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International Journal of Bioprinting 3D-printed silicon nitride-PEEK implants

the most common causes of deep infections. It is probable professor, during the early stages of the project, particularly
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that increased antimicrobial properties could be achieved for her invaluable work in designing and printing activities
with higher concentrations of Si N , but these increases for the cages used in this study.
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will need to be balanced with the composite material’s
ability to be 3D-printed and the effects on mechanical Funding
properties as the Si N concentration probes or exceeds the This research was supported, in part, by the National
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percolation threshold. Institute of General Medical Sciences of the
In addition to reduced bacteria activity, Si N coating National Institutes of Health under award number
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onto PEEK surfaces was shown to promote cell responses R41GM146268.
in vitro and improve osseointegration in vivo. 41,42 The
application of Si N coating led to increased adhesion, Conflict of interest
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proliferation, differentiation, and osteoblast gene Dr. Ryan M. Bock is currently employed by SINTX, a
expression using MC3T3-E1 cells in vitro. Moreover, company specializing in the production of silicon nitride
the bioactive Si N coating on PEEK facilitated bone powder. As our research pertains to silicon nitride-
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regeneration and enhanced osseointegration in vivo. Hu et based materials, there is a potential conflict of interest
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al. found that Si N -coated PEEK significantly enhanced that arises due to Dr. Bock’s affiliation with SINTX. Dr.
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the adhesion, proliferation, differentiation, and expression Noreen Hickok and Dr. Steven Kurtz are paid consultants
of osteogenesis-related genes in rat bone marrow stromal for SINTX and also have a conflict of interest. However,
cells (rBMSCs) when compared to PEEK. In our research, we want to emphasize that the research presented in this
Si N -PEEK enhanced cell proliferation and also increased paper has been conducted independently and without
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the normalized osteogenic activity in comparison to any undue influence from the company. Dr. Kurtz also
PEEK; AFSN showed greater proliferation and osteogenic reports that he is a member of Gyroid LLC, a scientific
maturation than either Si N -PEEK or PEEK itself. and technical consulting firm. Unrelated to the present
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Importantly, cumulative mineralization at 28 days showed work, Dr. Kurtz reports institutional funding from 3Spine;
no differences between the Si N -PEEK and AFSN groups, Celanese; Ceramtec; DJO Global; Invibio; Lima Corporate;
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and perhaps more importantly, both were greater than that Mitsubishi Chemical Advanced Materials; Orthoplastics;
measured for the PEEK and Ti6Al4V groups. SINTX Technologies; Stryker; Wright Medical Technology;
and Zimmer Biomet. Dr. Kurtz is a board member of
5. Conclusion Formae, Inc., and receives book royalties from Elsevier,
Various designs of Si N -PEEK spinal cages fabricated Inc. We have taken necessary measures to ensure the
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using fused filament fabrication were assessed for integrity and objectivity of the present study, adhering to
mechanical strength. The findings revealed that Si N - the highest standards of scientific rigor and ethics. We are
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PEEK cages exhibited satisfactory mechanical strength committed to transparency and have disclosed Dr. Bock’s,
across all designs tested in this study. Further, the Si N Dr. Hickok’s, and Dr. Kurtz’s conflicts of interest to ensure
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additive concentration was sufficiently low to maintain that the journal’s readers can evaluate our work within
the plastic properties of the PEEK matrix. Antimicrobial this context.
activity and osseocompatibility were compared on Si N -
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PEEK with virgin PEEK, AFSN, and titanium surfaces. Author contributions
Compared to PEEK, Si N -PEEK surfaces demonstrated Conceptualization: Ryan M. Bock, Steven M. Kurtz,
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reduced bacterial adhesion, and increased osteoblast-like Noreen J. Hickok
cell proliferation and mineralization. These results suggest Formal analysis: Cemile Basgul, Paul DeSantis, Tabitha Derr
that Si N -PEEK holds promise as a viable biomaterial for Investigation: Cemile Basgul, Paul DeSantis, Tabitha Derr
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spinal implant applications. Methodology: Cemile Basgul, Paul DeSantis, Ryan M. Bock,
Steven M. Kurtz, Noreen J. Hickok
Acknowledgments Writing – original draft: Cemile Basgul, Paul DeSantis
The authors acknowledge the contributions of Mr. Sean Writing – review & editing: Cemile Basgul, Paul DeSantis,
Ronayne, formerly of SINTX Technologies, along with Mr. Tabitha Derr, Noreen J. Hickok, Ryan M. Bock, Steven
Douglas Hoxworth and Ms. Nicole Martoccio of SINTX M. Kurtz
Technologies, for their efforts in filament production, Ethics approval and consent to participate
sample preparation, and testing. We would also like to
acknowledge the contributions of Dr. Hannah Spece, IRC Not applicable.
Volume 10 Issue 2 (2024) 442 doi: 10.36922/ijb.2124