Antibacterial metals and alloys for potential biomedical implants

Cu2+ Release from Polylactic Acid Coating on Titanium Reduces Bone Implant-Related Infection

Implant-related infection (IRI) is a major problem in orthopedics. Copper (Cu) is an essential trace element with strong bactericidal activity and, thus, presents potential for reducing IRI. The present study explored a straightforward strategy for releasing Cu²⁺ from titanium (Ti) implants, and we conducted a preliminary study to assess the feasibility of this approach in clinical translation. Polylactic acid (PLA) coatings containing different concentrations of copper ions were prepared on Ti discs. The antibacterial activity and biocompatibility of the copper ion-incorporated Ti implants were evaluated using Staphylococcus aureus (S. aureus), bone marrow mesenchymal stem cells (BMSCs) and animal models. In vitro, the coatings produced burst release of Cu²⁺ in 12 h, and inhibited S. aureus growth in a dose-dependent manner. The coatings prepared from PLA solutions containing 0.5 or 1.0 mg/mL reduced the viability and osteogenic differentiation of BMSCs, but these effects were negated after the coatings were immersed in culture medium for 6 h. Four weeks after implantation, the Cu-free K-wires challenged with S. aureus had persistent infection and inferior fracture healing to the other three groups, while Cu-coated wires had no evidence of infection. Furthermore, the Cu-coated wires placed in rabbits without S. aureus challenge showed superior fracture healing to the other three groups. These results suggest that PLA coatings containing Cu²⁺ may be an effective design for reducing IRI without adversely affecting adjacent bone healing.

Mg-, Zn-, and Fe-Based Alloys With Antibacterial Properties as Orthopedic Implant Materials

Implant-associated infection (IAI) is one of the major challenges in orthopedic surgery. The development of implants with inherent antibacterial properties is an effective strategy to resolve this issue. In recent years, biodegradable alloy materials have received considerable attention because of their superior comprehensive performance in the field of orthopedic implants. Studies on biodegradable alloy orthopedic implants with antibacterial properties have gradually increased. This review summarizes the recent advances in biodegradable magnesium- (Mg-), iron- (Fe-), and zinc- (Zn-) based alloys with antibacterial properties as orthopedic implant materials. The antibacterial mechanisms of these alloy materials are also outlined, thus providing more basis and insights on the design and application of biodegradable alloys with antibacterial properties as orthopedic implants.

Hydrogels for Antitumor and Antibacterial Therapy

As a highly absorbent and hydrophobic material with a three-dimensional network structure, hydrogels are widely used in biomedical fields for their excellent biocompatibility, low immunogenicity, adjustable physicochemical properties, ability to encapsulate a variety of drugs, controllability, and degradability. Hydrogels can be used not only for wound dressings and tissue repair, but also as drug carriers for the treatment of tumors. As multifunctional hydrogels are the focus for many researchers, this review focuses on hydrogels for antitumor therapy, hydrogels for antibacterial therapy, and hydrogels for co-use in tumor therapy and bacterial infection. We highlighted the advantages and representative applications of hydrogels in these fields and also outlined the shortages and future orientations of this useful tool, which might give inspirations for future studies.

Dissection of the antibacterial mechanism of zinc oxide nanoparticles with manipulable nanoscale morphologies

Despite the extensive uses of ZnO nanoparticles as promising antimicrobial agents to tackle the severe microbial infections, the systematic antibacterial studies on ZnO nanoparticles with manipulable nanoscale morphologies at the genetic expression level remain ill-defined. In this study, via a controllable thermal decomposition, ZnO nanoparticles of different morphologies were facilely prepared. Additionally, the surface PEGylation of ZnO was conducted to obtain the nanoparticles of low biotoxicity. While all the prepared ZnO nanoparticles exhibited the significantly chemical activities, the pronounced antibacterial effect of obtained ZnO nanoparticles was also identified, in which the ultra-small ones (~5 nm) showed the best performance. Moreover, the antibacterial activities of ZnO nanoparticles were studied by bacterial nucleic acid leakage, alkaline phosphatase, biofilm and reactive oxygen species (ROS) assays. Furthermore, the transcriptome analysis of ZnO nanoparticles with different morphologies against Escherichia coli (E. coli) revealed the underlying antibacterial mechanism involved the signal transduction, material transport, energy metabolism and other biological processes. Therefore, the cost-effective preparation of ZnO nanoparticles with distinct morphological features provides insights for the development of application specific antibacterial agents.

Detect the Antibacterial and Antitumor of synthesized Silver Nanoparticles Using Microbacterium sp

Metal nanoparticles are widely utilized in biotechnology and biomedicine for various applications, including medication delivery, imaging, and bacterial growth control. Silver nanoparticles (AgNPs) were synthesized by bacteria, fungi, algae, and plants. The Study aimed to synthesize nanomaterial with a cost-effective, environmentally friendly, and the uses of AgNPs as antibacterial (against pathogenic bacteria) and anticancer (on MCF7 cell line). In this Study, bacteria were collected from different soil samples. Isolated, purified by selective media, identification genotypically by 16rRNA sequencing analysis, then compared with NCBI, GenBank as Microbacterium sp. Biosynthesis of silver nanoparticles using Microbacterium for extracellular synthesis by reducing silver ions to silver nanoparticles. The color change to brown and reddish-brown was the first indication of the AgNPs formation; physical characterization using UV-Visible spectroscopy showed a wavelength in 489 nm, while X-ray diffraction (XRD) revealed that the silver nanoparticles were crystalline; transmission electron microscope (TEM) image showed that AgNPs spherical in shape with an average diameter of around 50 nm, in SEM (Scanning electron microscope) AgNPs formed with a diameter of 41-44 nm, spherical and uniform, while Energy-dispersive X-ray show very high silver peaks. Bioactivity of AgNPs by antimicrobial on pathogenic bacteria, which collected from Al- Sadr hospital in Misan (identified by using VITEK). This experiment showed that the inhibition zone was rung from (6- 38mm) on pathogenic bacteria; it was tremendous compared with antibiotics (Gentamycin in this project ranged from(7-28.5mm). Antitumor activity of extracellular biosynthesized AgNPs was determined using the MTT test against breast cancer cells (MCF7 cell line), which showed very high results. AgNPs inhibition breast cancer cell line by about 81% at 100ug/ml, indicating that the rate is outstanding. Finally, different biomedical approaches can benefit from AgNPs as antibacterial agents and anticancer agents with many results. Keywords. Silver Nanoparticles, Biosynthesis, Antibacterial, and Antitumor.

Antibacterial Longevity of a Novel Gallium Liquid Metal/Hydroxyapatite Composite Coating Fabricated by Plasma Spray

Hydroxyapatite (HAp)-coated metallic implants are known for their excellent bioactivity and osteoconductivity. However, infections associated with the microstructure of the HAp coatings may lead to implant failures as well as increased morbidity and mortality. This work addresses the concerns about infections by developing novel composite coatings of HAp and gallium liquid metal (GaLM) using atmospheric plasma spray (APS) as the coating technique. Five weight percent Ga was mixed into a commercially supplied HAp powder using an orbital shaker; then, the HAp-Ga particle feedstock was coated onto Ti₆Al₄V substrates using the APS technique. The X-ray diffraction results indicated that Ga did not form any Ga-related phases in either the HAp-Ga powder or the respective coating. The GaLM filled the pores of the HAp coating presented both on the top surface and within the coating, especially at voids and cracks, to prevent failures of the coating at these locations. The wettability of the surface was changed from hydrophobic for the HAp coating to hydrophilic for the HAp-Ga composite coating. Finally, the HAp-Ga coating presented excellent antibacterial efficacies against both initial attachments and established biofilms generated from methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa after 18 h and 7 days of incubation in comparison to the control HAp coating. This study shows that GaLM improves the antibacterial properties of HAp-based coatings without sacrificing the beneficial properties of conventional HAp coatings. Thus, the HAp-Ga APS coating is a viable candidate for antibacterial coatings.

Light-Activated Hydroxyapatite Photocatalysts: New Environmentally-Friendly Materials to Mitigate Pollutants

This review focuses on a reasoned search for articles to treat contaminated water using hydroxyapatite (HAp)-based compounds. In addition, the fundamentals of heterogeneous photocatalysis were considered, combined with parameters that affect the pollutants’ degradation using hydroxyapatite-based photocatalyst design and strategies of this photocatalyst, and the challenges of and perspectives on the development of these materials. Many critical applications have been analyzed to degrade dyes, drugs, and pesticides using HAp-based photocatalysts. This systematic review highlights the recent state-of-the-art advances that enable new paths and good-quality preparations of HAp-derived photocatalysts for photocatalysis.

Multi-activity cobalt ferrite/MXene nanoenzymes for drug-free phototherapy in bacterial infection treatment

Drug-free antibacterial strategies are of great significance for pathogenic bacterial infection treatment in clinical practice. Phototherapy with antibacterial function plays a vital role in mainstream germicidal research. However, phototherapy could lead to residual heat and excess reactive oxygen species (ROS), which are the main side-effects during antibacterial treatment. Unique CoFe₂O₄/MXene (CM) nanoenzymes, which were fabricated with electrostatic interactions, have been designed to conquer those challenges caused by side-effects of phototherapy in our research. The CM nanoenzymes possess many promising properties including photothermal and photodynamic induced phototherapy and mimic peroxidase (POD), glutathione oxidase (GSHOx), and catalase (CAT). Upon treatment with near-infrared (NIR) light, CM nanoenzymes can create a local high-temperature circumstance as well as raise bacterial membrane permeability. Furthermore, the photodynamic process and multi-enzyme-mimicking activities of CM enzymes boost the interbacterial ROS level. Herein, bacteria can hardly survive in synergistic phototherapy and multi-enzyme-mimicking catalytic therapy in vitro and in vivo. Meanwhile, the CM nanoenzymes exhibit excellent biocompatibility in vitro and in vivo. Overall, this research establishes a strong foundation for effectively employing nanoenzymes, leading to a new way to cure bacterial infections.

The CM nanoenzymes are synthesized with electrostatic interactions. Bacteria can hardly survive synergistic phototherapy and multi-enzyme-mimicking catalytic therapy with CM, which reinforces the foundation of drug-free antibacterial strategies.

Development of Silver-Containing Hydroxyapatite-Coated Antimicrobial Implants for Orthopaedic and Spinal Surgery

The prevention of surgical site infections is directly related to the minimization of surgical invasiveness, and is in line with the concept of minimally invasive spine therapy (MIST). In recent years, the incidence of postoperative infections has been increasing due to the increased use of spinal implant surgery in patients at high risk of infection, including the elderly and easily infected hosts, the limitations of poor bone marrow transfer of antibiotics, and the potential for contamination of surgical gloves and instruments. Thus, the development of antimicrobial implants in orthopedic and spinal surgery is becoming more and more popular, and implants with proven antimicrobial, safety, and osteoconductive properties (i.e., silver, iodine, antibiotics) in vitro, in vivo, and in clinical trials have become available for clinical use. We have developed silver-containing hydroxyapatite (Ag-HA)-coated implants to prevent post-operative infection, and increase bone fusion capacity, and have successfully commercialized antibacterial implants for hip prostheses and spinal interbody cages. This narrative review overviews the present status of available surface coating technologies and materials; describes how the antimicrobial, safety, and biocompatibility (osteoconductivity) of Ag-HA-coated implants have been demonstrated for commercialization; and reviews the clinical use of antimicrobial implants in orthopedic and spinal surgery, including Ag-HA-coated implants that we have developed.

Effects of a ZnCuO-Nanocoated Ti-6Al-4V Surface on Bacterial and Host Cells

This study aims to investigate the effects of a novel ZnCuO nanoparticle coating for dental implants—versus those of conventional titanium surfaces—on bacteria and host cells. A multispecies biofilm composed of Streptococcus sanguinis, Actinomyces naeslundii, Porphyromonas gingivalis, and Fusobacterium nucleatum was grown for 14 days on various titanium discs: machined, sandblasted, sandblasted and acid-etched (SLA), ZnCuO-coated, and hydroxyapatite discs. Bacterial species were quantified with qPCR, and their viability was examined via confocal microscopy. Osteoblast-like and macrophage-like cells grown on the various discs for 48 h were examined for proliferation using an XTT assay, and for activity using ALP and TNF-α assays. The CSLM revealed more dead bacteria in biofilms grown on titanium than on hydroxyapatite, and less on sandblasted than on machined and ZnCuO-coated surfaces, with the latter showing a significant decrease in all four biofilm species. The osteoblast-like cells showed increased proliferation on all of the titanium surfaces, with higher activity on the ZnCuO-coated and sandblasted discs. The macrophage-like cells showed higher proliferation on the hydroxyapatite and sandblasted discs, and lower activity on the SLA and ZnCuO-coated discs. The ZnCuO-coated titanium has anti-biofilm characteristics with desired effects on host cells, thus representing a promising candidate in the complex battle against peri-implantitis.

Surgical Applications of Materials Engineered with Antimicrobial Properties

The infection of surgically placed implants is a problem that is both large in magnitude and that broadly affects nearly all surgical specialties. Implant-associated infections deleteriously affect patient quality-of-life and can lead to greater morbidity, mortality, and cost to the health care system. The impact of this problem has prompted extensive pre-clinical and clinical investigation into decreasing implant infection rates. More recently, antimicrobial approaches that modify or treat the implant directly have been of great interest. These approaches include antibacterial implant coatings (antifouling materials, antibiotics, metal ions, and antimicrobial peptides), antibacterial nanostructured implant surfaces, and antibiotic-releasing implants. This review provides a compendium of these approaches and the clinical applications and outcomes. In general, implant-specific modalities for reducing infections have been effective; however, most applications remain in the preclinical or early clinical stages.

Recent Advances in Copper-Doped Titanium Implants

Titanium (Ti) and its alloys have been extensively used as implant materials in clinical practice due to their high corrosion resistance, light weight and excellent biocompatibility. However, the insufficient intrinsic osteogenic capacity of Ti and its alloys impedes bone repair and regeneration, and implant-related infection or inflammation remains the leading cause of implant failure. Bacterial infections or inflammatory diseases constitute severe threats to human health. The physicochemical properties of the material are critical to the success of clinical procedures, and the doping of Cu into Ti implants has been confirmed to be capable of enhancing the bone repair/regeneration, angiogenesis and antibacterial capability. This review outlines the recent advances in the design and preparation of Cu-doped Ti and Ti alloy implants, with a special focus on various methods, including plasma immersion implantation, magnetron sputtering, galvanic deposition, microarc oxidation and sol-gel synthesis. More importantly, the antibacterial and mechanical properties as well as the corrosion resistance and biocompatibility of Cu-doped Ti implants from different methods are systematically reviewed, and their prospects and limitations are also discussed.

Biomechanical Analysis of Patient-Specific Temporomandibular Joint Implant and Comparison with Natural Intact Jaw Bone Using Finite Element Method

The purpose of this study is to design a patient-specific TMJ implant and study its behaviour under different loading conditions compared with natural intact TMJ. There are several diseases, which affect the proper growth and function of TMJ, and in some cases, TMJ injury results from accidents. To repair the TMJ, temporomandibular joint replacement or TJR surgery is performed. In this work, CT-scan data of the skull and mandible region with broken condylar head were used to study the biomechanical behaviour of the intact mandible and customized TMJ prostheses in order to design a patient-specific total TMJ implant. The customized TMJ implant was virtually studied under simulated loading conditions using finite element method (FEM) in ANSYS Workbench and then compared to the intact jaw-mandible for the combinations of two different biocompatible material models. It is observed that the natural TMJ has a higher deformation value as compared to the patient-specific TMJ implant due to the lower mechanical strength of bone relative to the Ti-6Al-4V and Co-Cr alloy. Hence, we can conclude that the designed custom TMJ implant is safe for the patient from the point of design perspective.

Microstructural, Mechanical and Corrosion Characteristics of Degradable PM Biomaterials Made from Copper-Coated Iron Powders

Copper-containing iron-based materials have recently been recognized as potential biomaterials possessing antimicrobial ability. Since then, iron-copper systems have been prepared by different methods and investigated. This article is focused on PM materials made from composite powders. The powders, each particle of which consisted of an iron core and a copper shell, were prepared by electroplating. Test-pieces with copper contents of 0, 3.2, and 8 wt.% were fabricated by pressing and sintering from iron and composite powders. Some microstructural, mechanical, and corrosion characteristics of test-pieces were examined. Microstructures were composed of pores and iron grains with alloyed peripheral regions and copper-free cores. As the copper content in test-pieces was increased, their density and Young’s modulus decreased, and macrohardness, corrosion potential and corrosion current density increased. Likely causes of density and Young’s modulus reduction were higher porosity, low enough copper content, and compliant inclusions in stiff matrix. The increase in macrohardness was attributed to the precipitation hardening which prevailed over softening induced by pores. The increase in corrosion potential and corrosion current density was most likely due to the presence of more noble phase providing surfaces for a faster cathodic reaction.

Zinc-Doping Induces Evolution of Biocompatible Strontium-Calcium-Phosphate Conversion Coating on Titanium to Improve Antibacterial Property

Implant-associated infections (IAI) remains a common and devastating complication in orthopedic surgery. To reduce the incidence of IAI, implants with intrinsic antibacterial activity have been proposed. The surface functionalization and structure optimization of metallic implants can be achieved by surface modification using the phosphate chemical conversion (PCC) technique. Zinc (Zn) has strong antibacterial behavior toward a broad-spectrum of bacteria. Herein, Zn was incorporated into strontium-calcium-phosphate (SrCaP) coatings on titanium (Ti) via PCC method, and the influence of its doping amount on the phase, microstructure, antibacterial activity, and biocompatibility of the composite coating was researched. The results indicated that traces of Zn doping produced grain refinement of SrCaP coating with no significant effect on its phase and surface properties, while a higher Zn content induced its phase and microstructure transformed into zinc-strontium-phosphate (SrZn₂(PO₄)₂). SrCaP-Zn1 and SrCaP-Zn4 represented trace and high content Zn-doped coatings, respectively, which exhibited a similar bacterial attachment for a short time but showed inhibition of biofilm formation after continuous incubation up to 24 h. The killing rates of SrCaP-Zn1 coating for Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) reached 61.25% and 55.38%, respectively. While that data increased to 83.01% and 71.28% on SrCaP-Zn4 coating due to the more-releasing Zn²⁺. Furthermore, in vitro culture of MC3T3-E1 cells proved that the Zn-doped coatings also possessed excellent biocompatibility. This study provides a new perception for the phase and microstructural optimization of phosphate coatings on implant surfaces, as well as fabricating promising coatings with excellent biocompatibility and antimicrobial properties against IAI.

The role of metal ions in the behavior of bovine serum albumin molecules under physiological environment

Metal ions released from metallic implants can affect the conformation and structural stability of proteins in biological fluids, which eventually affects the biocompatibility of implants. The present study aimed at understanding the interactions between the metal ions (Mn²⁺, Fe²⁺, Fe³⁺, Co²⁺, Cu²⁺, and Zn²⁺) and bovine serum albumin (BSA) molecules in physiological context. The structural information of BSA molecules and the microenvironment of functional groups were investigated using UV, Raman, and circular dichroism spectroscopy. The results revealed that addition of Fe³⁺, Fe²⁺, and Cu²⁺ ions alters the tertiary structure of BSA molecules and exposes the aromatic heterocyclic hydrophobic group of BSA amino acid residues. The addition of Fe³⁺ and Cu²⁺ ions results in increased viscosity and decreased intensity of the water peak in the BSA solution. Furthermore, Fe³⁺ and Cu²⁺ ions evidently promote the α-helix to β-sheet transformation of BSA molecules due to decreased disulfide bond stability. Tryptophan residues of BSA and metal ions containing BSA (Me⁺/BSA) solutions were found to be in a hydrophilic environment. Moreover, the addition of metal ions to BSA results in several of tyrosine residues acting as hydrogen-bond donors. Coomassie brilliant blue staining revealed that the addition of Cu²⁺ ions promotes the aggregation of BSA molecules. The findings of this study will be helpful for evaluating the biocompatibility of metallic implants.

Re-appraising the role of flavonols, flavones and flavonones on osteoblasts and osteoclasts- A review on its molecular mode of action

Bone disorders have become a global concern illustrated with decreased bone mineral density and disruption in microarchitecture of natural bone tissue organization. Natural compounds that promote bone health by augmenting osteoblast functions and suppressing osteoclast functions has gained much attention and offer greater therapeutic value compared to conventional therapies. Amongst several plant-based molecules, flavonoids act as a major combatant in promoting bone health through their multi-faceted biological activities such as antioxidant, anti-inflammatory, and osteogenic properties. They protect bone loss by regulating the signalling cascades involved in osteoblast and osteoclast functions. Flavonoids augment osteoblastogenesis and inhibits osteoclastogenesis through their modulation of various signalling pathways. This review discusses the role of various flavonoids and their molecular mechanisms involved in maintaining bone health by regulating osteoblast and osteoclast functions.

A novel Ti-Au alloy with strong antibacterial properties and excellent biocompatibility for biomedical application

In order to avoid the toxic and side effects on human body of long-term dissolution of metal ions from antibacterial titanium alloys, Au element with non-toxicity and non-side effect was selected as the alloying element to prepare a new Ti-Au alloy with strong antibacterial property. We produced Ti-Au(S) sintered alloy by powder metallurgy and Ti-Au ingot alloy by ingot metallurgy, and investigated the influence of the secondary phase on the relative antimicrobial properties and antibacterial mechanism in this work. The results indicated that the aged Ti-Au(T6) alloy and Ti-Au(S) sintered alloy exhibited strong antibacterial rate against S. aureus due to the formation of Ti₃Au phases. In vitro cell culture (MC3T3 cells) experiments showed that Ti-Au alloys had good cytocompatibility and osteogenic properties. The following viewpoints of antibacterial mechanism are that the Ti₃Au destroyed the ROS homeostasis of bacteria, causing oxidative stress in bacterial cells and preventing from the biofilms formation.

Opposite effects of gold and silver nanoparticle decoration of graphenic surfaces on bacterial attachment

The interaction between bacteria and nanoparticles is currently a central topic in bionanotechnology.

Advancing of 3D-Printed Titanium Implants with Combined Antibacterial Protection Using Ultrasharp Nanostructured Surface and Gallium-Releasing Agents

This paper presents the development of advanced Ti implants with enhanced antibacterial activity. The implants were engineered using additive manufacturing three-dimensional (3D) printing technology followed by surface modification with electrochemical anodization and hydrothermal etching, to create unique hierarchical micro/nanosurface topographies of microspheres covered with sharp nanopillars that can mechanically kill bacteria in contact with the surface. To achieve enhanced antibacterial performance, fabricated Ti implant models were loaded with gallium nitrate as an antibacterial agent. The antibacterial efficacy of the fabricated substrates with the combined action of sharp nanopillars and locally releasing gallium ions (Ga³⁺) was evaluated toward Staphylococcus aureus and Pseudomonas aeruginosa. Results confirm the significant antibacterial performance of Ga³⁺-loaded substrates with a 100% eradication of bacteria. The nanopillars significantly reduced bacterial attachment and prevented biofilm formation while also killing any bacteria remaining on the surface. Furthermore, 3D-printed surfaces with microspheres of diameter 5-30 μm and interspaces of 12-35 μm favored the attachment of osteoblast-like MG-63 cells, as confirmed via the assessment of their attachment, proliferation, and viability. This study provides important progress toward engineering of next-generation 3D-printed implants, that combine surface chemistry and structure to achieve a highly efficacious antibacterial surface with dual cytocompatibility to overcome the limitations of conventional Ti implants.

Zinc-nutrient element based alloys for absorbable wound closure devices fabrication: Current status, challenges, and future prospects

The need for the development of load-bearing, absorbable wound closure devices is driving the research for novel materials that possess both good biodegradability and superior mechanical characteristics. Biodegradable metals (BMs), namely: magnesium (Mg), zinc (Zn) and iron (Fe), which are currently being investigated for absorbable vascular stent and orthopaedic implant applications, are slowly gaining research interest for the fabrication of wound closure devices. The current review presents an overview of the traditional and novel BM-based intracutaneous and transcutaneous wound closure devices, and identifies Zn as a promising substitute for the traditional materials used in the fabrication of absorbable load-bearing sutures, internal staples, and subcuticular staples. In order to further strengthen Zn to be used in highly stressed situations, nutrient elements (NEs), including calcium (Ca), Mg, Fe, and copper (Cu), are identified as promising alloying elements for the strengthening of Zn-based wound closure device material that simultaneously provide potential therapeutic benefit to the wound healing process during implant biodegradation process. The influence of NEs on the fundamental characteristics of biodegradable Zn are reviewed and critically assessed with regard to the mechanical properties and biodegradability requirements of different wound closure devices. The opportunities and challenges in the development of Zn-based wound closure device materials are presented to inspire future research on this rapidly growing field.

Rivet-Inspired Modification of Carbon Nanotubes by In Situ-Reduced Ag Nanoparticles To Enhance the Strength and Ductility of Zn Implants

Zinc shows promise for bone repair applications, while its strength and ductility require to be improved. Carbon nanotubes (CNTs) are exceptional reinforcements due to their superior strength, ultrahigh Young's modulus, and large aspect ratio. However, their strong agglomeration and weak interfacial bonding with the matrix are key bottleneck problems restricting the reinforcing effect. In this study, Ag nanoparticles were in situ reduced on CNTs and then the CNT@Ag powders were used to prepare Zn-CNT@Ag implants by laser powder bed fusion. Results showed that Ag reacted with Zn to form a "knot"-like AgZn₃ phase. It had the same lattice structure (HCP) with Zn, which indicated a good lattice matching with the matrix, thus improving the dispersion of CNTs. More significantly, the knot played a "rivet" role and enhanced the load transfer capacity, which advantaged the CNT strengthening effects by assisting in transferring the load. Moreover, it enhanced the heterogeneous nucleation effects during solidification, which weakened the texture strength of the matrix and thus increased the ductility by improving the sliding capacity. The compressive yield strength, ultimate tensile strength, and elongation of the Zn-CNT@Ag implant were increased by 22, 26, and 17% in comparison to Zn-CNTs. Moreover, the Zn-CNT@Ag implant exhibited favorable antibacterial activity with a bacterial inhibition rate of 87.79%. Additionally, it also exhibited a suitable degradation rate and acceptable biocompatibility.

Copper single-atom catalysts with photothermal performance and enhanced nanozyme activity for bacteria-infected wound therapy

Nanozymes have become a new generation of antibiotics with exciting broad-spectrum antibacterial properties and negligible biological toxicity. However, their inherent low catalytic activity limits their antibacterial properties. Herein, Cu single-atom sites/N doped porous carbon (Cu SASs/NPC) is successfully constructed for photothermal-catalytic antibacterial treatment by a pyrolysis-etching-adsorption-pyrolysis (PEAP) strategy. Cu SASs/NPC have stronger peroxidase-like catalytic activity, glutathione (GSH)-depleting function, and photothermal property compared with non-Cu-doped NPC, indicating that Cu doping significantly improves the catalytic performance of nanozymes. Cu SASs/NPC can effectively induce peroxidase-like activity in the presence of H2O2, thereby generating a large amount of hydroxyl radicals (•OH), which have a certain killing effect on bacteria and make bacteria more susceptible to temperature. The introduction of near-infrared (NIR) light can generate hyperthermia to fight bacteria, and enhance the peroxidase-like catalytic activity, thereby generating additional •OH to destroy bacteria. Interestingly, Cu SASs/NPC can act as GSH peroxidase (GSH-Px)-like nanozymes, which can deplete GSH in bacteria, thereby significantly improving the sterilization effect. PTT-catalytic synergistic antibacterial strategy produces almost 100% antibacterial efficiency against Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA). In vivo experiments show a better PTT-catalytic synergistic therapeutic performance on MRSA-infected mouse wounds. Overall, our work highlights the wide antibacterial and anti-infective bio-applications of Cu single-atom-containing catalysts.

Fitting pieces into the puzzle: The impact of titanium-based dental implant surface modifications on bacterial accumulation and polymicrobial infections

Polymicrobial infection is the main cause of dental implant failure. Although numerous studies have reported the ability of titanium (Ti) surface modifications to inhibit microbial adhesion and biofilm accumulation, the majority of solutions for the utilization of Ti antibacterial surfaces have been testedin in vitro and animal models, with only a few developed surfaces progressing into clinical research. Motivated by this huge gap, we critically reviewed the scientific literature on the existing antibacterial Ti surfaces to help understand these surfaces' impact on the "puzzle" of undesirable dental implant-related infections. This manuscript comprises three main sections: (i) a narrative review on topics related to oral biofilm formation, bacterial-implant surface interactions, and on how implant-surface modifications can influence microbial accumulation; (ii) a critical evidence-based review to summarize pre-clinical and clinical studies in an attempt to "fit pieces into the puzzle" to unveil the best way to reduce microbial loads and control polymicrobial infection around dental implants showed by the current in vivo evidence; and (iii) discussion and recommendations for future research testing emerging antibacterial implant surfaces, connecting basic science and the requirements for future clinical translation. The findings of the present review suggest no consensus regarding the best available Ti surface to reduce bacterial colonization on dental implants. Smart release or on-demand activation surface coatings are a "new piece of the puzzle", which may be the most effective alternative for reducing microbial colonization on Ti surfaces, and future studies should focus on these technologies.

Simultaneous Ultrasound-Assisted Hybrid Polyzwitterion/Antimicrobial Peptide Nanoparticles Synthesis and Deposition on Silicone Urinary Catheters for Prevention of Biofilm-Associated Infections

Nosocomial infections caused by antibiotic-resistant bacteria are constantly growing healthcare threats, as they are the reason for the increased mortality, morbidity, and considerable financial burden due to the poor infection outcomes. Indwelling medical devices, such as urinary catheters, are frequently colonized by bacteria in the form of biofilms that cause dysfunction of the device and severe chronic infections. The current treatment strategies of such device-associated infections are impaired by the resistant pathogens but also by a risk of prompting the appearance of new antibiotic-resistant bacterial mechanisms. Herein, the one-step sonochemical synthesis of hybrid poly(sulfobetaine) methacrylate/Polymyxin B nanoparticles (pSBMA@PM NPs) coating was employed to engineer novel nanoenabled silicone catheters with improved antifouling, antibacterial, and antibiofilm efficiencies. The synergistic mode of action of nanohybridized zwitterionic polymer and antimicrobial peptide led to complete inhibition of the nonspecific protein adsorption and up to 97% reduction in Pseudomonas aeruginosa biofilm formation, in comparison with the pristine silicone. Additionally, the bactericidal activity in the hybrid coating reduced the free-floating and surface-attached bacterial growth by 8 logs, minimizing the probability for further P. aeruginosa spreading and host invasion. This coating was stable for up to 7 days under conditions simulating the real scenario of catheter usage and inhibited by 80% P. aeruginosa biofilms. For the same time of use, the pSBMA@PM NPs coating did not affect the metabolic activity and morphology of mammalian cells, demonstrating their capacity to control antibiotic-resistant biofilm-associated bacterial infections.

NanoZnO-modified titanium implants for enhanced anti-bacterial activity, osteogenesis and corrosion resistance

Titanium (Ti) implants are widely used in dentistry and orthopedics owing to their excellent corrosion resistance, biocompatibility, and mechanical properties, which have gained increasing attention from the viewpoints of fundamental research and practical applications. Also, numerous studies have been carried out to fine-tune the micro/nanostructures of Ti and/or incorporate chemical elements to improve overall implant performance. Zinc oxide nanoparticles (nano-ZnO) are well-known for their good antibacterial properties and low cytotoxicity along with their ability to synergize with a variety of substances, which have received increasingly widespread attention as biomodification materials for implants. In this review, we summarize recent research progress on nano-ZnO modified Ti-implants. Their preparation methods of nano-ZnO modified Ti-implants are introduced, followed by a further presentation of the antibacterial, osteogenic, and anti-corrosion properties of these implants. Finally, challenges and future opportunities for nano-ZnO modified Ti-implants are proposed.

A case report on a IV-degree thermal crush injury of right upper arm：The application of functional prosthesis implantation technology

Severe IV-degree thermal crush injury of limbs involved the subcutaneous fascia, muscle and bone, which may lead to amputation and has a great impact on the patient's quality of life. We can repair wounds with pedicle flaps or even free flaps, However, there are still huge challenges in bone defect of extremities and functional reconstruction. In recent years, with the development of functional prostheses, we have reconstructed limb functions in many patients helping them to complete their daily lives. We report a case where the right upper arm was injured by thermal crush, leading severe burns to the skin, fascia, muscle and bone. We applied a pedicled latissimus dorsi flap and a free anterolateral thigh flap to repair the wound, and realized the function of limb salvage and movement of the right upper arm by implanting 3D printed scapula, upper arm and elbow joint prostheses. This case illustrates that IV-degree burns involving bones have new technologies to repair and achieve mobility now.

Tailoring Additively Manufactured Titanium Implants for Short-Time Pediatric Implantations with Enhanced Bactericidal Activity

Paediatric titanium (Ti) implants are used for the short-term fixation of fractures, after which they are removed. However, bone overgrowth on the implant surface can complicate their removal. The current Ti implants research focuses on improving their osseointegration and antibacterial properties for long-term use while overlooking the requirements of temporary implants. This paper presents the engineering of additively manufactured Ti implants with antibacterial properties and prevention of bone cell overgrowth. 3D-printed implants were fabricated followed by electrochemical anodization to generate vertically aligned titania nanotubes (TNTs) on the surface with specific diameters (∼100 nm) to reduce cell attachment and proliferation. To achieve enhanced antibacterial performance, TNTs were coated with gallium nitrate as antibacterial agent. The physicochemical characteristics of these implants assessed by the attachment, growth and viability of osteoblastic MG-63 cells showed significantly reduced cell attachment and proliferation, confirming the ability of TNTs surface to avoid cell overgrowth. Gallium coated TNTs showed strong antibacterial activity against S. aureus and P. aeruginosa with reduced bacterial attachment and high rates of bacterial death. Thus a new approach for the engineering of temporary Ti implants with enhanced bactericidal properties with reduced bone cell attachment is demonstrated as a new strategy toward a new generation of short-term implants in paediatrics.

Surface Design for Antibacterial Materials: From Fundamentals to Advanced Strategies

Healthcare-acquired infections as well as increasing antimicrobial resistance have become an urgent global challenge, thus smart alternative solutions are needed to tackle bacterial infections. Antibacterial materials in biomedical applications and hospital hygiene have attracted great interest, in particular, the emergence of surface design strategies offer an effective alternative to antibiotics, thereby preventing the possible development of bacterial resistance. In this review, recent progress on advanced surface modifications to prevent bacterial infections are addressed comprehensively, starting with the key factors against bacterial adhesion, followed by varying strategies that can inhibit biofilm formation effectively. Furthermore, "super antibacterial systems" through pre-treatment defense and targeted bactericidal system, are proposed with increasing evidence of clinical potential. Finally, the advantages and future challenges of surface strategies to resist healthcare-associated infections are discussed, with promising prospects of developing novel antimicrobial materials.

Construction of a TiO2/MoSe2/CHI coating on dental implants for combating Streptococcus mutans infection

Infection and inflammation are the main causes resulting in the failure of dental implants. In this work, molybdenum diselenide (MoSe₂) was synthesized hydrothermally on the surface of porous TiO₂ coating prepared by micro-arc oxidation on titanium (Ti) implants to render the coating excellent in situ antibacterial activity under the irradiation of near-infrared (NIR) light. Chitosan (CHI) was adsorbed on the surface of MoSe₂ nanosheets by electrostatic bonding to improve the biocompatibility. The introduction of MoSe₂ significantly improved the photothermal and photodynamic ability of TiO₂ coating and made the implants possess excellent in vitro and in vivo antibacterial property against Streptococcus mutans (S. mutans) under the irradiation of 808 nm NIR light for 15 min because of the synergistic of hyperthermia and reactive oxygen species (ROS). The immobilization of CHI improved the hydrophilicity and biocompatibility of MoSe₂, and the hybrid coating (TiO₂/MoSe₂/CHI) promoted osseointegration even in the presence of infection in vivo under 808 nm light irradiation. The light - assisted antibacterial coating described here has large clinical potential in dental implants applications.

Osteoinduction Evaluation of Fluorinated Hydroxyapatite and Tantalum Composite Coatings on Magnesium Alloys

Magnesium (Mg) alloys have a wide range of biomaterial applications, but their lack of biocompatibility and osteoinduction property impedes osteointegration. In order to enhance the bioactivity of Mg alloy, a composite coating of fluorinated hydroxyapatite (FHA) and tantalum (Ta) was first developed on the surface of the alloy through thermal synthesis and magnetron sputtering technologies in this study. The samples were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), energy dispersive spectroscopy (EDS) mapping, X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and water contact angle measurement (WCA), which characterized the surface alternation and confirmed the deposition of the target FHA/Ta coating. The results of cell morphology showed that the MC3T3-E1 cells on the surface of Mg/FHA/Ta samples had the largest spreading area and lamellipodia. Moreover, the FHA coating endowed the surface with superior cell viability and osteogenic properties, while Ta coating played a more important role in osteogenic differentiation. Therefore, the combination of FHA and Ta coatings could synergistically promote biological functions, thus providing a novel strategy for implant design.

Spectroscopic Investigations of 316L Stainless Steel under Simulated Inflammatory Conditions for Implant Applications: The Effect of Tryptophan as Corrosion Inhibitor/Hydrophobicity Marker

In this paper, the conformational changes of tryptophan (Trp) on the corroded 316 L stainless steel (SS) surface obtained under controlled simulated inflammatory conditions have been studied by Raman (RS) and Fourier-transform infrared (FT-IR) spectroscopy methods. The corrosion behavior and protective efficiency of the investigated samples were performed using the potentiodynamic polarization (PDP) technique in phosphate-buffered saline (PBS) solution acidified to pH 3.0 at 37 °C in the presence and absence of 10−2 M Trp, with different immersion times (2 h and 24 h). The amino acid is adsorbed onto the corroded SS surface mainly through the lone electron pair of the nitrogen atom of the indole ring, which adopts a more/less tilted orientation, and the protonated amine group. The visible differences in the intensity of the Fermi doublet upon adsorption of Trp onto the corroded SS surface, which is a sensitive marker of the local environment, suggested that a stronger hydrophobic environment is observed. This may result in an improvement of the corrosion resistance, after 2 h than 24 h of exposure time. The electrochemical results confirm this statement—the inhibition efficiency of Trp, acting as a mixed-type inhibitor, is made drastically higher after a short period of immersion.

Antibacterial effect of TiAg alloy motivated by Ag-containing phases

The precipitates in Ti-Ag alloy made an important contribution to antibacterial activity. In order to study this specific effects, Ti-Ag samples with different forms of precipitates were produced by powder metallurgy and ingot metallurgy followed by heat treatment: Ti-Ag(T4) with no precipitate, Ti-Ag(as-cast) and Ti-Ag(T6) with Ti₂Ag and Ti-Ag(PM) with Ti₂Ag and Ag-rich phase. Microstructure was analyzed by scanning electronic microscope (SEM), and the antibacterial effects, expression of reactive oxygen species (ROS), protein leakage and biocompatibility were investigated by plate count method, staining technology and cell test. The antibacterial ability was in the following order from low to high: Ti-Ag(T4) < Ti-Ag(as-cast) < Ti-Ag(T6) < Ti-Ag(PM). It was elucidated that Ag-containing phase was the major controlling factor of Ti-Ag antibacterial property and Ti-Ag(PM) with micro-size Ti₂Ag and Ag-rich phase exhibited high antibacterial activity. It was proposed that the existence of Ag-containing phases induced high expression of ROS in bacteria, which destroyed the homeostasis of the bacteria and eventually leads to the rupture of the bacterial membrane. Cell test indicated that Ti-Ag samples had no adverse effect on cells and had good biocompatibility.

What affects the biocompatibility of polymers?

In recent decades synthetic polymers have gained increasing popularity, and nowadays they are an integral part of people's daily lives. In addition, owing to their competitive advantage and being susceptible to modification, polymers have stimulated the fast development of innovative technologies in many areas of science. Biopolymers are of particular interest in various branches of medicine, such as implantology of bones, cartilage and skin tissues as well as blood vessels. Biomaterials with such specific applications must have appropriate mechanical and strength characteristics and above all they must be compatible with the surrounding tissues, human blood and its components, i.e. exhibit high hemo- and biocompatibility, low or no thrombo- and carcinogenicity, foreign body response (host response), appropriate osteoconduction, osteoinduction and mineralization. For biocompatibility improvement many surface treatment techniques have been utilized leading to fabricate the polymer biomaterials of required properties, also at nanoscale. This review paper discusses the most important physicochemical and biological factors that affect the biocompatibility, thus the reaction of the living organism after insertion of the polymer-based biomaterials, i.e. surface modification and/or degradation, surface composition (functional groups and charge), size and shapes, hydrophilic-hydrophobic character, wettability and surface free energy, topography (roughness, stiffness), crystalline and amorphous structure, nanostructure, cell adhesion and proliferation, cellular uptake. Particularly, the application of polysaccharides (chitosan, cellulose, starch) in the tissue engineering is emphasized.

Bactericidal and Fungistatic Properties of LDPE Modified with a Biocide Containing Metal Nanoparticles

The aim of this study was to ascertain whether the combined action of metal nanoparticles (silver, copper, zinc oxide, iron oxide) would ensure the appropriate biocidal properties oflow-density polyethylene (LDPE) against pathogenic microorganisms. According to the research hypothesis, appropriately selected concentrations of the applied metal nanoparticles allow for a high level of biocidal activity of polymeric materials against both model and pathogenic bacterial strains (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Legionella pneumophila, Salmonella enterica subsp. enterica) and fungi (Aspergillus brasiliensis, Saccharomyces cerevisiae, Candida albicans, Penicilium expansum), whilst ensuring the safety of use due to the lack of migration of particles to the surrounding environment. Studies have shown that adding 4% of a biocide containing Ag, Cu, ZnO, and Fe₂O₃ nanoparticles is the most optimal solution to reduce the number of S. aureus, S. enterica and P. aeruginosa by over 99%. The lowest effectiveness was observed against L. pneumophila bacteria. As for E. coli, a higher biocide content did not significantly increase the antibacterial activity. The results showed a high efficiency of the applied biocide at a concentration of 2% against fungal strains. The high efficiency of the obtained biocidal results was influenced by the uniform dispersion of nanoparticles in the material and their low degree of agglomeration. Furthermore, a slight migration of components to the environment is the basis for further research in the field of the application of the developed materials in industry.

Recent Advances in Research on Antibacterial Metals and Alloys as Implant Materials

Implants are widely used in orthopedic surgery and are gaining attention of late. However, their use is restricted by implant-associated infections (IAI), which represent one of the most serious and dangerous complications of implant surgeries. Various strategies have been developed to prevent and treat IAI, among which the closest to clinical translation is designing metal materials with antibacterial functions by alloying methods based on existing materials, including titanium, cobalt, tantalum, and biodegradable metals. This review first discusses the complex interaction between bacteria, host cells, and materials in IAI and the mechanisms underlying the antibacterial effects of biomedical metals and alloys. Then, their applications for the prevention and treatment of IAI are highlighted. Finally, new insights into their clinical translation are provided. This review also provides suggestions for further development of antibacterial metals and alloys.

A Combined Strategy to Improve the Performance of Dental Alloys Using a New CoCrNbMoZr Alloy with Mn and Si Coated via an Anodic Oxidation Procedure

The aim of the paper is based on a combined approach to improve dental alloy performance using a new Ni-free Co–Cr composition with Mo, Nb and Zr and coated with an anodic oxidation film. The coated and uncoated samples were surface characterized by performing SEM (scanning electronic microscopy), XRD (X-rays diffraction) contact angle measurements and corrosion studies with open circuit potential, potentiodynamic polarization and EIS (impedance electrochemical spectroscopy) procedures. The SEM equipment with an EDX (Energy-dispersive X-ray spectroscopy) module indicated the sample morphology and the XRD investigations established the formation of the oxides. The electrochemical procedures were performed in Ericsson artificial saliva for coated samples in various conditions. Based on all the experiments, including the decrease in the hydrophobic character of the uncoated samples and the decrease in the hydrophilic values of the anodized alloys, the improved performance of the coated samples was established as a conclusion.

Dynamic Recrystallization and Its Effect on Superior Plasticity of Cold-Rolled Bioabsorbable Zinc-Copper Alloys

High plasticity of bioabsorbable stents, either cardiac or ureteral, is of great importance in terms of implants’ fabrication and positioning. Zn-Cu constitutes a promising group of materials in terms of feasible deformation since the superplastic effect has been observed in them, yet its origin remains poorly understood. Therefore, it is crucial to inspect the microstructural evolution of processed material to gain an insight into the mechanisms leading to such an extraordinary property. Within the present study, cold-rolled Zn-Cu alloys, i.e., Zn with addition of 1 wt.% and 5 wt.% of Cu, have been extensively investigated using scanning electron microscopy as well as transmission electron microscopy, so as to find out the possible explanation of superior plasticity of the Zn-Cu alloys. It has been stated that the continuous dynamic recrystallization has a tremendous impact on superior plasticity reported for Zn-1Cu alloy processed by rolling to 90% of reduction rate. The effect might be supported by static recrystallization, provoking grain growth and thereby yielding non-homogeneous microstructures. Such heterogeneous microstructure enables better formability since it increases the mean free path for dislocation movement.

Contact Guidance Effect and Prevention of Microfouling on a Beta Titanium Alloy Surface Structured by Electron-Beam Technology

Nano- and micro-structuring of implantable materials constitute a promising approach to introduce mechanical contact guidance effect, drive cells colonization, as well as to prevent bacteria adhesion and biofilm aggregation, through antifouling topography. Accordingly, this paper aims to extend the application of e-beam surface texturing and nano-structuring to the beta titanium alloys, which are of great interest for biomedical implants because of the low Young modulus and the reduction of the stress shielding effect. The paper shows that surface texturing on the micro-scale (micro-grooves) is functional to a contact guidance effect on gingival fibroblasts. Moreover, nano-structuring, derived from the e-beam surface treatment, is effective to prevent microfouling. In fact, human fibroblasts were cultivated directly onto grooved specimens showing to sense the surface micro-structure thus spreading following the grooves’ orientation. Moreover, Staphylococcus aureus colonies adhesion was prevented by the nano-topographies in comparison to the mirror-polished control, thus demonstrating promising antifouling properties. Furthermore, the research goes into detail to understand the mechanism of microfouling prevention due to nano-topography and microstructure.

Understanding and optimizing the antibacterial functions of anodized nano-engineered titanium implants

Nanoscale surface modification of titanium-based orthopaedic and dental implants is routinely applied to augment bioactivity, however, as is the case with other cells, bacterial adhesion is increased on nano-rough surfaces. Electrochemically anodized Ti implants with titania nanotubes (TNTs) have been proposed as an ideal implant surface with desirable bioactivity and local drug release functions to target various conditions. However, a comprehensive state of the art overview of why and how such TNTs-Ti implants acquire antibacterial functions, and an in-depth knowledge of how topography, chemistry and local elution of potent antibiotic agents influence such functions has not been reported. This review discusses and details the application of nano-engineered Ti implants modified with TNTs for maximum local antibacterial functions, deciphering the interdependence of various characteristics and the fine-tuning of different parameters to minimize cytotoxicity. An ideal implant surface should cater simultaneously to ossoeintegration (and soft-tissue integration for dental implants), immunomodulation and antibacterial functions. We also evaluate the effectiveness and challenges associated with such synergistic functions from modified TNTs-implants. Particular focus is placed on the metallic and semi-metallic modification of TNTs towards enabling bactericidal properties, which is often dose dependent. Additionally, there are concerns over the cytotoxicity of these therapies. In that light, research challenges in this domain and expectations from the next generation of customizable antibacterial TNTs implants towards clinical translation are critically evaluated. STATEMENT OF SIGNIFICANCE: One of the major causes of titanium orthopaedic/dental implant failure is bacterial colonization and infection, which results in complete implant failure and the need for revision surgery and re-implantation. Using advanced nanotechnology, controlled nanotopographies have been fabricated on Ti implants, for instance anodized nanotubes, which can accommodate and locally elute potent antibiotic agents. In this pioneering review, we shine light on the topographical, chemical and therapeutic aspects of antibacterial nanotubes towards achieving desirable tailored antibacterial efficacy without cytotoxicity concerns. This interdisciplinary review will appeal to researchers from the wider scientific community interested in biomaterials science, structure and function, and will provide an improved understanding of controlling bacterial infection around nano-engineered implants, aimed at bridging the gap between research and clinics.

Zinc alloy-based bone internal fixation screw with antibacterial and anti-osteolytic properties

There is no targeted effective treatment for patients undergoing internal fixation surgery/two-stage total joint revision surgery with a high risk of postoperative infection and osteolysis, while the rate of reoperation due to infection and osteolysis remains high. In this study, we report a pioneering application of implants made of biodegradable Zn–Ag alloy with active antibacterial and anti-osteolytic properties in three classical animal models, illustrating antibacterial, anti-osteolysis, and internal fixation for fractures. The antibacterial activity of the Zn–2Ag alloy was verified in a rat femur osteomyelitis prevention model, while the anti-osteolytic properties were evaluated using a mouse cranial osteolysis model. Moreover, the Zn–2Ag based screws showed similar performance in bone fracture fixation compared to the Ti–6Al–4V counterpart. The fracture healed completely after 3 months in the rabbit femoral condyle fracture model. Furthermore, the underlying antibacterial mechanism may include inhibition of biofilm formation, autolysis-related pathways, and antibiotic resistance pathways. Osseointegration mechanisms may include inhibition of osteoclast-associated protein expression, no effect on osteogenic protein expression, and no activation of related inflammatory protein expression. The empirical findings here reveal the great potential of Zn–Ag-based alloys for degradable biomaterials in internal fixation surgery/two-stage total joint revision surgery for patients with a high risk of postoperative infection and osteolysis.

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Zn–2Ag alloy is designed for orthopedic applications.

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Zn–2Ag alloy exhibit outstanding antibacterial properties in a rat femur osteomyelitis prevention model.

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Zn–2Ag alloy exhibit outstanding anti-osteolytic properties in a mouse cranial osteolysis model.

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Zn-2Ag based screws showed reliable performance in bone fracture fixation in the rabbit femoral condyle fracture model.

Development of a low elastic modulus and antibacterial Ti-13Nb-13Zr-5Cu titanium alloy by microstructure controlling

In order to prepare a titanium with a low elastic modulus and good antibacterial property to meet the requirements as a biomedical material, Ti-13Nb-13Zr-5Cu (TNZ-5Cu) alloy was prepared by high vacuum consume electric arc melting furnace and then subjected to a solution treatment at 950 °C followed by a short-term aging treatment at 600 °C, for 15 min, 30 min, 1 h and 2 h, respectively. The microstructure, mechanical property, antibacterial property and biocompatibility of TNZ-5Cu were investigated in detail. The research results have shown that the solid solution treated alloy was mainly composed of β-phase and α″-phase, while the aged alloys of β-phase, α″-phase, α-phase and Ti₂Cu. Compared with Ti-13Nb-13Zr alloy (65 GPa) and Ti-6Al-4 V alloy (111 GPa), the elastic modulus of TNZ-5Cu alloy after solution treatment was about 72 GPa and increased with the aging treatment up to 85 GPa, and the hardness was maintained at a higher level than that of Ti-13Nb-13Zr alloys (288 HV). The bacteria plate count results showed that the antibacterial ability of TNZ-5Cu alloy increased with the extension of the aging duration from <60% at 15-30 min to >90% at 1-2 h. Cell experiments showed that all TNZ-5Cu alloy had good cell compatibility. The low modulus and the antibacterial property could provide potential to avoid stress shield and device-related inflection in the clinical application.