protruding from
the surface resulting from the rolling process.[36] These structures led to a relatively coarse surface with
an average Ra of 95.5 ± 3.8 nm and
a maximum peak to valley height of the profile of 403.9 ± 17.4
nm.
Figure 1
Physicochemical analysis of metallic surfaces including (a) surface
SEM images, (b) measured arithmetic mean height (Ra), root mean squared height (Rq) and maximum height of profile (Rz),
(c) chemical analysis through energy-dispersive X-ray spectroscopy,
(d) CA for four liquids with different polar and dispersive free energy
components, (e) apparent ζ-potential of aliphatic amine latex
tracer particles versus surface displacement, and (f) surface ζ-potential
for all the processed surfaces, where * indicates p < 0.05 between groups.
Physicochemical analysis of metallic surfaces including (a) surface
SEM images, (b) measured arithmetic mean height (Ra), root mean squared height (Rq) and maximum height of profile (Rz),
(c) chemical analysis through energy-dispersive X-ray spectroscopy,
(d) CA for four liquids with different polar and dispersive free energy
components, (e) apparent ζ-potential of aliphatic amine latex
tracer particles versus surface displacement, and (f) surface ζ-potential
for all the processed surfaces, where * indicates p < 0.05 between groups.CA measurements indicated that all surfaces were
hydrophilic (CA
< 90°), although the titanium alloys revealed a steep increase
in wettability between the polished, 56.42 ± 0.74°, passivated,
69.06 ± 1.04° and vibratory finished, 79.85 ± 1.14°
surfaces when compared to the stainless-steel, 89.9 ± 1.4°
control. A similar trend and range of CA measurements are followed
through the sessile assay conducted with glycerol although, more interestingly,
the two less polar liquids, namely, ethylene glycol and DMSO subdivide
the tested samples into two clearly differentiated groups (polished/passivated
and vibratory finished/stainless-steel). These trends result in a
generalized decrease in total and polar surface free energy (Table ) as the CA increases,
with similar nonpolar components in all samples analyzed. In contrast,
further subdivision of the polar component into electron donor and
acceptor constituents resulted in the former being almost unchanged,
with the latter highly decreasing for the vibratory finish and stainless-steel
control.
Table 2
Components of the Surface Free Energy
of the Selected Materials Calculated Following the LW/AB Theory (mJ/m2)a
γt
γLW
γAB
γ+
γ–
γAB/γLW
polished
40.9
27.8
13.1
1.7
24.8
0.5
passivated
39.3
30.7
8.7
1.7
11.2
0.3
vibratory finish
34.3
28.6
5.7
1.8
4.5
0.2
stainless-steel
32.1
30.1
2.0
1.9
0.5
0.1
Columns represent the total, γt, nonpolar or Lifshitz–van der Waals, γLW, polar or acid–base, γAB, electron acceptors,
γ+, donors, γ-, components,
and polarity γAB/γLW.
Columns represent the total, γt, nonpolar or Lifshitz–van der Waals, γLW, polar or acid–base, γAB, electron acceptors,
γ+, donors, γ-, components,
and polarity γAB/γLW.To fully understand the role of nonspecific forces
on surface–cell
interactions, all previous measurements were complemented by the evaluation
of surface ζ-potential, SZP. All metallic surfaces presented
negative SZP values (Figure e,f), with a slight decrease between polished, passivated,
and vibratory finished Ti-6Al-4V, −100.7 ± 35.8 mV, −88.0
± 17.5 mV, and −78.3 ± 12.9 mV, respectively. Nevertheless,
no statistical difference was observed between these groups (p > 0.05), with only material suggested to be the main
driver
behind variations in SZP. Previous reports of Ti surface potential
are scarce, although SZP values between −60 and −80
mV for Ti-6Al-4V can be found in the literature,[52] suggesting that processing via AM results in a similar
surface potential than conventional techniques. In the case of stainless
steel, the range of SZP values reported is broad (+30 to −100
mV) and dependent on finish, roughness, and cleaning treatments as
well as on ionic strength and pH of the solution used during measurements.[53,54] SZP values for bare stainless steel in Figure f are negative, in agreement with most of
the reported SZP values at pH 7 in the literature.[49,52,55]Figure indicates
that all postprocessing methods applied affected the topology and
chemistry of the samples, resulting in an increase in hydrophobicity
and reduced surface free energy. Available literature in postprocessing
of additive manufactured parts is focused on the physicochemical analysis
of microrough samples[16,17] with limited manuscripts understanding
their effect in the sub-micro- and nano-scales. Nevertheless, reports
on the physicochemical properties of mechanically or electropolished
titanium alloys indicate that the CA, 60–70°, and surface
free energies, ∼40 mJ/m2, are in agreement with
those presented in this study.[56,57] The similarities in
topology between the passivated and polished samples suggest that
variations in wettability were driven by chemical modification. In
this regard, it is recognized that the hydrophilic nature of titanium-based
surfaces is caused by its protective oxide layer.[35,58] Kubies et al.[57] showed a reduction in
the CA on titanium alloys etched with hydrochloric acid as a result
of a hydrated TiO2 layer, contrasting with the increase
noticeable in Figure d. EDS measurements indicated that this postprocessing did not increase
the presence of oxygen-rich groups but resulted in more adhered carbon-rich
species. Thus, it seems likely that the reduction in hydrophilicity
is a consequence of inorganic anions or organic hydrocarbon groups,
which rapidly bind to high-energy titanium surfaces.[35] A similar chemically driven modification may explain the
further increase in the CA experienced by the vibratory finished samples;
however, it is necessary to mention that the valleys formed on the
surface could have enhanced this effect. The valleys formed by the
ceramic abrasive may have entrapped air between the solid liquid interface
following the Cassie–Baxter theory, instead of a complete wetting
mode as proposed by Wenzel’s model.[59,60] Nevertheless, the contribution of this effect may be limited, as
suggested by the similarities in surface roughness revealed in Figure b. In contrast, both
chemical and topological effects should impact the control stainless-steel,
in line with the analysis of Bakterij et al.[36] and Estrada-Martínez et al.[61]
Bacterial Response to Surface Properties
The ability of S. epidermidis to
colonize and produce a biofilm was highly dependent on the selected
postprocess and material (Figure a,b). Total biomass attached to the engineering surfaces
was subdivided in two clear groups with both polished and passivated
samples supporting greater biomass production (absorbances up to 0.008
a.u./mm2), contrasting with lower values obtained for the
vibratory finished and stainless-steel samples (absorbance of 0.003–0.002
a.u./mm2). A similar trend was confirmed by confocal staining,
although statistical differences were dependent on the stain used.
Coverage calculated through nucleic acid staining (directly reflecting
cell numbers) followed similar trends to those obtained through crystal
violet staining. In contrast, glycoprotein staining through WGA (reflecting
matrix production) showcased more subtle differences, with only the
polished sample statistically, p < 0.05, different
from stainless-steel. The data suggest that the main effect of the
postprocessing and material selection has been the reduction or enhancement
of bacterial attachment and growth with minimal to no influence in
early biofilm formation. These differences can be clearly appreciated
in both SEM and confocal images (Figure c,d). For both polished and passivated samples,
numerous small aggregations of bacterial cells can be seen in the
confocal images. A lower density of larger aggregates is noticeable
for both vibratory finished and stainless-steel coupons with large
voids between these structures. SEM micrographs are prepared through
a more complex and destructive process which may explain the differences
in coverage between techniques; nevertheless, the variations in number
of cells seen is consistent with biomass measurements.
Figure 2
S. epidermidis response to postprocessed
surfaces after 24 h of inoculation including (a) biomass quantification
through crystal violet staining and (b) DAPI and fluorescein conjugated
wheat germ agglutinin coverage analysis alongside (c) SEM micrographs
and (d) confocal images, where * indicates p <
0.05 between groups.
S. epidermidis response to postprocessed
surfaces after 24 h of inoculation including (a) biomass quantification
through crystal violet staining and (b) DAPI and fluorescein conjugated
wheat germ agglutinin coverage analysis alongside (c) SEM micrographs
and (d) confocal images, where * indicates p <
0.05 between groups.The ability of bacteria to colonize and proliferate
on surfaces
is highly dependent on the physicochemical properties of the tested
material and the nature of the microorganism tested. In the case of
surface roughness, topology and dimensions of the surface features
are of special relevance in the micro and nano scale where the bacterial
size is of similar magnitude to the aforementioned parameters.[36,39] Research on the relationship between surface features and bacterial
size has generally shown that ultrasmooth and submicron finishes tend
to reduce bacterial attachment, while microtopologies tend to promote
it.[3,22,23] Two examples
emphasizing the importance of the surface roughness scale can be found
in the work of Taylor et al.[62] and Jhong
et al.[28] who have showcased the higher
affinity for bacterial attachment when an initial ultrasmooth surface,
10 nm, becomes coarser, 1240 nm, and similar in size to that of the
bacteria analyzed. Nevertheless, controversy still exists with reviews
of the available literature reporting conflicting results.[3] In the present study, both polished and passivated
samples showcase an ultrasmooth surface. These display an Ra one scale of magnitude smaller than the average
diameter of S. epidermidis cells (0.5–1
μm) with no visible imperfections that could act as reservoirs
for bacterial attachment. On the other hand, the vibratory finish
and stainless-steel samples showcase imperfections in the form of
peaks and valleys that can act as promoters for bacterial attachment.
However, the present study indicates the opposite which, coupled with
the similarities in surface finish between samples, suggest a major
role of other physicochemical properties on bacterial proliferation.
It must be mentioned that numerous mechanisms influence bacterial
attachment in the nanoscale, namely, chemical gradients, physicochemical
forces and cell membrane deformation, and configuration.[41]S. epidermidis is a Gram-positive bacteria surrounded by a protective peptidoglycan
layer,[63] meaning that it has a limited
ability to deform to comply with rough surfaces. In the case of both
vibratory finished and stainless-steel surfaces, the depth and spatial
configuration of the valleys limit the available contact area which,
coupled with the stiff outer membrane, may have influenced the attachment
of S. epidermidis.[39,64]Alongside surface topography, the roles of wettability and
surface
free energy in biomaterial and cell interactions have to be recognized.
Great effort has been made by the biomaterials community to understand
the role of hydrophilic (CA < 90°), hydrophobic (CA > 90°)
and superhydrophobic (CA > 150°) materials in cell attachment.[65] It has been shown that, generally, increasing
CAs tend to reduce bacterial adhesion.[28,66,67] Thus, it seems reasonable to infer that increased
hydrophobicity of the vibratory finished and stainless-steel samples
may explain the reduced bacterial biomass observed in Figure . Nevertheless, the main mechanism
explaining hydrophobicity in the Cassie–Baxter theory relies
on air entrapment in topological features.[68] The stability of air inside valleys is not completely understood
which, coupled with contradictory reports[69] highlight that wettability may not be a clear indicator of bacterial
attachment. In fact, other researchers have shown that its influence
may be dependent on the wettability of both surface and bacterial
strain, leading to a rule of thumb for which hydrophobic bacteria
adhere predominantly to hydrophobic surfaces and vice-versa.[21,70,71] Available literature regards S. epidermidis as a hydrophilic species;[72] thus, its affinity with water would result in
a surrounding layer of adsorbed water, limiting further contact and
adhesion to hydrophobic materials, as proposed by van Loosdrecht et
al.[25] At the same time, there appears to
be a remarkable correlation between bacterial proliferation (Figure ) and acid–base,
γAB, and electron donor, γ–, components of the surface free energy (Table ). While it has been hypothesized that higher
values of total surface free energy could led to higher probabilities
of attachment,[73] the studies of Boulange-Petermann
et al.[74] and Sardin et al.[75] suggest that this correlation is mostly dependent on the
balance between polar and nonpolar components. Based on the results
obtained in the present study, it seems probable that S. epidermidis adhesion and proliferation are enhanced
on polar and less hydrophobic materials, which has also previously
been suggested by Renner et al.[76] At the
same time, it must be mentioned that specific materials may need further
consideration. UV-irradiated titanium alloys have recently shown their
ability to retain their antimicrobial properties after exposure.[77,78] While this may have influenced the current study, it should be recognized
that irradiated stainless steel has revealed a reduced effect on other
Gram-positive bacteria with low exposure times.[79] In this case, the bacterial growth observed in Figure and its comparison
with the titanium substrates suggest a limited effect of UV irradiation.S. epidermidis cells are normally
considered to have a net negative surface charge (i.e., -10 mV),[49] which coupled with the negative SZP (Figure f) indicate that
a net repulsive force would prevent bacterial adhesion more effectively
on titanium surfaces than stainless steel. However, bacterial colonization
was more substantial on polished and passivated titanium substrates,
which could indicate that attractive van der Waals or acid–base
forces may have been predominant on these surfaces. When the attractive
energy arising from Lifshitz–van der Waals forces and the repulsive
electrostatic interactions of a bacterial cell approaching a surface
are considered through the classical Derjaguin–Landau–Verwey–Overbeek,
DLVO, theory (Figure a),[80,81] it can be seen that only stainless steel
presents an attractive net negative energy. In contrast, the analyzed
titanium surfaces would reveal an initial attraction followed by a
repulsive maximum around 1 and 2 nm with an energy barrier ∼30kT,
which should be overcome to enable adhesion. If the Lewis acid–base
interaction is considered through the extended-DLVO theory (Figure b),[80,81] there is a slight reduction in this energy barrier for the passivated
and vibratory finish, indicating an attractive nature of this force.
However, the high electron donor component of polished Ti-6Al-4V and S. epidermidis has resulted in a positive characteristic
decay length, ΔGhoAB,
and subsequent repulsive energy with a dramatic increase in the energy
barrier, ∼1940 kT. Both models support the dominance of repulsive
forces for the bacteria species considered, which contrast with the
results obtained in this manuscript. Previous studies have tried to
explain bacterial interactions through both mathematical models with
various degrees of success;[82,83] however, it is becoming
clearer that these theories are limited. The cell wall is not a perfectly
rigid body instead able to adapt to the substrate, while the surface
is not a perfectly flat plane, both of which are essential assumptions
in these theories.[49,84] Similarly, most bacterial species
possess fimbria and other appendages, which have been suggested to
create adhesion points by overcoming the surface energy barrier,[49,85] while only nonspecific forces are considered.[80] Thus, it is clear that more complex theories are necessary
to account for surface bacterial interactions.[82] Similarly, the current manuscript focuses on early surface
interactions of S. epidermidis, nevertheless,
and given the importance of biofilm formation on medical devices,
follow up studies centered on different bacterial strains with various
biofilm forming abilities should be performed.
Figure 3
Total interaction free
energy between a S. epidermidis cell
and the analyzed surfaces using the (a) Derjaguin–Landau–Verwey–Overbeek,
DLVO, and (b) extended-DLVO, XDLVO, colloidal theories.
Total interaction free
energy between a S. epidermidis cell
and the analyzed surfaces using the (a) Derjaguin–Landau–Verwey–Overbeek,
DLVO, and (b) extended-DLVO, XDLVO, colloidal theories.
Biological Response of Eukaryotic Cells
The influence of surface treatment on early attachment to mammalian
cells was initially analyzed through confocal staining of SAOS-2 human
osteosarcoma cells (Figure a). After 2.5 h of contact, all Ti-based surfaces revealed
large clusters of cells divided by areas with limited cell coverage
while stainless steel showcased a homogeneous layering. At this stage,
the actin cytoskeleton seems to be highly packed into a generally
ovoidal or irregular contour, although slight differences could be
observed through morphological analysis (Figure b). Average results indicate that cells deposited
on stainless-steel tend to have a significantly (p < 0.05) lower circularity, 0.41 and 0.5, respectively, suggesting
slightly superior spreading on this surface. Nevertheless, the similarities
in both aspect ratio and roundness seem to indicate that these differences
may be minimal with a general elongation in one axis of the cell.
Further contact time led to an increase in surface coverage, reaching
confluent levels after 24 h, similar to those displayed on stainless-steel
(Figure c). In all
cases, the previously bundled structures were more open with long
actin filaments leading to mostly ovoid or triangular shapes. Thus,
the limited differences in early attachment were mostly caused by
material selection rather than postprocessing, which quickly became
negligible after a single day of contact. The decrease in cell coverage
for stainless steel between 2.5 h (63.16 ± 6.89) and 24 h (52.89
± 13.06) is noted and may have resulted from cell migration during
the early stages of surface interaction.[86]
Figure 4
Early
attachment of human osteosarcoma cell line SAOS-2 on postprocessed
surfaces including (a) actin and DAPI confocal staining after 2.5
and 24 h of seeding, (b) shape analysis (circularity, aspect ratio,
and roundness) after 2.5 h of contact, and (c) coverage percentage
of actin for both timeframes considered, where * indicates p < 0.05 between groups.
Early
attachment of human osteosarcoma cell line SAOS-2 on postprocessed
surfaces including (a) actin and DAPI confocal staining after 2.5
and 24 h of seeding, (b) shape analysis (circularity, aspect ratio,
and roundness) after 2.5 h of contact, and (c) coverage percentage
of actin for both timeframes considered, where * indicates p < 0.05 between groups.To further analyze the biological response of SAOS-2
cells to postprocessing
and substrate material, protein adhesion, metabolic activity, DNA
content, collagen production, and mineralization were analyzed (Figure ). An affinity for
protein adsorption could be observed for the passivated, 3.24 ±
0.44 ng/mL mm2, and vibratory finished, 3.63 ± 0.46,
samples (Figure a),
contrasting with the similarities in metabolic activity of seeded
osteosarcoma human cell line SAOS-2 (Figure b). All groups showed a general increase
in activity after 3 and 7 days of cell seeding, followed by a decrease
in metabolism after 14 days. Limited statistical differences could
be observed, mostly focused on the lower normalized fluorescence of
stainless steel, p < 0.05, which could indicate
lower coverage of the sample. The amount of recovered DNA (Figure c) steadily increased
in all groups over the first week of cultivation, suggesting that
the cell number may have increased equally between groups in accordance
with the metabolic activity and early cell seeding (Figure ). In contrast, DNA content
generally decreased to levels similar to those observed at day 3 after
2 weeks of seeding, which are maintained until the end of the study.
Statistical analysis revealed that during the early stages of proliferation,
day 3, both passivated and stainless steel displayed significantly
higher DNA content, p < 0.05. However, further
cultivation suggested that vibratory finishing encouraged cell proliferation,
with stainless steel showing the lowest DNA content from all surfaces
considered.
Figure 5
Biological evaluation of the selected surfaces analyzed through
(a) total protein adsorption after 24 h of cultivation in 10% FBS
DMEM media and viability and mineralization of human osteosarcoma
cell line SAOS-2 including (b) metabolic activity assessed by Alamar
Blue (c) DNA content, (d) collagen production, (e) internal ALP content
normalized with DNA, (f) calcium deposits measured by Alizarin red
staining, and (g) XRF elemental maps for calcium and phosphate (scale
bar = 10 mm), where* indicates p < 0.05 between
groups and ns p > 0.05.
Biological evaluation of the selected surfaces analyzed through
(a) total protein adsorption after 24 h of cultivation in 10% FBS
DMEM media and viability and mineralization of human osteosarcoma
cell line SAOS-2 including (b) metabolic activity assessed by Alamar
Blue (c) DNA content, (d) collagen production, (e) internal ALP content
normalized with DNA, (f) calcium deposits measured by Alizarin red
staining, and (g) XRF elemental maps for calcium and phosphate (scale
bar = 10 mm), where* indicates p < 0.05 between
groups and ns p > 0.05.Collagen production steadily increased in all groups
considered
(Figure d), albeit
vibratory finishing and stainless steel revealed significantly higher
and lower, respectively, content throughout days 7, 14, and 21. Normalized
ALP (Figure e) was
minimal at day one, slightly raising during day three and seven. Interestingly,
enzyme content was highest on both polished and passivated AM surfaces,
followed by stainless steel and vibratory finish, suggesting that
postprocessing and material selection may have influenced early cell
differentiation. Nevertheless, ALP content became more homogeneous
between groups after the maximum reached at day 14 and after continuously
decreasing over the next two weeks, with polishing and vibratory finishing
being the only treatments showing statistically higher and lower enzyme
expression at days 14 and 21, respectively.Contrasting with
the limited differences in metabolic activity
and late ALP production, the amount of calcium deposits resulting
from cell differentiation is highly dependent on the material and
postprocessing selected (Figure f). After the first week of differentiation, all AM
postprocessed materials showcased a significantly (p < 0.05) higher presence of AR than stainless steel, although
calcium deposits rapidly increased over the next week, followed by
a more subtle raise throughout all groups at days 21 and 28. During
these latter points, it is clear that polishing followed by passivation
enhanced the amount of calcium deposits when compared to vibratory
finishing. On the other hand, stainless steel displayed a significantly
higher AR content at day 14, stagnated 1 week after, and finally rapidly
increased on the last timepoint considered. Qualitative XRF imaging
(Figure g) revealed
limited calcium and phosphate deposited over the first week, after
which high concentrations of both elements could be found at the center
of the samples. Nevertheless, further cultivation led to these centralized
deposits becoming more homogeneously distributed over the surface
for both elements.When normalized ALP and AR are compared,
it is clear that the rapid
increase in enzyme between days 7 and 14 was tied with the quick mineralization
at day 14. However, more interesting are the similar trends observed
when postprocessing conditions are considered, with the polished and
stainless steel exhibiting a higher AR quantification compared with
the passivation and stainless-steel samples. ALP is commonly seen
as a marker for early mineralization, indicating that rises in enzyme
content should be followed by mineral deposition. Generally, this
seems to be the case with shifts in ALP leading to similar variations
in calcium deposits (Figure e), suggesting that cells expressing higher levels of ALP
during the first mineralization stages may have mineralized earlier.
Nevertheless, ALP is focused on phosphate formation with tissue-nonspecific
alkaline phosphatase providing inorganic phosphates through hydrolyzation
of pyrophosphate, promoting mineralization.[87] Thus, differences between ALP and AR during the later stages may
be caused by upregulation of other genes involved in mineralization
(e.g., osteopontin).[87,88]Comparable degrees of cell
confluency can be seen in most of the
selected surfaces at day 3 (Figure ), which also indicated the presence of extracellular
matrix in the vibratory finished sample (red arrow in the detailed
image). This similar coverage can still be observed after 7 days,
although cells seem to start agglomerating under all conditions considered.
At day 14, an explosive proliferation of cells and the apparition
of large patches that Vieira et al.[89] had
previously confirmed as mineral deposits occur in SAOS-2 cells treated
with osteogenic media, which are in agreement with DNA, ALP, and AR.
Interestingly, further cultivation led to a slight remodeling of these
mineral and cell patches, spreading into smaller agglomerations over
the surface in accordance with the XRF mapping. Detailed images of
these cells indicate that the visible membranes start developing mineral
deposits at day 14; however, these become more prominent at days 21
and 28, with some appearing highly mineralized (Figure ). This seems to be in agreement with the
decrease in ALP after day 14 and rise in AR, which have been previously
mentioned as the indicator of calcium nodule formation.[90,91] It should be noticed that a significant reduction in collagen content
is observed (Figure d) for all samples displaying prevalent mineralization over time.
Previous studies on human osteosarcoma SAOS-2 have shown that these
osteosarcoma cells produce a rich extracellular matrix (ECM) composed
of collagen, fibronectin, laminin, and proteoglycans with functionality
beyond cell growth (e.g., tumorigenesis and metastasis).[92,93] Although in this study only collagen was measured, this seems to
indicate that polishing, passivation, and stainless steel have impaired
ECM production while enhancing mineralization. Given that these postprocesses
and materials have not significantly affected cell attachment and
proliferation, it may be possible to assume that the limited collagen
available is enough to support cell growth. Nevertheless, the significantly
higher collagen produced by the vibratory finished sample followed
by impaired mineral development and reduced ALP expression seems to
point out that surface influence in cell behavior is more complex
and highly focused on ECM production and differentiation. Thus, further
genomic analysis and gene expression tests should be carried out to
unravel all pathways driven by AM postprocessing.
Figure 6
SEM imaging of SAOS-cells
deposited on polished, passivated, and
vibratory finished additively manufactured titanium surfaces and 316L
stainless steel after 3–28 days of cultivation and differentiation.
SEM imaging of SAOS-cells
deposited on polished, passivated, and
vibratory finished additively manufactured titanium surfaces and 316L
stainless steel after 3–28 days of cultivation and differentiation.Titanium and its alloys are predominantly used
in medical applications
as a result of their biocompatibility as well as mechanical and chemical
stability.[94] Nevertheless, some clinical
applications have showed that integration may not be sufficiently
fast, leading to significant research on surface treatments to enhance
their natural osseointegration.[57] Similarly,
to bacterial behavior, cell–surface interactions are dependent
on the physicochemical properties of the base material and, although
correlations can be found in the literature, differences in materials,
methods, and contradicting reports complicate the extraction of concrete
relationships. For instance, it is generally accepted that optimal
bone-to-implant contact and peri-implant bone formation takes place
for average Ra in the 1–1.5 or
3–4 μm ranges.[95−97] This coupled with in vivo reports
of poor integration for smooth machined titanium,[95,96,98] ∼0.8 μm, and better bone-implant
interlocking offered by macrostructured surfaces,[99] has led to a predominant role of micro and macro roughness
in these devices. However, the works of Lavenus et al.,[100] Li et al.,[32] and
Ting et al.[96] reveal the ability of cells
to interact with submicron and nano-topographic surfaces, Ra < 0.5 μm, albeit the range of optimal
biological response differs between reports. Other studies on smooth
surfaces have also shown their ability to enhance spreading and proliferation
of osteoblasts[51,101] which is in agreement with the
current study. The results obtained in Figure indicate a limited effect on cell viability
and material coverage with surfaces studied revealing a uniform and
rapid proliferation. Interestingly, a similar lack of statistical
significance in cell viability for different postprocessed titanium
samples has already been reported by Bernhardt et al.[51] In the present study, some statistically significant differences
were observed between groups in normalized ALP during the initial
stages of cell differentiation and mineralization. In contrast, these
become more subdued in the long term, although it is necessary to
mention the similarities in ALP between stainless steel and postprocessed
AM surfaces. These differ from the rapid increase in mineral deposits
showcased by the stainless-steel substrate after 28 days of culturing
(Figure e,f), similar
to the observations of Malheiro et al.[102] Given that ALP is an indicator of early mineralization and coupled
with the large calcium deposits observed,[87] it seems that cells deposited on this rougher material, Ra = 95.8 ± 3.8 nm, reached the latter stages
of mineralization later than all AM Ti-6Al-4V samples, Ra = 40–50 nm. Thus, it suggests that mineralization
may be influenced if the surface roughness is similar in size to that
of bone extracellular matrix, ∼400 to 600 nm, as proposed by
the work of by Rafiee et al.[99] That said,
there are a number of differences in chemistry and other physicochemical
properties, which may also play a role.When a biomaterial is
submerged in cultured media, interstitial
fluids, or blood, protein adsorption takes place before eukaryotic
or bacterial cells interact with the substrate.[58,103] As mammalian cells approach the surface, integrins or transmembrane
heterodimeric glycoproteins controlling cell adhesion, shape modifications,
proliferation, and migration bind with the resulting layer of proteins.[104] Thus, it is apparent that protein surface interaction
heavily influences cell contact. From Figure a, it is clear that protein adsorption has
been maximum in both passivated and vibratory finished AM Ti-6Al-4V
samples, although the main reason for these differences may be uncertain.
It has been previously suggested that an increase in surface roughness
and wettability provides a larger surface area of contact for protein
adsorption, indicating that topology plays a more fundamental role
than chemistry.[35,40,105] On the other hand, it has been demonstrated that oxidized Ti-Al-V
alloys can enhance adsorption of key extracellular matrix proteins.[106] At the same time, ζ-potential has been
suggested to affect protein adsorption and configuration,[107] with Cai et al.[108] indicating that lower ζ-potentials may constrain protein adsorption.
Interestingly, the results obtained in this manuscript suggest that
the surface chemistry may be the main driver behind this interaction.
All Ti-6Al-4V samples revealed similar surface finishes, stainless
steel being the sample with higher roughness, thus, offering increased
area for protein interaction (Figure ). Nevertheless, no increased protein adsorption could
be found on this sample. Consequently, it seems plausible that the
passivation and vibratory finishes caused the appearance or larger
oxygen-rich species on the surface, which combined with their hydrophobicity
may explain the greater protein adsorption. Nevertheless, viability
assays did not indicate any significant differences between groups
in metabolic activity, suggesting a limited effect of this layer in
cell proliferation. This may have resulted from conformational changes
in the adsorbed proteins or from strong nonreceptor chemical binding
such as hydrogen binding, electrostatic, polar, or ionic interactions,
being the main initiator of cell–surface attachment.[31,58]Studies concerning the effects of both cell attachment and
differentiation
on some of the aforementioned parameters have been conducted through
wettability and surface free energy measurements. Most of the available
literature[57,58,109] has suggested that hydrophilic and, as such, high surface free metals
result in high biocompatibility and osteogenic responses, with other
in vitro and in vivo studies further supporting these results.[35,110,111] Part of this effect come from
the higher spreadability offered by high wetting surfaces, although
the role of surface free energy cannot be neglected. The work of adhesion
is dependent on both polar and nonpolar components of the surface
free energy; however, it is the γAB or polar component
that mostly affects polar molecules such as water and proteins.[57,112]Figure f indicates
that as the polar component of the Ti-6Al-4V samples rises and the
CA diminishes, the calcium deposits obtained after 14, 21, and 28
days are reduced. Similar trends for postprocessed metallic alloys
can be found in the work of Kubies et al.[57] who subdivided the biological response of different bone-implant
materials based on the measured values for the polar component, >8.88,
2.5–7.55, and <2.46 mN/m. The presented results seem to
support the previous statements; nevertheless, stainless steel displayed
the lowest polar and higher CA measurements, with similar mineralization
levels to those of the polished surface at days 14 and 28 (Figure e). Consequently,
it seems that for the AM Ti-6Al-4V wettability and surface free energy
may be a good indicator of cell behavior to guide implant manufacturing,
while for the stainless steel, this is driven by a combination of
these properties and surface topology.[113] Although the role of roughness, chemistry, wettability, surface
free energy, and surface ζ-potential in biological interactions
has been previously recognized in the literature, herein we have shown
that this is the main driver for postprocessed titanium AM surfaces
which may be used as a tool to develop novel medical devices.
Conclusions
In the present study, additively
manufactured Ti-6Al-4V samples
were produced and postprocessed to analyze the fundamental physicochemical
properties affecting the biological responses of both eukaryotic and
prokaryotic cells. From all variables analyzed (roughness, chemistry,
CA, surface free energy, and ζ-potential), variations in S. epidermidis colonization were mostly driven by
wettability and surface free energy, showcasing a reduced attachment
and proliferation on hydrophobic or low acid–base, γAB, substrates. Similarly, mineralization on Ti-6Al-4V AM substrates
was directly correlated with the total surface free energy and its
acid–base component, albeit optimal bacterial reduction resulted
in limited mineralization. These results indicate that surface free
energy has a dominant effect on the biological outcome of metallic
surfaces; however, it must be recognized that other factors also played
an important role while cellular behavior is constricted by the species
and time frames selected. The central role of surface free energy
could be used to guide the development of future medical devices,
although chemical modifications achieved through single postprocessing
methods may not be enough to optimize medical devices. As a consequence,
it seems plausible that a combination of different physicochemical
processes would be required to ensure limited bacterial proliferation
while maximizing mammalian cell interactions for optimal biological
interactions.
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