Nucleation and growth of calcium phosphates in the presence of fibrinogen on titanium implants with four potentially bioactive surface preparations. An in vitro study

The aim of this study was to compare the nucleating and crystal growth behaviour of calcium phosphates on four types of potentially bioactive surfaces, using the simulated body fluid (SBF) model with added fibrinogen. Blasted titanium discs were modified by alkali and heat treatment, anodic oxidation, fluoride treatment, or hydroxyapatite coating. The discs were immersed in SBF with fibrinogen for periods of 3 days and 1, 2, 3 and 4 weeks. The topography, morphology, and chemistry of the surfaces were evaluated with optical interferometry, scanning electron microscopy/energy dispersive X-ray analysis (SEM/EDX), and x-ray photoelectron spectroscopy (XPS), respectively. All surface modifications showed early calcium phosphate formation after 3 days, and were almost completely covered by calcium phosphates after 2 weeks. After 4 weeks, the Ca/P ratio was approximately 2.0 for all surface groups except the fluoride modified surface, which had a Ca/P ratio of 1.0-1.5. XPS measurements of the nitrogen concentration, which can be interpreted as an indirect measure of the protein content, reached a peak value after 3 days immersion and decreased thereafter. In conclusion, the results in the present study, when compared to earlier SBF studies without proteins, showed that fibrinogen stimulates calcium phosphates formation. Furthermore, no pronounced differences could be detected between blasted controls and the potentially bioactive specimens.