Titanium and hydroxyapatite are widely used as materials for implants. Titanium has good mechanical properties, good corrosion resistance, and a high modulus of elasticity. Hydroxyapatite has good biocompatibility, bioactivity, and significant osteoinductivity. In this study, powder metallurgy was used as a method to combine titanium and hydroxyapatite for use in implants. Shellac was used as a binder between ceramic and metal due to its lower melting point. The surface morphology and chemical properties were evaluated by scanning electron microscopy–energy dispersive X-ray (SEM-EDX), whereby the SEM revealed the appearance of micropores in the Ti-HA composites during the sintering process, and the EDX showed that the final product had high amounts of Ti and Ca and low P. X-ray diffraction (XRD) and Fourier transform infrared (FTIR) analyses were used to achieve the chemical characterization of composites, whereby a weak diffraction peak was observed in the XRD spectrum of Ti-HA composites, and the FTIR analysis confirmed that the composites had carbonate (CO3)2−, phosphate (PO4)3−, and hydroxyl (OH)− groups. Oxygen was sufficient due to the sintering process being conducted in an air environment. The antibacterial activities were characterized using the disc diffusion method with Escherichia coli and Staphylococcus aureus bacteria, whereby the prepared Ti-HA composites had a greater antibacterial effect on E. coli than on S. aureus. Finally, pH changes were observed during the 24 h incubation. The result showed that the Ti-HA composite did not contain chemical compounds that could cause harmful effects for humans and had good antibacterial activity against E. coli.
Objective: This review focuses on the in vitro degradation of eggshell-based hydroxyapatite for analyzing the weight loss of hydroxyapatite when applied in the human body. Cytotoxicity tests were used to observe cell growth and morphological effects. A systematic review and meta-analysis were conducted to observe the weight loss and viable cells of hydroxyapatite when used for implants. Method: Based on the Population, Intervention, Comparison, and Outcome (PICO) strategy, the articles used for literature review were published in English on SCOPUS, PubMed, and Google Scholar from 1 January 2012 to 22 May 2021. Data regarding existing experiments in the literature articles the in vitro degradation and cytotoxicity testing of eggshell-based hydroxyapatite determined the biocompatibility of the materials. A meta-analysis was conducted to calculate the mean difference between the solutions and soaking times used for degradation and the stem cells used for cytotoxicity. Results: From 231 relevant studies, 71 were chosen for full-text analysis, out of which 33 articles met the inclusion criteria for degradation and cytotoxicity analysis. A manual search of the field of study resulted in three additional articles. Thus, 36 articles were included in this systematic review. Significance: The aim of this study was to highlight the importance of the biocompatibility of eggshell-based hydroxyapatite. The weight loss and viability cells of eggshell-based hydroxyapatite showed optimum results for viable cells requirements above 70%, and there is a weight loss of eggshell-based hydroxyapatite for a material implant. The meta-analysis indicated significant differences in the weight loss of eggshell-based hydroxyapatite materials with different soaking times and solutions used. The various kinds of stem cells for incubation of cultured cells in contact with a device, either directly or through diffusions with various kinds of stem cells from animals and humans, yielded viability cells above 70%.
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