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BMC Musculoskeletal Disorders

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Open Access 01-12-2019 | Research article

The effect of ultraviolet photofunctionalization of titanium instrumentation in lumbar fusion: a non-randomized controlled trial

Authors: Hiroyuki Tominaga, Kanehiro Matsuyama, Yukihiro Morimoto, Takuya Yamamoto, Setsuro Komiya, Yasuhiro Ishidou

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Abstract

Background

Titanium instrumentations are widely used in orthopedics; the metal bonds with bone in a process called osseointegration. Over time, hydrocarbons adhere to the instrumentation, which weakens the bone-binding ability. Ultraviolet photofunctionalization enhances the bone-binding ability of instrumentation by reducing hydrocarbons. The process has been proven effective in dentistry, but its effects in orthopedics are unverified. We aimed to determine the effect of ultraviolet photofunctionalization of titanium instrumentation used in lumbar fusion.

Methods

This was a non-randomized controlled trial. We prospectively enrolled 13 patients who underwent lumbar fusion surgery. We inserted two pure titanium cages into each intervertebral space; one cage had undergone ultraviolet photofunctionalization, while the other was untreated. The degree of osteosclerosis around both cages was then compared by measuring the densities around the cages on imaging at 2, 3, 6, and 12 months postoperatively compared with 1 month postoperatively. The carbon attachment of the titanium cages was measured using X-ray photoelectron spectroscopy.

Results

There was no significant difference between the degree of osteosclerosis (as assessed by the density) around the treated versus untreated cages at any timepoint. The ratio of carbon attachment of the titanium cages was only 20%, which was markedly less than the ratio of carbon attachment to titanium instrumentation previously reported in the dentistry field.

Conclusions

The effect of ultraviolet photofunctionalization of titanium instrumentation in spine surgery is questionable at present. The biological aging of the titanium may be affected by differences in the manufacturing process of orthopedics instrumentation versus dentistry instrumentation.

Trial registration

UMIN Clinical Trials Registry (Identifier: UMIN000014103; retrospectively registered on June 1, 2014).

Att W, Hori N, Takeuchi M, Ouyang J, Yang Y, Anpo M, Ogawa T. Time-dependent degradation of titanium osteoconductivity: an implication of biological aging of implant materials. Biomaterials. 2009;30:5352–63. https://doi.org/10.1016/j.biomaterials.2009.06.040.CrossRefPubMed

Hori N, Att W, Ueno T, Sato N, Yamada M, Saruwatari L, Suzuki T, Ogawa T. Age-dependent degradation of the protein adsorption capacity of titanium. J Dent Res. 2009;88:663–7. https://doi.org/10.1177/0022034509339567.CrossRefPubMed

Att W, Hori N, Iwasa F, Yamada M, Ueno T, Ogawa T. The effect of UV-photofunctionalization on the time-related bioactivity of titanium and chromium-cobalt alloys. Biomaterials. 2009;30:4268–76. https://doi.org/10.1016/j.biomaterials.2009.04.048.CrossRefPubMed

Aita H, Hori N, Takeuchi M, Suzuki T, Yamada M, Anpo M, Ogawa T. The effect of ultraviolet functionalization of titanium on integration with bone. Biomaterials. 2009;30:1015–25. https://doi.org/10.1016/j.biomaterials.2008.11.004.CrossRefPubMed

Hori N, Ueno T, Suzuki T, Yamada M, Att W, Okada S, Ohno A, Aita H, Kimoto K, Ogawa T. Ultraviolet light treatment for the restoration of age-related degradation of titanium bioactivity. Int J Oral Maxillofac Implants. 2010;25:49–62.PubMed

Suzuki T, Hori N, Att W, Kubo K, Iwasa F, Ueno T, Maeda H, Ogawa T. Ultraviolet treatment overcomes time-related degrading bioactivity of titanium. Tissue Eng Part A. 2009;15:3679–88. https://doi.org/10.1089/ten.TEA.2008.0568.CrossRefPubMed

Flanagan D. Photofunctionalization of dental implants. J Oral Implantol. 2016;42:445–50. https://doi.org/10.1563/aaid-joi-D-15-00145.CrossRefPubMed

Hirota M, Ozawa T, Iwai T, Ogawa T, Tohnai I. Implant stability development of Photofunctionalized implants placed in regular and complex cases: a case-control study. Int J Oral Maxillofac Implants. 2016;31:676–86. https://doi.org/10.11607/jomi.4115.CrossRefPubMed

Funato A, Yamada M, Ogawa T. Success rate, healing time, and implant stability of photofunctionalized dental implants. Int J Oral Maxillofac Implants. 2013;28:1261–71. https://doi.org/10.11607/jomi.3263.CrossRefPubMed

10.

Winograd N, Baitinger WE, Amy JW, Munarin JA. X-ray photoelectron spectroscopic studies of interactions in multicomponent metal and metal oxide thin films. Science. 1974;184:565–7. https://doi.org/10.1126/science.184.4136.565.CrossRefPubMed

11.

Iwaya Y, Machigashira M, Kanbara K, Miyamoto M, Noguchi K, Izumi Y, Ban S. Surface properties and biocompatibility of acid-etched titanium. Dent Mater J. 2008;27:415–21.CrossRef

12.

Berglundh T, Abrahamsson I, Albouy JP, Lindhe J. Bone healing at implants with a fluoride-modified surface: an experimental study in dogs. Clin Oral Implants Res. 2007;18:147–52. https://doi.org/10.1111/j.1600-0501.2006.01309.x.CrossRefPubMed

13.

de Avila ED, Lima BP, Sekiya T, Torii Y, Ogawa T, Shi W, Lux R. Effect of UV-photofunctionalization on oral bacterial attachment and biofilm formation to titanium implant material. Biomaterials. 2015;67:84–92. https://doi.org/10.1016/j.biomaterials.2015.07.030.CrossRefPubMedPubMedCentral

14.

Yamada Y, Yamada M, Ueda T, Sakurai K. Reduction of biofilm formation on titanium surface with ultraviolet-C pre-irradiation. J Biomater Appl. 2014;29:161–71. https://doi.org/10.1177/0885328213518085.CrossRefPubMed

15.

Sadoghi P, Liebensteiner M, Agreiter M, Leithner A, Bohler N, Labek G. Revision surgery after total joint arthroplasty: a complication-based analysis using worldwide arthroplasty registers. J Arthroplast. 2013;28:1329–32. https://doi.org/10.1016/j.arth.2013.01.012.CrossRef

Title: The effect of ultraviolet photofunctionalization of titanium instrumentation in lumbar fusion: a non-randomized controlled trial
Authors: Hiroyuki Tominaga
Kanehiro Matsuyama
Yukihiro Morimoto
Takuya Yamamoto
Setsuro Komiya
Yasuhiro Ishidou
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-019-2672-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The effect of ultraviolet photofunctionalization of titanium instrumentation in lumbar fusion: a non-randomized controlled trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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