Assessment of the cytocompatibility of different coated titanium surfaces to fibroblasts and osteoblasts

Over the years, many metal and polymer implants have been developed for internal fracture fixation. However, there are always some problems associated with their application, such as implant loosening or infection. This study describes how the morphology and adhesion of both fibroblasts and osteoblasts to two manufactured commercially pure, medical implant-quality anodized titanium surfaces (TS and TSS), and five modified titanium surfaces (TLF, low friction gray anodized titanium; TIG, nitrogen ion implanted TSS; THY, TSS grafted with sodium hyaluronate; TAST, TSS coated with hydrophilic hydrogel; and TT, tiodized TS) were used to obtain an indication of their relative cytocompatibility and to assess which modified surface could potentially be used in vivo. Small variations were observed both qualitatively and quantitatively in the spreading and adhesion of fibroblasts and osteoblasts to the studied surfaces. Overall, fibroblast spreading and adhesion were greatest on the TIG and TLF surfaces. Osteoblast spreading and adhesion were greatest on TS, TIG, and TAST surfaces. No fibroblasts or osteoblasts were found attached to the THY-coated surfaces. Coating medical implant-quality anodized titanium surfaces (TS and TSS) with a TLF, TAST, or more specifically TIG could probably improve soft tissue adhesion and/or osseointegration of bone in vivo. However, it seemed that a hyaluronic acid coating (THY) has potential as a coating in areas where cell adhesion is undesirable, such as orbital fractures, where muscles should avoid adhesion to the implant, and distal radius fractures, where tendons should freely glide over the implant.