Effects of co-incorporated ternary elements on biocorrosion stability, antibacterial efficacy, and cytotoxicity of plasma electrolytic oxidized titanium for implant dentistry

In this study, calcium, phosphorus, and copper co-incorporated titanium oxide (TiO₂) layers were prepared on titanium substrates using the plasma electrolytic oxidation process. Thereafter, their features were studied to be used in dental implants. Surface characterization revealed that the addition of calcium and copper ions to the phosphate-based electrolyte led to the development of the ternary elements incorporated TiO₂ layer with greater surface homogeneity, roughness, hydrophobicity, and growth rate. As well, electrochemical impedance spectroscopy proved that the placement of the ternary elements caused more compaction of the TiO₂ layer by reducing inherent defects. Thus, the corrosion behavior of the TiO₂ layer in artificial saliva solution has promoted, which consequently enhanced the corrosion potential by 187 mV and diminished the corrosion current density by one order of magnitude. Antibacterial assessment against Escherichia coli showed that incorporation of copper along with calcium and phosphorus significantly restored the bactericidal activity of the TiO₂ layer. Furthermore, the integration, proliferation, and viability of MG-63 osteoblastic cells have considerably improved in the biological response to the calcium, phosphorus, and copper-containing layer.