Chimei Foundation Hospital

Tainan, Taiwan

Chimei Foundation Hospital

Tainan, Taiwan
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Chien C.-S.,Chimei Foundation Hospital | Chien C.-S.,Southern Taiwan University of Science and Technology | Hung Y.-C.,Southern Taiwan University of Science and Technology | Hong T.-F.,National Pingtung University of Science and Technology | And 6 more authors.
Applied Physics A: Materials Science and Processing | Year: 2017

Fluorapatite (FA) has better chemical and thermal stability than hydroxyapatite (HA), and has thus attracted significant interest for biomaterial applications in recent years. In this study, porous bioceramic layers were prepared on pure titanium surfaces using a micro-arc oxidation (MAO) technique with an applied voltage of 450 V and an oxidation time of 5 min. The MAO process was performed using three different electrolyte solutions containing calcium fluoride (CaF2), calcium acetate monohydrate (Ca(CH3COO)2·H2O), and sodium phosphate monobasic dihydrate (NaH2PO4·2H2O) mixed in ratios of 0:2:1, 1:1:1, and 2:0:1, respectively. The surface morphology, composition, micro-hardness, porosity, and biological properties of the various MAO coatings were examined and compared. The results showed that as the CaF2/Ca(CH3COO)2·H2O ratio increased, the elemental composition of the MAO coating transformed from HA, A-TiO2 (Anatase) and R-TiO2 (Rutile); to A-TiO2, R-TiO2, and a small amount of HA; and finally A-TiO2, R-TiO2, CaF2, TiP2O5, and FA. The change in elemental composition was accompanied by a higher micro-hardness and a lower porosity. The coatings exhibited a similar in vitro bioactivity performance during immersion in simulated body fluid for 7–28 days. Furthermore, for in initial in vitro biocompatibility tests performed for 24 h using Dulbecco’s Modified Eagle Medium (DMEM) supplement containing 10%Fetal bovine serum, the attachment and spreading of osteoblast-like osteosarcoma MG63 cells were found to increase slightly with an increasing CaF2/Ca(CH3COO)2·H2O ratio. In general, the results presented in this study show that all three MAO coatings possess a certain degree of in vitro bioactivity and biocompatibility. © 2017, Springer-Verlag Berlin Heidelberg.


Chien C.S.,Chimei Foundation Hospital | Chien C.S.,Southern Taiwan University of Science and Technology | Kuo T.Y.,Southern Taiwan University of Science and Technology | Liu C.W.,Southern Taiwan University of Science and Technology | And 4 more authors.
Materials Research Innovations | Year: 2015

In this paper, hydroxyapatite or fluorapatite, was clad on the Ti-6Al-4V substrate by Nd-YAG laser technology, respectively. Scanning electron microscopy, energy dispersive X-ray spectrometry, X-ray diffraction were utilised to compare the differences of microstructures, chemical compositions and the compounds in the coating layer and transition layer of samples. The results show that CaTiO3, TiO2, Al2O3 and Ca2P2O7 are compounds in the coating layer of hydroxyapatite cladding sample, and CaTiO3 is the main phase which appears a dendrite-like structure feature. Besides, the dendrite-like CaTiO3 phase, few compounds of TiO2, Al2O3 and the granular residual FA were found that dispersed between interdendritic areas in the coating layer of fluorapatite cladding sample. Compared with these hydroxyapatite and fluorapatite cladding samples, the distribution feature of elements Ca, P, Ti in the coating layer and transition layer is similar, but relatively higher amount of Ca, P and lower Ca/P ratio were found in the coating layer of fluorapatite cladding sample. © W. S. Maney & Son Ltd 2015.


Chien C.S.,Chimei Foundation Hospital | Hong T.F.,National Pingtung University of Science and Technology | Han T.J.,Southern Taiwan University of Science and Technology | Kuo T.Y.,Southern Taiwan University of Science and Technology | Liao T.Y.,Southern Taiwan University of Science and Technology
Applied Surface Science | Year: 2011

The laser clad coating technique can help to produce metallurgical bonding with high bonding strength between the coating layer and the substrate, which has been gradually applied for hydroxyapatite (HA) coating on metallic substrates. In this study, HA powder is mixed with two different binders, namely water glass (WG) and polyvinyl alcohol (PVA), respectively, and is then clad on Ti-6Al-4V substrates using an Nd:YAG laser system under various processing conditions. The microstructure, chemical composition and hardness of the coating layer and transition layer of the various samples are then systematically explored. The experimental results show that the coating layers of the various samples all contain both cellular dendrites and rod-like piled structures, while the transition layers contain only cellular dendrites. For all samples, the coating layer consists mostly of CaTiO3, Ca2P 2O7, CaO and HA phases, whereas the transition layer contains primarily CaTiO3, Ca2P2O7, Ti3P, Ti and HA phases. In addition, the transition layer of the WG samples also contains SiO2 and Si2Ti phases. In all of the specimens, the transition layer has a higher average hardness than the substrate or coating layer. Moreover, the transition layer in the WG sample is harder than that in the PVA sample. © 2010 Elsevier B.V. All rights reserved.


Chien C.S.,Chimei Foundation Hospital | Liao T.Y.,Southern Taiwan University of Science and Technology | Hong T.F.,National Pingtung University of Science and Technology | Kuo T.Y.,Southern Taiwan University of Science and Technology | And 2 more authors.
Surface and Coatings Technology | Year: 2011

Biomedical implants are generally coated with a thin layer of hydroxyapatite (HA) using a plasma spraying or pulsed laser deposition method. However, the bonding strength between the coating layer and the substrate is relatively low. Moreover, the high temperature of the deposition process causes a structural instability of the HA, and therefore degrades its bioactivity and reduces the service life of the coating layer following implantation. Accordingly, the present study replaces HA with fluorapatite (FA) as the coating material, and examines the effects of two different binders, namely polyvinyl alcohol (PVA) and water glass (WG), on the properties of FA coatings deposited on Ti-6Al-4V substrates using an Nd-YAG laser cladding process. Scanning electron microscopy (SEM) observations reveal that the FA coating has a coral- and dendrite-like structure when mixed with the PVA binder, but a pure dendrite-like structure when mixed with the WG binder. In addition, the Ca/P value of the WG-based FA coating is significantly higher than that of the PVA-based coating. Fluorapatite, Al2O3, CaTiO3 and Ca3(PO4)2 phases are observed in both coating layers. However, the XRD analysis results indicate that the microstructure of the WG sample is dominated by Ca3(PO4)2 phase while that of the PVA sample is dominated by FA. After soaking in SBF, it was observed that the specimen produced with PVA binder or less laser output power possessed a better apatite induction ability. © 2010 Elsevier B.V.


Chien C.-S.,Chimei Foundation Hospital | Ko Y.-S.,Southern Taiwan University of Science and Technology | Kuo T.-Y.,Southern Taiwan University of Science and Technology | Liao T.-Y.,Southern Taiwan University of Science and Technology | And 2 more authors.
Advanced Materials Research | Year: 2011

Hydroxyapatite (HA) is a frequently used bioactive coating material. However, when HA coating is soaked in the simulated body fluid (SBF), it is usually detached from substrate material due to its high dissolution rate in the solution. Recently, it is found that Fluorapatite (FA) has a better anti-dissolution ability than HA. In this study, Fluorapatite was mixed with TiO2 powder (either Anatase phase (A) or Rutile phase (R)) as a coating material precursor, and then be deposited on Ti-6Al-4V substrate to form the coating layer by using Nd-YAG laser cladding process. After soaking in SBF for various days, it is observed that dense ball-like apatite grew faster on the surface of the FA+R coating layer than that on the surface of the FA+A specimens. The corresponding Ca/P ratios of FA+R specimens also dropped faster than FA+A ones. © (2011) Trans Tech Publications.


Chien C.-S.,Chimei Foundation Hospital | Chien C.-S.,Southern Taiwan University of Science and Technology | Liao Z.-Y.,National Cheng Kung University | Hong T.-F.,National Pingtung University of Science and Technology | And 4 more authors.
Journal of Medical and Biological Engineering | Year: 2014

Hydroxyapatite (HA) and fluorapatite (FA) coatings were deposited on Ti-6Al-4V substrates with an Nd-YAG laser and then immersed in simulated body fluid (SBF) for up to 21 days to evaluate their bioactivity. Prior to SBF immersion, the coating layer of the HA specimen had a coral-like structure, and was mainly composed of Ti, CaTiO3, TiO2, Al2O3, and Ca2P2O7, whereas that of the FA specimen had a dense cellular-like structure, and was mainly composed of Ti, CaTiO3, TiO2, Al2O3, and residual FA. The Ca/P ratios of the HA and FA coating layers were 7.61 and 2.12, respectively. After 21 days of immersion in SBF, only a very small amount of precipitates, mainly consisting of CaCO3 with some hydroxycarbonated apatite (HCA) and HA, formed on the HA coating layer, whose Ca/P ratio retained a high value of 6.34. In contrast, a dense accumulation of granulated precipitates, mainly consisting of HCA, formed on the FA coating layer after just 7 days of SBF immersion, with a corresponding Ca/P ratio of 1.63. The SBF immersion test shows that FA coatings produced via an Nd-YAG laser cladding technique on a Ti-6Al-4V substrate have better bioactivity than that of their HA counterparts.


Chien C.-S.,Chimei Foundation Hospital | Ho H.-O.,Taipei Medical University | Liang Y.-C.,Taipei Medical University | Ko P.-H.,Taipei Medical University | And 2 more authors.
Journal of Biomedical Materials Research - Part B Applied Biomaterials | Year: 2012

The goal of this study was to assess the incorporation of exudates of human platelet-rich fibrin (hPRF) that is abundant in platelet cytokines and growth factors into biodegradable fibrin (FB) scaffolds as a regeneration matrix for promoting chondrocyte proliferation and re-differentiation. hPRF was obtained from human blood by centrifugation without an anticoagulant, and the exudate of hPRF was collected and mixed with bovine fibrinogen, and then thrombin was added to form the FB scaffold. Proliferation and differentiation of human primary chondrocytes and a human chondrosarcoma cell line, the SW-1353, embedded in the three-dimensional (3D) scaffolds and on the two-dimensional (2D) surface of the FB scaffolds so produced were evaluated in comparison with an agarose (AG) scaffold serving as the control. Results demonstrated that the amounts of these cytokines and growth factors in hPRF exudates were higher than those in the blood-derived products except for TGF-β1. Chondrocytes and SW1353 cells on the 2D and 3D FB scaffolds with the addition of the exudates of PRF exhibited more-available proliferation and differentiation than cells on 2D and 3D FB and AG scaffolds. It was concluded that FB scaffolds can provide an appropriate environment for chondrocyte proliferation and re-differentiation, and it could be improved by adding exudates of hPRF. These 3D scaffolds have great promise for cartilage tissue engineering. © 2012 WILEY PERIODICALS, INC.


Chien C.S.,Chimei Foundation Hospital | Chien C.S.,Southern Taiwan University of Science and Technology | Liu C.W.,Southern Taiwan University of Science and Technology | Kuo T.Y.,Southern Taiwan University of Science and Technology | And 2 more authors.
Applied Physics A: Materials Science and Processing | Year: 2016

Hydroxyapatite (HA) is one of the most commonly used coating materials for metal implants. However, following high-temperature deposition, HA easily decomposes into an unstable phase or forms an amorphous phase, and hence, the long-term stability of the implant is reduced. Accordingly, the present study investigates the use of fluorapatite (FA) fortified with 20 wt% alumina (α-Al2O3) as an alternative biomedical coating material. The coatings are deposited on Ti6Al4V substrates using a Nd:YAG laser cladding process performed with laser powers and travel speeds of 400 W/200 mm/min, 800 W/400 mm/min and 1200 W/600 mm/min, respectively. The results show that for all of the specimens, a strong metallurgical bond is formed at the interface between the coating layer and the transition layer due to melting and diffusion. The XRD analysis results reveal that the cladding layers in all of the specimens consist mainly of FA, β-TCP, CaF2, Ti and θ-Al2O3 phases. In addition, the cladding layers of the specimens prepared using laser powers of 400 and 800 W also contain CaTiO3 and CaAl2O4, while that of the specimen clad using a power of 1200 W contains TTCP and CaO. Following immersion in simulated body fluid for 14 days, all of the specimens precipitate dense bone-like apatite and exhibit excellent bioactivity. However, among all of the specimens, the specimen that is prepared with a laser power of 800 W shows the best biological activity due to the presence of residual FA, apatite-generating CaTiO3 and a rough cladding layer surface. © 2016, Springer-Verlag Berlin Heidelberg.


Chien C.-S.,Chimei Foundation Hospital | Chien C.-S.,Southern Taiwan University of Science and Technology | Liu C.-W.,Southern Taiwan University of Science and Technology | Kuo T.-Y.,Southern Taiwan University of Science and Technology
Materials | Year: 2016

Hydroxyapatite (HA) is one of the most commonly used materials for the coating of bioceramic titanium (Ti) alloys. However, HA has poor mechanical properties and a low bonding strength. Accordingly, the present study replaces HA with a composite coating material consisting of fluorapatite (FA) and 20 wt % yttria (3 mol %) stabilized zirconia (ZrO2, 3Y-TZP). The FA/ZrO2 coatings are deposited on Ti6Al4V substrates using a Nd:YAG laser cladding system with laser powers and travel speeds of 400 W/200 mm/min, 800 W/400 mm/min, and 1200 W/600 mm/min, respectively. The experimental results show that a significant inter-diffusion of the alloying elements occurs between the coating layer (CL) and the transition layer (TL). Consequently, a strong metallurgical bond is formed between them. During the cladding process, the ZrO2 is completely decomposed, while the FA is partially decomposed. As a result, the CLs of all the specimens consist mainly of FA, Ca4(PO4)2O (TTCP), CaF2, CaZrO3, CaTiO3 and monoclinic phase ZrO2 (m-ZrO2), together with a small amount of θ-Al2O3. As the laser power is increased, CaO, CaCO3 and trace amounts of tetragonal phase ZrO2 (t-ZrO2) also appear. As the laser power increases from 400 to 800 W, the CL hardness also increases as a result of microstructural refinement and densification. However, at the highest laser power of 1200 W, the CL hardness reduces significantly due to the formation of large amounts of relatively soft CaO and CaCO3 phase. © 2016 by the authors.


Chien C.-S.,Chimei Foundation Hospital | Chien C.-S.,Southern Taiwan University of Science and Technology | Ko Y.-S.,Southern Taiwan University of Science and Technology | Kuo T.-Y.,Southern Taiwan University of Science and Technology | And 3 more authors.
Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine | Year: 2014

To study the effect of titania (TiO2) addition on the surface microstructure and bioactivity of fluorapatite coatings, fluorapatite was mixed with TiO2 in 1:0.5 (FA + 0.5TiO2), 1:0.8 (FA + 0.8TiO 2), and 1:1 (FA + TiO2) ratios (wt%) and clad on Ti-6Al-4V substrates using an Nd:YAG laser system. The experimental results show that the penetration depth of the weld decreases with increasing TiO2 content. Moreover, the subgrain structure of the coating layer changes from a fine cellular-like structure to a cellular-dendrite-like structure as the amount of TiO2 increases. Consequently, as the proportion of TiO 2 decreases (increase in fluorapatite content), the Ca/P ratio of the coating layer also decreases. The immersion of specimens into simulated body fluid resulted in the formation of individual apatite. With a lower Ca/P ratio before immersion, the growth of the apatite was faster and then the coating layer provided a better bioactivity. X-ray diffraction analysis results show that prior to simulated body fluid immersion, the coating layer in all three specimens was composed mainly of fluorapatite, CaTiO3, and Al2O3 phases. Following simulated body fluid immersion, a peak corresponding to hydroxycarbonated apatite appeared after 2 days in the FA + 0.5TiO2 and FA + 0.8TiO2 specimens and after 7 days in the FA + TiO 2 specimen. Overall, the results show that although the bioactivity of the coating layer tended to decrease with increasing TiO2 content, in accordance with the above-mentioned ratios, the bioactivity of all three specimens remained generally good.© IMechE 2014.

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