PDF(Pubmed)
Abstract：
Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone defects. However, the bio-inert nature of Ti material limits its capability for rapid osseointegration and thus influences the implant lifetime in vivo. Despite the macroscale porosity for promoting osseointegration, 3D-printed Ti implant surface morphologies at the nanoscale have gained considerable attention for their potential to improve specific outcomes. To evaluate the influence of nanoscale surface morphologies on osseointegration outcomes of 3D-printed Ti implants and discuss the available strategies, we systematically searched evidence according to the PRISMA on PubMed, Embase, Web of Science, and Cochrane (until June 2022). The inclusion criteria were in vivo (animal) studies reporting the osseointegration outcomes of nanoscale morphologies on the surface of 3D-printed Ti implants. The risk of bias (RoB) was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE\'s) tool. The quality of the studies was evaluated using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. (PROSPERO: CRD42022334222). Out of 119 retrieved articles, 9 studies met the inclusion criteria. The evidence suggests that irregular nano-texture, nanodots and nanotubes with a diameter of 40-105nm on the surface of porous/solid 3D-printed Ti implants result in better osseointegration and vertical bone ingrowth compared to the untreated/polished ones by significantly promoting cell adhesion, matrix mineralization, and osteogenic differentiation through increasing integrin expression. The RoB was low in 41.1% of items, unclear in 53.3%, and high in 5.6%. The quality of the studies achieved a mean score of 17.67. Our study demonstrates that nanostructures with specific controlled properties on the surface of 3D-printed Ti implants improve their osseointegration. However, given the small number of studies, the variability in experimental designs, and lack of reporting across studies, the results should be interpreted with caution.
摘要：
三维（3D）打印是制造个性化钛（Ti）植入物以精确治疗复杂骨缺损的最有前途的方法。然而,Ti材料的生物惰性性质限制了其快速骨整合的能力，因此影响了体内植入物的寿命。尽管具有促进骨整合的宏观孔隙度，纳米尺度的3D打印Ti植入物表面形态因其改善特定结果的潜力而获得了相当大的关注。为了评估纳米表面形态对3D打印钛植入物骨整合结果的影响，并讨论可用的策略，我们根据PubMed上的PRISMA系统地搜索了证据，Embase,WebofScience,和科克伦（至2022年6月）。纳入标准是体内（动物）研究，报告3D打印的Ti植入物表面上纳米级形态的骨整合结果。使用实验动物实验系统审查中心（SYRCLE）工具评估偏倚风险（RoB）。使用动物研究:体内实验报告(ARRIVE)指南评价研究的质量。（PROSPERO：CRD4202234222）。在119篇检索到的文章中，9项研究符合纳入标准。证据表明不规则的纳米纹理，多孔/固体3D打印Ti植入物表面上直径为40-105nm的纳米点和纳米管通过显着促进细胞粘附，与未处理/抛光的植入物相比，可以产生更好的骨整合和垂直骨向内生长，基质矿化，和通过增加整合素表达的成骨分化。RoB在41.1％的项目中处于低位，53.3%不清楚，高达5.6%。研究的质量达到平均得分为17.67。我们的研究表明，在3D打印的Ti植入物表面上具有特定受控特性的纳米结构可以改善其骨整合。然而,鉴于研究数量很少，实验设计的可变性，缺乏跨研究的报告，结果应谨慎解释.
