Thyroid dysfunction in the first 20 wk of pregnancy may result in fetal loss and dysplasia and some congenital malformations.

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Rapid and effective osseointegration, as a critical factor in affecting the success rate of titanium (Ti) implants in orthopedic applications, is significantly affected by their surface microstructure and chemical composition. In this work, surface microgrooved Ti–6Al–4V alloys with graphene oxide coating (Ti–G–GO) were fabricated by a combination of laser processing and chemical assembly techniques. The osteogenic capability in vitro and new bone formation in vivo of the implants were systematically investigated, and biomechanical pull-out tests of the screws were also performed. First, in vitro studies indicated that the optimal microgroove width of the titanium alloy surface was 45 μm (Ti–G), and the optimum GO concentration was 1 mg/mL. Furthermore, the effects of the surface microstructure and GO coating on the in vitro bioactivity were investigated through culturing bone marrow mesenchymal stem cells (BMSCs) on the surface of titanium alloy plates. The results showed that the BMSCs cultured on the Ti–G–GO group exhibited the best adhesion, proliferation, and differentiation, compared with that on the Ti–G and Ti groups. Micro-computed tomography evaluation, histological analysis, and pull-out testing demonstrated that both Ti–G and Ti–G–GO implants had the higher osseointegration than the untreated Ti implant. Moreover, the osteogenic capability of the Ti–G–GO group appeared to be superior to that of the Ti–G group, which could be attributed to the improvement of surface wettability and apatite formation by the GO coatings. These results suggest that the combination of the microgroove structure and GO coatings exhibits considerable potential for enhancing the surface bioactivation of materials, and the combination modification is expected to be used on engineered titanium alloy surfaces to enhance osseointegration for orthopedic applications.

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