Research Article Combined Optimized Effect of a Highly Self-Organized Nanosubstrate and an Electric Field on Osteoblast Bone Cells Activity Diana V. Portan, 1 Despina D. Deligianni , 2 George C. Papanicolaou, 1 Vassilis Kostopoulos , 1 Georgios C. Psarras, 3 and Minos Tyllianakis 4 1 Department of Mechanical and Aeronautics Engineering, Composite Materials Group, University of Patras, Patras 265 00, Greece 2 Department of Mechanical and Aeronautics Engineering, Laboratory of Biomechanics and Biomedical Engineering, University of Patras, Patras 265 00, Greece 3 Department of Materials Science, University of Patras, Patras 265 00, Greece 4 Department of Shoulder and Elbow Surgery, University Hospital of Patras, Rio, Greece Correspondence should be addressed to Despina D. Deligianni; deliyian@upatras.gr Received 17 December 2018; Revised 12 February 2019; Accepted 7 March 2019; Published 21 March 2019 Academic Editor: Jinsong Ren Copyright © 2019 Diana V. Portan et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te efect of an electric feld within specifc intensity limits on the activity of human cells has been previously investigated. However, there are a considerable number of factors that infuence the in vitro development of cell populations. In biocompatibility studies, the nature of the substrate and its topography are decisive in osteoblasts bone cells development. Further on, electrical feld stimulation may activate biochemical paths that contribute to a faster, more efective self-adjustment and proliferation of specifc cell types on various nanosubstrates. Within the present research, an electrical stimulation device has been manufactured and optimum values of parameters that led to enhanced osteoblasts activity, with respect to the alkaline phosphatase and total protein levels, have been found. Homogeneous electric feld distribution induced by a highly organized titanium dioxide nanotubes substrate had an optimum efect on cell response. Specifc substrate topography in combination with appropriate electrical stimulation enhanced osteoblasts bone cells capacity to self-adjust the levels of their specifc biomarkers. Te fndings are of importance in the future design and development of new advanced orthopaedic materials for hard tissue replacement. 1. Introduction In a physiologic condition, all human cells perform in a low frequency electric environment. Although the infuence of electromagnetic felds on biological systems has attracted attention in recent years, few publications describe the efects of interaction and the underlying mechanisms involved. Initially, focus was given to the genotoxic efect of electric and magnetic felds [1]. However, about the same period it was also found that under certain conditions there was no efect of electric and/or magnetic feld on DNA structure and function in cultured human cells. Exposure of cultured cells to 50 Hz electric (0.2-20 kV/m), magnetic (0.002-2 G), or combined electric and magnetic felds for up to 24 h did not result in the production of detectable DNA lesions. Te rate of cell growth was also unafected as well as the intracellular ATP and NAD + levels. Tese results proved that, under an intensity threshold, magnetic and electromagnetic felds are not geno- and cytotoxic in cultured mammalian cells [2]. Moreover, a more recent study has shown that the external electric feld can positively infuence the membrane electrical activity and perhaps the insulin secretion of pancreatic -cell when its amplitude exceeds a threshold value. Furthermore, it has been shown that diferent waveforms have distinct efects on the -cell membrane electrical activity and the characteristic features of the excitation like frequency would change the interaction mechanism [3]. Generally, focus was given to identifying the intensity and feld parameters that result in a positive efect on human cells. Between diferent cell types, bone cells were several times chosen, since they may be Hindawi BioMed Research International Volume 2019, Article ID 7574635, 8 pages https://doi.org/10.1155/2019/7574635