Antibacterial and osteogenic properties of silver-containing hydroxyapatite coatings produced using a sol gel process

Antibacterial effect of Ag-containing hydroxyapatite thin film fabricated by sputtering

BACKGROUND

Infections related to joint prosthesis are still a major concern for orthopedic surgeons. Hydroxyapatite (HA) is a useful biocompatible material because of its good osteocompatibility. Antibacterial HA coatings have been fabricated with addition of antibacterial agents such as Ag to HA using the plasma spraying method. However, the plasma-sprayed HA coating suffers from fractures at large thicknesses. The sputter-coated HA thin film has a high density, and has been applied clinically for dental implants. However, there are no extensive studies on Ag-containing HA thin films.

OBJECTIVE

The aim of this study was to prepare an Ag-containing HA thin film by sputtering, and evaluate its antibacterial effect and cytotoxicity.

METHODS

The Ag-containing HA thin films were prepared by radio-frequency magnetron sputtering. The films were characterized using X-ray photoelectron spectroscopy, X-ray diffractometry, and scanning electron microscopy (SEM). The antibacterial activities and cytotoxicities of the films were also evaluated.

RESULTS

The Ag/Ca molar ratio of the films increased with the Ag ratio in the target. The SEM observation of the hydrothermally treated films showed surfaces covered with globular particles. All Ag-containing HA films exhibited an antibacterial effect against E. Coli. The number of cells of the films decreased with the Ag ratio. The films subjected to the hydrothermal treatment exhibited a higher number of cells than the as-sputtered films.

CONCLUSION

The Ag-containing HA thin film was effective in terms of antibacterial effect, and had a low cytotoxicity in the proliferation of osteoblast cells at a low Ag ratio in the target.

In Vitro Evaluation of Ag- and Sr-Doped Hydroxyapatite Coatings for Medical Applications

Osseointegration plays the most important role in the success of an implant. One of the applications of hydroxyapatite (HAp) is as a coating for metallic implants due to its bioactive nature, which improves osteoconduction. The purpose of this research was to assess the in vitro behavior of HAp undoped and doped with Ag and/or Sr obtained by galvanostatic pulsed electrochemical deposition. The coatings were investigated in terms of chemical bonds, contact angle and surface free energy, electrochemical behavior, in vitro biomineralization in acellular media (SBF and PBS), and biocompatibility with preosteoblasts cells (MC3T3-E1 cell line). The obtained results highlighted the beneficial impact of Ag and/or Sr on the HAp. The FTIR spectra confirmed the presence of hydroxyapatite within all coatings, while in terms of wettability, the contact angle and surface free energy investigations showed that all surfaces were hydrophilic. The in vitro behavior of MC3T3-E1 indicated that the presence of Sr in the HAp coatings as a unique doping agent or in combination with Ag elicited improved cytocompatibility in terms of cell proliferation and osteogenic differentiation. Therefore, the composite HAp-based coatings showed promising potential for bone regeneration applications.

There Are over 60 Ways to Produce Biocompatible Calcium Orthophosphate (CaPO4) Deposits on Various Substrates

A The present overview describes various production techniques for biocompatible calcium orthophosphate (abbreviated as CaPO4) deposits (coatings, films and layers) on the surfaces of various types of substrates to impart the biocompatible properties for artificial bone grafts. Since, after being implanted, the grafts always interact with the surrounding biological tissues at the interfaces, their surface properties are considered critical to clinical success. Due to the limited number of materials that can be tolerated in vivo, a new specialty of surface engineering has been developed to desirably modify any unacceptable material surface characteristics while maintaining the useful bulk performance. In 1975, the development of this approach led to the emergence of a special class of artificial bone grafts, in which various mechanically stable (and thus suitable for load-bearing applications) implantable biomaterials and artificial devices were coated with CaPO4. Since then, more than 7500 papers have been published on this subject and more than 500 new publications are added annually. In this review, a comprehensive analysis of the available literature has been performed with the main goal of finding as many deposition techniques as possible and more than 60 methods (double that if all known modifications are counted) for producing CaPO4 deposits on various substrates have been systematically described. Thus, besides the introduction, general knowledge and terminology, this review consists of two unequal parts. The first (bigger) part is a comprehensive summary of the known CaPO4 deposition techniques both currently used and discontinued/underdeveloped ones with brief descriptions of their major physical and chemical principles coupled with the key process parameters (when possible) to inform readers of their existence and remind them of the unused ones. The second (smaller) part includes fleeting essays on the most important properties and current biomedical applications of the CaPO4 deposits with an indication of possible future developments.

Ion-Doped Calcium Phosphate-Based Coatings with Antibacterial Properties

Ion-substituted calcium phosphate (CP) coatings have been extensively studied as promising materials for biomedical implants due to their ability to enhance biocompatibility, osteoconductivity, and bone formation. This systematic review aims to provide a comprehensive analysis of the current state of the art in ion-doped CP-based coatings for orthopaedic and dental implant applications. Specifically, this review evaluates the effects of ion addition on the physicochemical, mechanical, and biological properties of CP coatings. The review also identifies the contribution and additional effects (in a separate or a synergistic way) of different components used together with ion-doped CP for advanced composite coatings. In the final part, the effects of antibacterial coatings on specific bacteria strains are reported. The present review could be of interest to researchers, clinicians, and industry professionals involved in the development and application of CP coatings for orthopaedic and dental implants.

Vapor-Induced Pore-Forming Atmospheric-Plasma-Sprayed Zinc-, Strontium-, and Magnesium-Doped Hydroxyapatite Coatings on Titanium Implants Enhance New Bone Formation-An In Vivo and In Vitro Investigation

OBJECTIVES

Titanium implants are regarded as a promising treatment modality for replacing missing teeth. Osteointegration and antibacterial properties are both desirable characteristics for titanium dental implants. The aim of this study was to create zinc (Zn)-, strontium (Sr)-, and magnesium (Mg)-multidoped hydroxyapatite (HAp) porous coatings, including HAp, Zn-doped HAp, and Zn-Sr-Mg-doped HAp, on titanium discs and implants using the vapor-induced pore-forming atmospheric plasma spraying (VIPF-APS) technique.

METHODS

The mRNA and protein levels of osteogenesis-associated genes such as collagen type I alpha 1 chain (COL1A1), decorin (DCN), osteoprotegerin (TNFRSF11B), and osteopontin (SPP1) were examined in human embryonic palatal mesenchymal cells. The antibacterial effects against periodontal bacteria, including Porphyromonas gingivalis and Prevotella nigrescens, were investigated. In addition, a rat animal model was used to evaluate new bone formation via histologic examination and micro-computed tomography (CT).

RESULTS

The ZnSrMg-HAp group was the most effective at inducing mRNA and protein expression of TNFRSF11B and SPP1 after 7 days of incubation, and TNFRSF11B and DCN after 11 days of incubation. In addition, both the ZnSrMg-HAp and Zn-HAp groups were effective against P. gingivalis and P. nigrescens. Furthermore, according to both in vitro studies and histologic findings, the ZnSrMg-HAp group exhibited the most prominent osteogenesis and concentrated bone growth along implant threads.

SIGNIFICANCE

A porous ZnSrMg-HAp coating using VIPF-APS could serve as a novel technique for coating titanium implant surfaces and preventing further bacterial infection.

Nanocrystalline Apatites: Post-Immersion Acidification and How to Avoid It-Application to Antibacterial Bone Substitutes

Biomimetic nanocrystalline apatites analogous to bone mineral can be prepared using soft chemistry. Due to their high similarity to bone apatite, as opposed to stoichiometric hydroxyapatite for example, they now represent an appealing class of compounds to produce bioactive ceramics for which drug delivery and ion exchange abilities have been described extensively. However, immersion in aqueous media of dried non-carbonated biomimetic apatite crystals may generate an acidification event, which is often disregarded and not been clarified to-date. Yet, this acidification process could limit their further development if it is not understood and overcome if necessary. This may, for example, alter biological test outcomes, during their evaluation as bone repair materials, due to potentially deleterious effects of the acidic environment on cells, especially in in vitro static conditions. In this study, we explore the origins of this acidification phenomenon based on complementary experimental data and we point out the central role of the hydrated ionic layer present on apatite nanocrystals. We then propose a practical strategy to circumvent this acidification effect using an adequate post-precipitation equilibration step that was optimized. Using this enutralization protocol, we then showed the possibility of performing (micro)biological assessments on such compounds and provide an illustration with the examples of post-equilibrated Cu²⁺- and Ag⁺-doped nanocrystalline apatites. We demonstrate their non-cytotoxicity to osteoblast cells and their antibacterial features as tested versus five major pathogens involved in bone infections, therefore pointing to their relevance in the field of antibacterial bone substitutes. The preliminary in vivo implantation of a relevant sample in a rat's calvarial defect confirmed its biocompatibility and the absence of adverse reaction. Understanding and eliminating this technical barrier should help promoting biomimetic apatites as a genuine new class of biomaterial-producing compounds for bone regeneration applications, e.g., with antibacterial features, far from being solely considered as "laboratory curiosities".

Development of Novel Tetracycline and Ciprofloxacin Loaded Silver Doped Hydroxyapatite Suspensions for Biomedical Applications

The objective of this study consisted of the development of new materials with antimicrobial properties at the nanometric scale that could lead to an increase in therapeutic efficacy and reduction of toxic side effects. This work focuses on obtaining and characterizing stable suspensions with narrow size distribution with antimicrobial properties. The stability of the suspensions obtained by an adapted co-precipitation method was evaluated by ultrasonic measurements. The size and size distribution of the particle populations were determined using scanning electron microscopy (SEM), and dynamic light scattering (DLS). Both methods of analysis showed a narrow distribution of particles. DLS gave a monomodal distribution with hydrodynamic diameters around 38 nm for ciprofloxacin embedded in silver doped hydroxyapatite (AgHA-C) and 45.7 nm for tetracycline embedded in silver doped hydroxyapatite (AgHA-T). The average diameters calculated from SEM were 17 nm for AgHA-C and 19 nm for AgHA-T. Both Ciprofloxacin and Tetracycline influenced the hydroxyapatite structure, which led to the appearance of new vibrational bands characteristic of the specific chemical composition in the FTIR spectrum. The antimicrobial properties of the AgHA-C and AgHA-T suspensions were assessed using the most common reference microbial strains Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, and Candida albicans ATCC 10231. The results of the in vitro antimicrobial assays determined that the AgHA-C and AgHA-T suspensions exhibited exceptional antimicrobial activity. Moreover, the data revealed that the antimicrobial activity increased with the increase of the incubation time.

Advances in Multifunctional Bioactive Coatings for Metallic Bone Implants

To fix the bone in orthopedics, it is almost always necessary to use implants. Metals provide the needed physical and mechanical properties for load-bearing applications. Although widely used as biomedical materials for the replacement of hard tissue, metallic implants still confront challenges, among which the foremost is their low biocompatibility. Some of them also suffer from excessive wear, low corrosion resistance, infections and shielding stress. To address these issues, various coatings have been applied to enhance their in vitro and in vivo performance. When merged with the beneficial properties of various bio-ceramic or polymer coatings remarkable bioactive, osteogenic, antibacterial, or biodegradable composite implants can be created. In this review, bioactive and high-performance coatings for metallic bone implants are systematically reviewed and their biocompatibility is discussed. Updates in coating materials and formulations for metallic implants, as well as their production routes, have been provided. The ways of improving the bioactive coating performance by incorporating bioactive moieties such as growth factors, osteogenic factors, immunomodulatory factors, antibiotics, or other drugs that are locally released in a controlled manner have also been addressed.

Safe-by-Design Antibacterial Peroxide-Substituted Biomimetic Apatites: Proof of Concept in Tropical Dentistry

Bone infections are a key health challenge with dramatic consequences for affected patients. In dentistry, periodontitis is a medically compromised condition for efficient dental care and bone grafting, the success of which depends on whether the surgical site is infected or not. Present treatments involve antibiotics associated with massive bacterial resistance effects, urging for the development of alternative antibacterial strategies. In this work, we established a safe-by-design bone substitute approach by combining bone-like apatite to peroxide ions close to natural in vivo oxygenated species aimed at fighting pathogens. In parallel, bone-like apatites doped with Ag⁺ or co-doped Ag⁺/peroxide were also prepared for comparative purposes. The compounds were thoroughly characterized by chemical titrations, FTIR, XRD, SEM, and EDX analyses. All doped apatites demonstrated significant antibacterial properties toward four major pathogenic bacteria involved in periodontitis and bone infection, namely Porphyromonas gingivalis (P. gingivalis), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Fusobacterium nucleatum (F. nucleatum), and S. aureus. By way of complementary tests to assess protein adsorption, osteoblast cell adhesion, viability and IC₅₀ values, the samples were also shown to be highly biocompatible. In particular, peroxidated apatite was the safest material tested, with the lowest IC₅₀ value toward osteoblast cells. We then demonstrated the possibility to associate such doped apatites with two biocompatible polymers, namely gelatin and poly(lactic-co-glycolic) acid PLGA, to prepare, respectively, composite 2D membranes and 3D scaffolds. The spatial distribution of the apatite particles and polymers was scrutinized by SEM and µCT analyses, and their relevance to the field of bone regeneration was underlined. Such bio-inspired antibacterial apatite compounds, whether pure or associated with (bio)polymers are thus promising candidates in dentistry and orthopedics while providing an alternative to antibiotherapy.

Effect Of Nano-Bioactive Glass On Flexural Strength And Antimicrobial Activity Of Resin-Modified Glass Ionomer Cement Containing 58S Nano-Bioactive Glass

Introduction:

Bioactive glass (BAG) is increasingly used in dentistry, aiming to provide superior mechanical properties, optimal chemical stability, and favorable antimicrobial activity in the oral environment. This study aimed to measure the flexural strength (FS) and antimicrobial activity of resin-modified glass ionomer (RMGI) cement containing 58S nano-BAG.

Materials and Methods:

In this in vitro study, 0wt (Weight) %, 10wt%, 20wt%, and 30wt% 58S nano-BAG particles were added to RMGI powder in groups 1 to 4, respectively (n=10). Forty specimens were fabricated in metal molds (2 x 25 x 2 mm), and their FS was measured by using a three-point bending test at a crosshead speed of 0.5 mm/min. The antibacterial activity of the materials against Streptococcus mutants was assessed by the disc diffusion test. In addition to the abovementioned experimental groups, one control group (n=10) containing 100% BAG was also considered. Data were analyzed by one-way ANOVA and Tukey’s test.

Results:

The mean (± standard deviation) FS was 38.71±8.84, 43.61±17.34, 45.62±15.89, and 54.71±14.25 MPa in groups 1 to 4, respectively. No significant difference was noted in FS among the groups (P=0.06). A significant difference was found in the diameter of the growth inhibition zone among the groups (P<0.05), and group 4 containing 30wt% BAG showed minimal bacterial growth.

Conclusion:

The addition of 10wt%, 20wt% and 30wt% nano-BAG to RMGI powder did not significantly change the FS but the addition of 30wt% nano-BAG to RMGI significantly inhibited the bacterial growth.

Bioactive Surface Modifications through Thermally Sprayed Hydroxyapatite Composite Coatings: A Review over Selective Reinforcements

Hydroxyapatite (HA) has been an excellent replacement for the natural bone in orthopedic applications, owing to its close resemblance; however, it is brittle and has low strength. Surface modification techniques...

Evaluation of the antibacterial properties and in-vitro cell compatibilities of doped copper oxide/hydroxyapatite composites

Mg, Zn and Ce-doped CuO/HA composites were prepared by a two-step sol-gel and hydrothermal process. SEM images showed a spherical appearance of HA and a needle-like morphology for doped CuO. XRD patterns revealed that all doped CuO/HA composites exhibited a hexagonal crystal structure of HA and a monoclinic crystal structure of CuO with no impurities. ICP analysis indicated that with the increase of loading amount of doped CuO, the concentrations of Cu²⁺ ions and doping ions released from composites increased. Moreover, CuO/HA composites exhibit improved antibacterial properties against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) as compared with HA. When the loading amount of doped CuO in composites increased to 15 wt%, the composites exhibited the best antibacterial activity and complete bacterial growth inhibition effect. Furthermore, the CCK-8 assay revealed that the doped CuO/HA composites are noncytotoxic and can promote the proliferation of osteosarcoma cells. This work highlights the potential of the doped CuO/HA composites with significant antibacterial activity, bioactivity and cell compatibility for potential biomedical applications in dental implants and bone regeneration.

Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry

Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.

Osteointegration, antimicrobial and antibiofilm activity of orthopaedic titanium surfaces coated with silver and strontium-doped hydroxyapatite using a novel blasting process

Poor integration of orthopaedic devices with the host tissue owing to aseptic loosening and device-associated infections are two of the leading causes of implant failure, which represents a significant problem for both patients and the healthcare system. Novel strategies have focused on silver to combat antimicrobial infections as an alternative to drug therapeutics. In this study, we investigated the impact of increasing the % substitution (12% wt) of silver and strontium in hydroxyapatite (HA) coatings to enhance antimicrobial properties and stimulate osteoblasts, respectively. Additionally, we prepared a binary substituted coating containing both silver and strontium (AgSrA) at 12% wt as a comparison. All coatings were deposited using a novel blasting process, CoBlast, onto biomedical grade titanium (V). Surface physicochemical properties, cytocompatibility and antimicrobial functionality were determined. The anticolonising properties of the coatings were screened using Staphylococcus aureus ATCC 1448, and thereafter, the AgA coating was evaluated using clinically relevant strains. Strontium-doped surfaces demonstrated enhanced osteoblast viability; however, a lower inhibition of biofilm formation was observed compared with the other surfaces. A co-substituted AgSrA surface did not show enhanced osteoblast or anticolonising properties compared with the SrA and AgA surfaces, respectively. Due to its superior anticolonising performance in preliminary studies, AgA was chosen for further studies. The AgA coated surfaces demonstrated good antibacterial activity (eluted and immobilised ion) against methicillin-resistant S. aureus followed by methicillin-sensitive Staphylococcus aureus clinical isolates; however, the AgA surface displayed poor impact against Staphylococcus epidermidis. In conclusion, herein, we demonstrate that HA can be substituted with a range of ions to augment the properties of HA coatings on orthopaedic devices, which offer promising potential to combat orthopaedic device-associated infections and enhance device performance.

Additive Manufacturing of Titanium-Based Implants with Metal-Based Antimicrobial Agents

Due to increasing bacterial resistance to antibiotics, surface coatings of medical devices with antimicrobial agents have come to the fore. These surface coatings on medical devices were basically thin coatings that delaminated from the medical devices due to the fluid environment and the biomechanical activities associated with in-service implants. The conventional methods of manufacturing have been used to alloy metal-based antimicrobial (MBA) agents such as Cu with Ti6Al4V to enhance its antibacterial properties but failed to produce intricate shapes. Additive manufacturing technology, such as laser powder bed fusion (LPBF), could be used to produce the Ti6Al4V–xCu alloy with intricate shapes to enhance osseointegration, but have not been successful for texturing the surfaces of the Ti6Al4V–xCu samples at the nanoscale.

Silver-hydroxyapatite nanocomposites prepared by three sequential reaction steps in one pot and their bioactivities in vitro

Hydroxyapatite (HA) combined with antimicrobial agents for biomedical application can effectively avoid the bacteria infection, while HA have the good performance. In this study, we prepared silver-hydroxyapatite (Ag-HA) nanocomposites using a one-pot method consisting of three sequential steps of wet chemical precipitation, ion exchange, and a silver mirror reaction. The HA nanoparticles used as the precursor for Ag ion doping were first synthesised by wet chemical precipitation. Next, Ag⁺ absorbed on HA surface through ion exchange reaction. Glucose was then added to initiate the silver mirror reaction, which made the Ag⁺ ions reduce to Ag⁰ and Ag nanoparticles in situ formed on HA nanoparticles. Subsequently, Ag-HA nanocomposites with different Ag content were prepared. X-ray diffraction, SEM, EDX mapping and TEM imaging confirmed that spherical Ag nanoparticles ~20-40 nm in diameter were adhered to the surface of HA nano-rods (0.4-0.8 μm in length and 15-40 nm in diameter). The Ag content (1.9-15.2 wt%) in the Ag-HA nanocomposites was adjusted by varying the feeding Ag/Ca molar ratio (2.0-20%). The cell viability evaluation in vitro proved that Ag-HA nanocomposites had low cytotoxicity to L929 normal cells. Meanwhile, the antibacterial examinations in vitro demonstrated that Ag-HA nanocomposites had obvious antibacterial effects on Gram-positive bacteria, Gram-negative bacteria, and fungus. The antibacterial results were dose-dependent on the accumulation of silver content. The Ag-HA nanocomposites loaded PMMA resins also demonstrated a potential antibacterial activity against S. mutans. This paper presents a convenient and bio-friendly approach for preparing Ag-HA nanocomposites with adjustable Ag content, which are a promising material for biomedical applications.

Key Properties of a Bioactive Ag-SiO2/TiO2 Coating on NiTi Shape Memory Alloy as Necessary at the Development of a New Class of Biomedical Materials

Recent years have seen the dynamic development of methods for functionalizing the surface of implants using biomaterials that can mimic the physical and mechanical nature of native tissue, prevent the formation of bacterial biofilm, promote osteoconduction, and have the ability to sustain cell proliferation. One of the concepts for achieving this goal, which is presented in this work, is to functionalize the surface of NiTi shape memory alloy by an atypical glass-like nanocomposite that consists of SiO2-TiO2 with silver nanoparticles. However, determining the potential medical uses of bio(nano)coating prepared in this way requires an analysis of its surface roughness, tribology, or wettability, especially in the context of the commonly used reference coat-forming hydroxyapatite (HAp). According to our results, the surface roughness ranged between (112 ± 3) nm (Ag-SiO2)-(141 ± 5) nm (HAp), the water contact angle was in the range (74.8 ± 1.6)° (Ag-SiO2)-(70.6 ± 1.2)° (HAp), while the surface free energy was in the range of 45.4 mJ/m2 (Ag-SiO2)-46.8 mJ/m2 (HAp). The adhesive force and friction coefficient were determined to be 1.04 (Ag-SiO2)-1.14 (HAp) and 0.247 ± 0.012 (Ag-SiO2) and 0.397 ± 0.034 (HAp), respectively. The chemical data showed that the release of the metal, mainly Ni from the covered NiTi substrate or Ag from Ag-SiO2 coating had a negligible effect. It was revealed that the NiTi alloy that was coated with Ag-SiO2 did not favor the formation of E. coli or S. aureus biofilm compared to the HAp-coated alloy. Moreover, both approaches to surface functionalization indicated good viability of the normal human dermal fibroblast and osteoblast cells and confirmed the high osteoconductive features of the biomaterial. The similarities of both types of coat-forming materials indicate an excellent potential of the silver-silica composite as a new material for the functionalization of the surface of a biomaterial and the development of a new type of functionalized implants.

Innovative Bioactive Ag-SiO2/TiO2 Coating on a NiTi-Shape Memory Alloy: Structure and Mechanism of Its Formation

In recent years, more and more emphasis has been placed on the development and functionalization of metallic substrates for medical applications to improve their properties and increase their applicability. Today, there are many different types of approaches and materials that are used for this purpose. Our idea was based on a combination of a chemically synthesized Ag-SiO2 nanocomposite and the electrophoretic deposition approach on a NiTi-shape memory substrate. As a result, silver-silica coating was developed on a previously passivated alloy, which was then subjected to sintering at 700 °C for 2 h. The micrometer-sized coat-forming material was composed of large agglomerates consisting of silica and a thin film of submicron- and nano- spherical-shaped particles built of silver, carbon, and oxygen. Structurally, the coatings consisted of a combination of nanometer-sized silver-carbonate that was embedded in thin amorphous silica and siloxy network. The temperature impact had forced morphological and structural changes such as the consolidation of the coat-forming material, and the partial coalescence of the silver and silica particles. As a result, a new continuous complex ceramic coating was formed and was analyzed in more detail using the XPS, XRD, and Raman methods. According to the structural and chemical analyses, the deposited Ag-SiO2 nanocomposite material's reorganization was due to its reaction with a passivated TiO2 layer, which formed an atypical glass-like composite that consisted of SiO2-TiO2 with silver particles that stabilized the network. Finally, the functionalization of the NiTi surface did not block the shape memory effect.

Robocasting of Single and Multi-Functional Calcium Phosphate Scaffolds and Its Hybridization with Conventional Techniques: Design, Fabrication and Characterization

In this work, dense, porous, and, for the first time, functionally-graded bi-layer scaffolds with a cylindrical geometry were produced from a commercially available hydroxyapatite powder using the robocasting technique. The bi-layer scaffolds were made of a dense core part attached to a surrounding porous part. Subsequently, these bi-layer robocast scaffolds were joined with an outer shell of an antibacterial porous polymer layer fabricated by solvent casting/salt leaching techniques, leading to hybrid ceramic-polymer scaffolds. The antibacterial functionality was achieved through the addition of silver ions to the polymer layer. All the robocast samples, including the bi-layer ones, were first characterized through scanning electron microscopy observations, mechanical characterization in compression and preliminary bioactivity tests. Then, the hybrid bi-layer ceramic-polymer scaffolds were characterized through antimicrobial tests. After sintering at 1300 °C for 3 h, the compressive strengths of the structures were found to be equal to 29 ± 4 MPa for dense samples and 7 ± 4 MPa for lattice structures with a porosity of 34.1%. Bioactivity tests performed at 37 °C for 4 weeks showed that the precipitated layer on the robocast samples contained octacalcium phosphate. Finally, it was evidenced that the hybrid structure was effective in releasing antibacterial Ag+ ions to the surrounding medium showing its potential efficiency in limiting Staphylococcus aureus proliferation during surgery.

Biological evaluation of preceramic organosilicon polymers for various healthcare and biomedical engineering applications: A review

Preceramic organosilicon materials combining the properties of a polymer and an inorganic ceramic phase are of great interest to scientists working in biomedical sciences. The interdisciplinary nature of organosilicon polymers and their molecular structures, as well as their diversity of applications have resulted in an unprecedented range of devices and synergies cutting across unrelated fields in medicine and engineering. Organosilicon materials, especially the polysiloxanes, have a long history of industrial and medical uses in many versatile aspects as they can be easily fabricated into complex-shaped products using a wide variety of computer-aided or polymer manufacturing techniques. Thus far, intensive research activities have been mainly devoted to the processing of preceramic organosilicon polymers toward magnetic, electronic, structural, optical, and not biological applications. Herein we present innovative research studies and recent developments of preceramic organosilicon polymers at the interface with biological systems, displaying the versatility and multi-functionality of these materials. This article reviews recent research on preceramic organosilicon polymers and corresponding composites for bone tissue regeneration and medical engineering implants, focusing on three particular topics: (a) surface modifications to create tailorable and bioactive surfaces with high corrosion resistance and improved biological properties; (b) biological evaluations for specific applications, such as in glaucoma drainage devices, orthopedic implants, bone tissue regeneration, wound dressing, drug delivery systems, and antibacterial activity; and (c) in vitro and in vivo studies for cytotoxicity, genotoxicity, and cell viability. The interest in organosilicon materials stems from the fact that a vast array of these materials have complementary attributes that, when integrated appropriately with functional fillers and carefully controlled conditions, could be exploited either as polymeric Si-based composites or as organosilicon polymer-derived Si-based ceramic composites to tailor and optimize properties of the Si-based materials for various proposed applications.

Fabrication of Silver- and Zinc-Doped Hydroxyapatite Coatings for Enhancing Antimicrobial Effect

This study develops, for the first time, composite coatings based on silver and zinc doped hydroxyapatite in chitosan matrix (AgZnHApCs). The AgZnHApCs composite coatings were prepared by dip coating method. The hydroxyapatite (HAp), biocompatible material for regenerating and strengthening damaged bones were doped with silver and zinc ions and coated with chitosan in order to produce a uniform and homogenous coating with biocompatibility and antimicrobial properties. The stability of AgZnHApCs suspensions was evaluated by ultrasound measurements. The value of stability parameters of AgZnHApCs suspension is in good agreement with the value of bidistilled water used as reference fluid. Homogeneously dispersed solutions of AgZnHApCs were synthesized to endeavor to optimize the physico-chemical and biological characteristics of the coatings obtained at room temperature. The AgZnHApCs composite suspension and coatings were analyzed using various investigation techniques, such as X-ray diffraction (XRD), Fourier transformed infrared spectroscopy (FTIR), MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenylte-2H-tetrazolium bromide) assay and antimicrobial studies. The optical spectroscopy, atomic force microscopy (AFM), metallographic examination and X-ray photoelectron spectroscopy (XPS) on AgZnHApCs composite coatings were also conducted. Cell culture and MTT assays demonstrate that AgZnHApCs composite suspension and coatings have no negative effect on the cell viability and proliferation. The cell morphology was not affected in presence of AgZnHApCs composite suspension and coatings. The antimicrobial assays conducted against Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, and Candida albicans ATCC 90029 microbial strains revealed that both the AgZnHApCs composite suspension and coatings exhibited great antimicrobial properties.

Crystallized TiO2 Nanosurfaces in Biomedical Applications

Crystallization alters the characteristics of TiO2 nanosurfaces, which consequently influences their bio-performance. In various biomedical applications, the anatase or rutile crystal phase is preferred over amorphous TiO2. The most common crystallization technique is annealing in a conventional furnace. Methods such as hydrothermal or room temperature crystallization, as well as plasma electrolytic oxidation (PEO) and other plasma-induced crystallization techniques, present more feasible and rapid alternatives for crystal phase initiation or transition between anatase and rutile phases. With oxygen plasma treatment, it is possible to achieve an anatase or rutile crystal phase in a few seconds, depending on the plasma conditions. This review article aims to address different crystallization techniques on nanostructured TiO2 surfaces and the influence of crystal phase on biological response. The emphasis is given to electrochemically anodized nanotube arrays and their interaction with the biological environment. A short overview of the most commonly employed medical devices made of titanium and its alloys is presented and discussed.

Substituted hydroxyapatite coatings of bone implants

Surface modification of orthopedic and dental implants has been demonstrated to be an effective strategy to accelerate bone healing at early implantation times. Among the different alternatives, coating implants with a layer of hydroxyapatite (HAp) is one of the most used techniques, due to its excellent biocompatibility and osteoconductive behavior. The composition and crystalline structure of HAp allow for numerous ionic substitutions that provide added value, such as antibiotic properties or osteoinduction. In this article, we will review and critically analyze the most important advances in the field of substituted hydroxyapatite coatings. In recent years substituted HAp coatings have been deposited not only on orthopedic prostheses and dental implants, but also on macroporous scaffolds, thus expanding their applications towards bone regeneration therapies. Besides, the capability of substituted HAps to immobilize proteins and growth factors by non-covalent interactions has opened new possibilities for preparing hybrid coatings that foster bone healing processes. Finally, the most important in vivo outcomes will be discussed to understand the prospects of substituted HAp coatings from a clinical point of view.

Evolving concepts in bone infection: redefining "biofilm", "acute vs. chronic osteomyelitis", "the immune proteome" and "local antibiotic therapy"

Osteomyelitis is a devastating disease caused by microbial infection of bone. While the frequency of infection following elective orthopedic surgery is low, rates of reinfection are disturbingly high. Staphylococcus aureus is responsible for the majority of chronic osteomyelitis cases and is often considered to be incurable due to bacterial persistence deep within bone. Unfortunately, there is no consensus on clinical classifications of osteomyelitis and the ensuing treatment algorithm. Given the high patient morbidity, mortality, and economic burden caused by osteomyelitis, it is important to elucidate mechanisms of bone infection to inform novel strategies for prevention and curative treatment. Recent discoveries in this field have identified three distinct reservoirs of bacterial biofilm including: Staphylococcal abscess communities in the local soft tissue and bone marrow, glycocalyx formation on implant hardware and necrotic tissue, and colonization of the osteocyte-lacuno canalicular network (OLCN) of cortical bone. In contrast, S. aureus intracellular persistence in bone cells has not been substantiated in vivo, which challenges this mode of chronic osteomyelitis. There have also been major advances in our understanding of the immune proteome against S. aureus, from clinical studies of serum antibodies and media enriched for newly synthesized antibodies (MENSA), which may provide new opportunities for osteomyelitis diagnosis, prognosis, and vaccine development. Finally, novel therapies such as antimicrobial implant coatings and antibiotic impregnated 3D-printed scaffolds represent promising strategies for preventing and managing this devastating disease. Here, we review these recent advances and highlight translational opportunities towards a cure.

Silver Doping Mechanism in Bioceramics—From Ag+: Doped HAp to Ag°/BCP Nanocomposite

The results presented in this paper, based on the powder X-ray diffraction technique followed by Rietveld analyses, are devoted to the mechanism of silver incorporation in biphasic calcium phosphates. Results were confirmed by SEM observation. Samples were synthesized via the sol-gel route, followed by heat treatments. Two incorporation sites were highlighted: Ca2+ replacement by Ag+ into the calcium phosphates (HAp: hydroxyapatite and β-TCP: tricalcium phosphate), and the other as metallic silver Ag° nanoparticles (formed by autogenous reduction). The samples obtained were thus nanocomposites, written Ag°/BCP, composed of closely-mixed Ag° particles of about 100 nm at 400 °C (which became micrometric upon heating) and calcium phosphates, themselves substituted by Ag+ cations. Between 400 °C and 700 °C the cationic silver part was mainly located in the HAp phase of the composition Ca10-xAgx(PO4)6(OH)2-x (written Ag+: HAp). From 600 °C silver cations migrated to β-TCP to form the definite compound Ca10Ag(PO4)7 (written Ag+: TCP). Due to the melting point of Ag°, the doping element completely left our sample at temperatures above 1000 °C. In order to correctly understand the biological behavior of such material, which is potentially interesting for biomaterial applications, its complex doping mechanism should be taken into consideration for subsequent cytotoxic and bacteriologic studies.

Surface Characteristics and Biological Evaluation of Si-DLC Coatings Fabricated Using Magnetron Sputtering Method on Ti6Al7Nb Substrate

Diamond-like carbon (DLC) coatings are well known as protective coatings for biomedical applications. Furthermore, the incorporation of different elements, such as silicon (Si), in the carbon matrix changes the bio-functionality of the DLC coatings. This has also been proven by the results obtained in this work. The Si-DLC coatings were deposited on the Ti6Al7Nb alloy, which is commonly used in clinical practice, using the magnetron sputtering method. According to the X-ray photoelectron spectroscopy (XPS) analysis, the content of silicon in the examined coatings varied from ~2 at.% up to ~22 at.%. Since the surface characteristics are key factors influencing the cell response, the results of the cells’ proliferation and viability assays (live/dead and XTT (colorimetric assays using tetrazolium salt)) were correlated with the surface properties. The surface free energy (SFE) measurements, Fourier transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS) analysis demonstrated that the polarity and wettability of the surfaces examined increase with increasing Si concentration, and therefore the adhesion and proliferation of cells was enhanced. The results obtained revealed that the biocompatibility of Si-doped DLC coatings, regardless of the Si content, remains at a very high level (the observed viability of endothelial cells is above 70%).

Toward the Development of an Innovative Implant: NiTi Alloy Functionalized by Multifunctional β-TCP+Ag/SiO2 Coatings

In recent years, one of the more important and costly problems of modern medicine is the need to replace or supplement organs in order to improve the quality of human life. In this field, promising solutions seem to have been implants which are based on NiTi alloys with shape memory effects. Unfortunately, this material is susceptible to the corrosion and release of toxic nickel to the human organism. Hence, its application as a long-term material is strongly limited. Therefore, this paper presents a new solution which should help to improve the functionality of the NiTi alloy and elongate its medical stability to use. The idea was focused on functionalization of the implant surface by a biocompatible, multifunctional coating without any impact on the features of the substrate, i.e., the martensitic transformation responsible for shape memory effects. For this purpose, we prepared a colloidal suspension, composed of β-TCP (particle size ∼450 nm) and the Ag/SiO₂ nanocomposite which due to the electrophoretic deposition (EPD) led to the formation of structurally atypical calcium phosphosilicate coating. Those biomaterials formed a crack-free coating, adhering well to the NiTi surface when distributed over the entire surface, with low concentration of metallic and oxide silver (<3 at. %). At the same time, the coat-forming materials had resulted in the growth of a Gram-negative bacterial biofilm. Additionally, the additive of the silver-silica composite enhances cell proliferation, effectively a few times higher than commonly used coat-forming materials (e.g., pure β-TCP).

Study of physico-chemical properties and in vitro antimicrobial activity of hydroxyapatites obtained from bone calcination

Hydroxyapatite was obtained by bone calcinations. To study the calcination process, bovine and porcine bones were first autoclaved to remove fat and other non-bone tissues. They were then heated in an alumina pan in an oxidizing atmosphere of air, where simultaneous thermal analysis curves were recorded. To prepare the hydroxyapatites, bone samples were calcined at 850 °C and 1000 °C using a muffle furnace for 1 h. The obtained materials were powdered using mortar and pestle, and sifted in a sieve (60 mesh) without any additional purification or chemical treatment. The materials obtained were characterized by energy-dispersive X-ray spectroscopy, X-ray diffraction, and Fourier-transform infrared spectroscopy. The antimicrobial properties of these materials were determined through direct contact tests against Staphylococcus aureus. The natural hydroxyapatites obtained by bone calcination inhibited S. aureus growth, with the material obtained by calcination of bovine bones at 1000 °C, showing the best antimicrobial activity. These results indicated that bone wastes can be used to obtain hydroxyapatites with antimicrobial activity.

Review of titanium surface modification techniques and coatings for antibacterial applications

Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. However, implant-related infections remain among the leading reasons for failure. The most critical pathogenic event in the development of infection on biomaterials is biofilm formation, which starts immediately after bacterial adhesion. In the last decade, numerous studies reported the ability of titanium surface modifications and coatings to minimize bacterial adhesion, inhibit biofilm formation and provide effective bacterial killing to protect implanted biomaterials. In the present review, the different strategies to prevent infection onto titanium surfaces are reported: surface modification and coatings by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers. STATEMENT OF SIGNIFICANCE: Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. Microbial infection is one of the main causes of implant failure. Currently, the global infection risk is 2-5% in orthopedic surgery. Numerous solutions exist to render titanium surfaces antibacterial. The LBPS team is an expert on the functionalization of titanium surfaces by using bioactive polymers to improve the biologiocal response. In this review, the different strategies to prevent infection are reported onto titanium and titanium alloy surfaces such as surface modification by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers.

Multifunctional Coatings and Nanotopographies: Toward Cell Instructive and Antibacterial Implants

In biomaterials science, it is nowadays well accepted that improving the biointegration of dental and orthopedic implants with surrounding tissues is a major goal. However, implant surfaces that support osteointegration may also favor colonization of bacterial cells. Infection of biomaterials and subsequent biofilm formation can have devastating effects and reduce patient quality of life, representing an emerging concern in healthcare. Conversely, efforts toward inhibiting bacterial colonization may impair biomaterial-tissue integration. Therefore, to improve the long-term success of medical implants, biomaterial surfaces should ideally discourage the attachment of bacteria without affecting eukaryotic cell functions. However, most current strategies seldom investigate a combined goal. This work reviews recent strategies of surface modification to simultaneously address implant biointegration while mitigating bacterial infections. To this end, two emerging solutions are considered, multifunctional chemical coatings and nanotopographical features.

TC4/Ag Metal Matrix Nanocomposites Modified by Friction Stir Processing: Surface Characterization, Antibacterial Property, and Cytotoxicity in Vitro

Numerous antibacterial biomaterials have been developed, but a majority of them suffer from poor biocompatibility. With the purpose of reducing biomaterial-related infection and cytotoxicity, friction stir processing (FSP) was employed to embed silver nanoparticles (Ag NPs) in a Ti-6Al-4V (TC4) substrate. Characterization using scanning electron microscopy, transmission electron microscopy, and three-dimensional atom probe tomography illustrates that NPs are distributed more homogeneously on the surface of TC4 as the groove depth increases, and silver-rich NPs with a size from 10 to 20 nm exist as metallic silver diffused into the substrate, where the silver content is 4.3-5.6%. Electrochemical impedance spectroscopy shows that both FSP and the addition of silver have positive effects on corrosion resistance. The modified samples effectively inhibit both Staphylococcus aureus and Escherichia coli strains and slightly reduce their adhesion while not displaying any cytotoxicity to bone mesenchymal stem cells in vitro. The antibacterial effect is independent of Ag-ion release and is likely due to the number of embedded silver NPs on the surface, which directly contact and subsequently destroy the cell membrane. Our study shows that the TC4/Ag metal matrix nanocomposite is a potential infection-related biomaterial and that embedding Ag NPs tightly on a biomaterial surface is an effective strategy for striking a balance between the antibacterial effect and biocompatibility, providing an innovative approach for accurately controlling the cytotoxicity of infection-related biomaterials.

Coatings as the useful drug delivery system for the prevention of implant-related infections

Implant-related infections (IRIs) which led to a large amount of medical expenditure were caused by bacteria and fungi that involve the implants in the operation or in ward. Traditional treatments of IRIs were comprised of repeated radical debridement, replacement of internal fixators, and intravenous antibiotics. It needed a long time and numbers of surgeries to cure, which meant a catastrophe to patients. So how to prevent it was more important than to cure it. As an excellent local release system, coating is a good idea by its local drug infusion and barrier effect on resisting biofilms which were the main cause of IRIs. So in this review, materials used for coatings and evidences of prevention were elaborated.

Bioceramic Layers with Antifungal Properties

The sol-gel method was used to synthesize the silver doped hydroxyapatite (Ag:HAp) gels in order to produce the antifungal composite layers. The pure Ti disks were used as the substrate for the composite layers. Important information about suspensions used to make Ag:HAp composite layers were obtained from an ultrasonic technique. The identification of the phase composition of the Ag:HAp composite layers was accomplished X-ray diffraction (XRD). The morphology and the thickness of the layers was evaluated using scanning electron microscopy (SEM). The uniform distribution of the constituent elements (Ag, Ca, P, and O) in both analyzed samples was observed. The antifungal activity of the samples against Candida albicans ATCC 10231 microbial strain were investigated immediately after their preparation and six months later. SEM and confocal laser scanning microscopy (CLSM) images showed that the composite layers at the two time intervals exhibited a strong antifungal activity against Candida albicans ATCC 10231 and completely inhibited the biofilm formation.

Facile hydrothermal synthesis of antibacterial multi-layered hydroxyapatite nanostructures with superior flexibility

The synthesis of silver-doped multi-layered hydroxyapatite nanobelts is of great importance due to their being a potential candidate to curb the infections associated with HA implants along with their advantage as a reinforcement in biomaterials.

Biocompatibility of Titania Nanotube Coatings Enriched with Silver Nanograins by Chemical Vapor Deposition

Bioactivity investigations of titania nanotube (TNT) coatings enriched with silver nanograins (TNT/Ag) have been carried out. TNT/Ag nanocomposite materials were produced by combining the electrochemical anodization and chemical vapor deposition methods. Fabricated coatings were characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopy. The release effect of silver ions from TNT/Ag composites immersed in bodily fluids, has been studied using inductively coupled plasma mass spectrometry (ICP-MS). The metabolic activity assay (MTT) was applied to determine the L929 murine fibroblasts adhesion and proliferation on the surface of TNT/Ag coatings. Moreover, the results of immunoassays (using peripheral blood mononuclear cells-PBMCs isolated from rats) allowed the estimation of the immunological activity of TNT/Ag surface materials. Antibacterial activity of TNT/Ag coatings with different morphological and structural features was estimated against two Staphylococcus aureus strains (ATCC 29213 and H9). The TNT/Ag nanocomposite layers produced revealed a good biocompatibility promoting the fibroblast adhesion and proliferation. A desirable anti-biofilm activity against the S. aureus reference strain was mainly noticed for these TiO₂ nanotube coatings, which contain dispersed Ag nanograins deposited on their surface.

Antibacterial activity of agricultural waste derived wollastonite doped with copper for bone tissue engineering

Bioactive ceramic materials with metal ions generation brought great attention in the class of biomaterials development and widely employed as a filler material for bone tissue regeneration. The present study aimed to fabricate calcium silicate based ceramic material doped with copper metal particles by sol-gel method. Rice straw of agricultural waste was utilized as a source material to synthesize wollastonite, then wollastonite was doped with copper to fabricate copper doped wollastonite (Cu-Ws) particles. The synthesized materials were subjected to physio-chemical characterization by TEM, DLS, FTIR, XRD and DSC analysis. It was found that the sizes of the WS particles was around 900nm, while adding copper the size was increased upto 1184nm and the addition of copper to the material sharpening the peak. The release of Cu ions was estimated by ICP analysis. The anti-bacterial potentiality of the particles suggested that better microbial growth inhibition against E. coli (Gram negative) and S. aureus (Gram positive) strains from ATCC, in which the growth inhibition was more significant against S. aureus. The biocompatibility in mouse Mesenchymal Stem cells (mMSC) showed the non-toxic effect up to 0.05mg/ml concentration while the increase in concentration was found to be toxic to the cells. So the particles may have better potential application with the challenging prevention of post implantation infection in the field of bone tissue engineering (BTE).

Mediating bone regeneration by means of drug eluting implants: From passive to smart strategies

In addition to excellent biocompatibility and mechanical performance, the new generation of bone and craniofacial implants are expected to proactively contribute to the regeneration process and dynamically interact with the host tissue. To this end, integration and sustained delivery of therapeutic agents has become a rapidly expanding area. The incorporated active molecules can offer supplementary features including promoting oteoconduction and angiogenesis, impeding bacterial infection and modulating host body reaction. Major limitations of the current practices consist of low drug stability overtime, poor control of release profile and kinetics as well as complexity of finding clinically appropriate drug dosage. In consideration of the multifaceted cascade of bone regeneration process, this research is moving towards dual/multiple drug delivery, where precise control on simultaneous or sequential delivery, considering the possible synergetic interaction of the incorporated bioactive factors is of utmost importance. Herein, recent advancements in fabrication of synthetic load bearing implants equipped with various drug delivery systems are reviewed. Smart drug delivery solutions, newly developed to provide higher tempo-spatial control on the delivery of the pharmaceutical agents for targeted and stimuli responsive delivery are highlighted. The future trend of implants with bone drug delivery mechanisms and the most common challenges hindering commercialization and the bench to bedside progress of the developed technologies are covered.

Electrophoretic Deposition of Chitosan Coatings Modified with Gelatin Nanospheres To Tune the Release of Antibiotics

Orthopedic and dental implants are increasingly used in the medical field in view of their high success rates. Implant-associated infections, however, still occur and are difficult to treat. To combat these infections, the application of an active coating to the implant surface is advocated as an effective strategy to facilitate sustained release of antibacterial drugs from implant surfaces. Control over this release is, however, still a major challenge. To overcome this problem, we deposited composite coatings composed of a chitosan matrix containing gelatin nanospheres loaded with antibiotics onto stainless steel plates by means of the electrophoretic deposition technique. The gelatin nanospheres were distributed homogeneously throughout the coatings. The surface roughness and wettability of the coatings could be tuned by a simple adjustment of the weight ratio between the gelatin nanospheres and chitosan. Vancomycin and moxifloxacin were released in sustained and burst-type manners, respectively, while the coatings were highly cytocompatible. The antibacterial efficacy of the coatings containing different amounts of antibiotics was tested using a zone of inhibition test against Staphylococcus aureus, which showed that the coatings containing moxifloxacin exhibited an obvious inhibition zone. The coatings containing a high amount of vancomycin were able to kill bacteria in direct contact with the implant surface. These results suggest that the antibacterial capacity of metallic implants can be tuned by orthogonal control over the release of (multiple) antibiotics from electrophoretically deposited composite coatings, which offers a new strategy to prevent orthopedic implant-associated infections.

Antimicrobial activity and biologic potential of silver-substituted calcium phosphate constructs produced with self-propagating high-temperature synthesis

There is significant demand for synthetic bone substitute materials that can decrease the incidence of implant-based bacterial infections. The intent of this research was to evaluate the antimicrobial activity and biologic potential of calcium phosphate (CaP) constructs substituted with silver (Ag) that were produced via self-propagating high-temperature synthesis (SHS). SHS is a combustion synthesis technique that has successfully generated porous CaP bioceramics intended for use in bone repair. SHS reactions are highly versatile; dopants can be added to the reactant powders to alter product chemistry and morphology. In this research, Ag powder was added to the reactants generating porous CaP constructs containing 0.5, 1, or 2 wt% Ag. Antibacterial performance of the constructs was assessed against Escherichia coli, a representative model for Gram-negative bacteria. Liquid solutions (1 μg/mL) of CaP-Ag particles to phosphate buffered saline were incubated with 10(5) cells/mL. After 24 h, 10 μL of solution were spread on an LB agar plate and cultured for 24 h at 37 °C. Samples cultured with CaP-Ag showed complete bacterial inhibition while the controls (E. coli only and CaP without Ag) exhibited significant colony formation. The effects of Ag concentration on cytotoxicity and biocompatibility were tested in vitro. At 7 days, osteoblasts uniformly enveloped the CaP-Ag particles and displayed a healthy flattened morphology suggesting the concentrations of Ag incorporated into constructs were not cytotoxic. CaP-Ag constructs produced via SHS represent a source of synthetic bone substitute materials that could potentially inhibit, or reduce the incidence of post-operative bacterial infections.

Influence of Silver-hydroxyapatite Nanocomposite Coating on Biofilm Formation of Joint Prosthesis and Its Mechanism

Background

The main reason for biomaterial related refractory infections is biofilm formation caused by bacterial adhesion on the surface of materials. Silver-hydroxyapatite (Ag/HA) nanocomposite coating can inhibit the formation of biofilm, but its mechanism is not clear.

Material and method

In order to clarify the mechanism, the amounts of biofilm on the Ag/HA composite coating and HA coating were determined, the release rates of silver nanoparticles in simulated body fluid (SBF) were detected by atomic absorption spectrometry, and the expression values of atlE, fbe, sap, iapB genes of Staphylococcus aureus were studied when they grew on Ag/HA composite coating and HA coating.

Results

The amount of the biofilm on the Ag/HA composite coating was significantly less than that on the HA coating, and the bacterial adhesion was decreased. The silver nanoparticles were released continuously in SBF and the release rate decreased gradually with time. The expression values of atlE, fbe and sap were high in the initial stage of adhesion and the expression value of iapB was high in the colonies-gathering stage in the control group, but they were all significantly inhibited in the presence of Ag.

Conclusion

These results indicated that the main antibacterial effect of Ag/HA composite coating was achieved by the release of silver nanoparticles. The addition of Ag inhibited the expression of genes related to biofilm formation, which in turn inhibited the formation of biofilms. This provided theoretical support for the clinical application of Ag/HA composite coating.

Multifunctional coatings to simultaneously promote osseointegration and prevent infection of orthopaedic implants

The two leading causes of failure for joint arthroplasty prostheses are aseptic loosening and periprosthetic joint infection. With the number of primary and revision joint replacement surgeries on the rise, strategies to mitigate these failure modes have become increasingly important. Much of the recent work in this field has focused on the design of coatings either to prevent infection while ignoring bone mineralization or vice versa, to promote osseointegration while ignoring microbial susceptibility. However, both coating functions are required to achieve long-term success of the implant; therefore, these two modalities must be evaluated in parallel during the development of new orthopaedic coating strategies. In this review, we discuss recent progress and future directions for the design of multifunctional orthopaedic coatings that can inhibit microbial cells while still promoting osseointegration.