An Amorphous Peri-Implant Ligament with Combined Osteointegration and Energy-Dissipation.

Progress toward developing metal implants as permanent hard-tissue substitutes requires both osteointegration to achieve load-bearing support, and energy-dissipation to prevent overload-induced bone resorption. However, in existing implants these two properties can only be achieved separately. Optimized by natural evolution, tooth-periodontal-ligaments with fiber-bundle structures can efficiently orchestrate load-bearing and energy dissipation, which make tooth-bone complexes survive extremely high occlusion loads (>300 N) for prolonged lifetimes. Here, a bioinspired peri-implant ligament with simultaneously enhanced osteointegration and energy-dissipation is presented, which is based on the periodontium-mimetic architecture of a polymer-infiltrated, amorphous, titania nanotube array. The artificial ligament not only provides exceptional osteoinductivity owing to its nanotopography and beneficial ingredients, but also produces periodontium-similar energy dissipation due to the complexity of the force transmission modes and interface sliding. The ligament increases bone-implant contact by more than 18% and simultaneously reduces the effective stress transfer from implant to peri-implant bone by ≈30% as compared to titanium implants, which as far as is known has not previously been achieved. It is anticipated that the concept of an artificial ligament will open new possibilities for developing high-performance implanted materials with increased lifespans.