Sandblasted/Acid-Etched Titanium Surface Modified with Calcium Phytate Enhances Bone Regeneration in a High-Glucose Microenvironment by Regulating Reactive Oxygen Species and Cell Senescence

Hyperglycemiain patients with diabetes affect osteoblast function,leading to abnormal bone metabolism and implant failure. Adequatebone volume surrounding an implant is essential for osseointegration,which can be improved by implant surface modifications. In this study,titanium surfaces were hydrothermally treated with a mixture of phyticacid (PA) and calcium hydroxide to produce a calcium-decorated surface.The control group comprised pure titanium with a sandblasted/acid-etched(SLA) surface. The elemental composition, hydrophilicity, surfaceroughness, and morphology of the titanium surfaces were examined.Evaluation of in vitro osteogenic differentiationability in a high-glucose environment using alkaline phosphatase (ALP)staining, ALP activity assays, Alizarin Red S staining, quantitativereverse transcription-polymerase chain reaction (qRT-PCR), and immunofluorescencestaining revealed that Ca-PA-modified SLA titanium surfaces can promoteosteogenic differentiation of human bone marrow mesenchymal stem cells(hBMSCs). Evaluation of oxidative stress and aging using reactiveoxygen species (ROS), malondialdehyde (MDA), superoxide dismutase(SOD), and & beta;-galactosidase staining revealed that Ca-PA-modifiedSLA titanium surfaces can reduce ROS production and ameliorate oxidativestress damage in hBMSCs. In vivo assessment of osteogenesisin a diabetic rat model revealed that Ca-PA coating promotes peri-implantosseointegration. Ca-PA-modified SLA titanium surface is a candidatefor improving implant osseointegration in patients with diabetes.