Exploring the Potential of Cerium-Zinc Co-Incorporated Titanium Implants for Enhanced Antibacterial Activity,...

The present study aspires to develop multifunctional titanium (Ti) surfaces by the incorporation of both cerium (Ce) and zinc (Zn) ions to ensure the success of orthopedic implants. The dual-element incorporation was facilitated by the alkali-mediated surface modification method, where NaOH treatment was followed by cerium nitrate and zinc nitrate at different volumetric ratios, and heat treatment. Surface characterizations revealed a nanonetwork-like surface morphology with Ce-Zn dual element incorporation, improved surface roughness, hydrophilicity, and the formation of mixed anatase and rutile TiO₂ in functionalized samples, as validated by FE-SEM, AFM, WCA, SEM-EDX, XPS, Raman spectroscopy, and HR-TEM analyses. In addition, the surface-incorporated Ce and Zn facilitated bactericidal properties against Staphylococcus aureus and Escherichia coli, whereas enhanced cytocompatibility in functionalized samples towards MG-63 cells was also evident from cell viability, protein adsorption, adhesion, mitochondrial potential, and mineralization assessments. Moreover, Ce-Zn functionalized Ti implants also demonstrated improved in vivo osseointegration in the rat tibial defect model, as supported by X-ray, micro-CT, and RT-PCR analyses. Altogether, these findings highlight the combinatorial effect of Ce-Zn co-incorporated Ti surface in facilitating antibacterial activity, improved cytocompatibility, and in vivo bone regeneration for orthopedic and dental implant applications.