Effects of different sterilization techniques and varying anodized TiO₂ nanotube dimensions on bacteria growth

Insight into antibacterial effect of titanium nanotubular surfaces with focus on Staphylococcus aureus and Pseudomonas aeruginosa

Materials used for orthopedic implants should not only have physical properties close to those of bones, durability and biocompatibility, but should also exhibit a sufficient degree of antibacterial functionality. Due to its excellent properties, titanium is still a widely used material for production of orthopedic implants, but the unmodified material exhibits poor antibacterial activity. In this work, the physicochemical characteristics, such as chemical composition, crystallinity, wettability, roughness, and release of Ti ions of the titanium surface modified with nanotubular layers were analyzed and its antibacterial activity against two biofilm-forming bacterial strains responsible for prosthetic joint infection (Staphylococcus aureus and Pseudomonas aeruginosa) was investigated. Electrochemical anodization (anodic oxidation) was used to prepare two types of nanotubular arrays with nanotubes differing in dimensions (with diameters of 73 and 118 nm and lengths of 572 and 343 nm, respectively). These two surface types showed similar chemistry, crystallinity, and surface energy. The surface with smaller nanotube diameter (TNT-73) but larger values of roughness parameters was more effective against S. aureus. For P. aeruginosa the sample with a larger nanotube diameter (TNT-118) had better antibacterial effect with proven cell lysis. Antibacterial properties of titanium nanotubular surfaces with potential in implantology, which in our previous work demonstrated a positive effect on the behavior of human gingival fibroblasts, were investigated in terms of surface parameters. The interplay between nanotube diameter and roughness appeared critical for the bacterial fate on nanotubular surfaces. The relationship of nanotube diameter, values of roughness parameters, and other surface properties to bacterial behavior is discussed in detail. The study is believed to shed more light on how nanotubular surface parameters and their interplay affect antibacterial activity.

TiO2 nanotubes as an antibacterial nanotextured surface for dental implants: Systematic review and meta-analysis

OBJECTIVES

Nanotechnology is constantly advancing in dental science, progressing several features aimed at improving dental implants. An alternative for surface treatment of dental implants is electrochemical anodization, which may generate a nanotubular surface (TiO2 nanotubes) with antibacterial potential and osteoinductive features. This systematic review and meta-analysis aims to elucidate the possible antibacterial properties of the surface in question compared to the untreated titanium surface.

SOURCES

For that purpose, was performed a systematic search on the bases PubMed, Lilacs, Embase, Web Of Science, Cinahl, and Cochrane Central, as well as, manual searches and gray literature.

STUDY SELECTION

The searches resulted in 742 articles, of which 156 followed for full-text reading. Then, 37 were included in the systematic review and 8 were included in meta-analysis.

RESULTS

Fifteen studies revealed significant antibacterial protection using TiO2 nanotube surfaces, while 15 studies found no statistical difference between control and nanotextured surfaces. Meta-analysis of in vitro studies demonstrated relevant bacterial reduction only for studies investigating Staphylococcus aureus in a period of 6 h. Meta-analysis of in vivo studies revealed three times lower bacterial adhesion and proliferation on TiO2 nanotube surfaces.

CONCLUSIONS

TiO2 nanotube topography as a surface for dental implants in preclinical research has demonstrated a positive relationship with antibacterial properties, nevertheless, factors such as anodization protocols, bacteria strains, and mono-culture methods should be taken into consideration, consequently, further studies are necessary to promote clinical translatability.

Biological effects of gamma-ray sterilization on 3 mol% yttria-stabilized tetragonal zirconia polycrystal: An in vitro study

STATEMENT OF PROBLEM

Selecting the sterilization method is important because sterilization can alter the surface chemistry of implant materials, including zirconia, and influence their cellular biocompatibility. Studies on the biological effects of sterilization on implant materials are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the biocompatibility of gamma-ray irradiated 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) compared with unirradiated titanium, 3Y-TZP, and pure gold.

MATERIAL AND METHODS

Disk-shaped specimens each of commercially pure grade 4 titanium, 3Y-TZP, gamma-rayed 3Y-TZP, and pure gold were prepared and evaluated for osteogenic potential by using a clonal murine cell line of immature osteoblasts derived from mice (MC3T3-E1 cells). The surface topography (n=3), chemical analysis of the disks (n=3), and cell morphology cultured on these surfaces were examined using scanning electron microscopy, confocal laser scanning microscopy, and energy dispersive spectroscopy. Cellular biocompatibility was analyzed for 1 and 3 days after seeding. Cell adhesion and spreading were evaluated using confocal laser scanning microscopy (n=3). Cell proliferation was evaluated using methyl thiazolyl tetrazolium assay (n=3). Kruskal-Wallis and Bonferroni corrections were used to evaluate the statistical significance of the intergroup differences (α=.05).

RESULTS

Gamma-ray sterilization of 3Y-TZP showed significantly higher surface roughness compared with titanium and gold (P<.002). On day 1, the proliferation and adhesion of MC3T3-E1 cells cultured on gamma-rayed 3Y-TZP were significantly higher than those cultured on gold (P<.05); however, cell spreading was significantly lower than that of titanium on days 1 and 3 (P<.05). On day 3, cell proliferation of gamma-rayed 3Y-TZP was significantly lower than that of unirradiated 3Y-TZP (P<.05). Cell adhesion of gamma-rayed 3Y-TZP was slightly lower than that of zirconia and titanium but without significant difference (P>.05).

CONCLUSIONS

Gamma-rayed zirconia exhibited increased surface roughness compared with titanium and significantly decreased bioactivity compared with titanium and zirconia. The use of gamma-ray sterilization on zirconia is not promising regarding biocompatibility, and the effect of this sterilization method on implant materials warrants further investigation.

Mass Spectral Imaging to Map Plant-Microbe Interactions

Plant-microbe interactions are of rising interest in plant sustainability, biomass production, plant biology, and systems biology. These interactions have been a challenge to detect until recent advancements in mass spectrometry imaging. Plants and microbes interact in four main regions within the plant, the rhizosphere, endosphere, phyllosphere, and spermosphere. This mini review covers the challenges within investigations of plant and microbe interactions. We highlight the importance of sample preparation and comparisons among time-of-flight secondary ion mass spectroscopy (ToF-SIMS), matrix-assisted laser desorption/ionization (MALDI), laser desorption ionization (LDI/LDPI), and desorption electrospray ionization (DESI) techniques used for the analysis of these interactions. Using mass spectral imaging (MSI) to study plants and microbes offers advantages in understanding microbe and host interactions at the molecular level with single-cell and community communication information. More research utilizing MSI has emerged in the past several years. We first introduce the principles of major MSI techniques that have been employed in the research of microorganisms. An overview of proper sample preparation methods is offered as a prerequisite for successful MSI analysis. Traditionally, dried or cryogenically prepared, frozen samples have been used; however, they do not provide a true representation of the bacterial biofilms compared to living cell analysis and chemical imaging. New developments such as microfluidic devices that can be used under a vacuum are highly desirable for the application of MSI techniques, such as ToF-SIMS, because they have a subcellular spatial resolution to map and image plant and microbe interactions, including the potential to elucidate metabolic pathways and cell-to-cell interactions. Promising results due to recent MSI advancements in the past five years are selected and highlighted. The latest developments utilizing machine learning are captured as an important outlook for maximal output using MSI to study microorganisms.

Antioxidation Effect of Graphene Oxide on Silver Nanoparticles and Its Use in Antibacterial Applications

Silver nanoparticles (AgNPs) have drawn great attention due to their outstanding antibacterial effect in a wide range of applications, such as biomass packaging materials, wound dressings, flexible sensors, etc. However, the oxidation of AgNPs limits the antibacterial effect. Firstly, the effects of pretreatment methods on the antibacterial property of AgNPs were investigated by the shake flask method and agar diffusion plate method. Secondly, graphene oxide/silver nanoparticle (GO/AgNPs) nanocomposite prepared by an in-situ growth method was used as antibacterial filler for polyacrylate emulsion via a blending method. The antibacterial mechanism of GO/AgNPs was revealed by comparing the actual contents of oxygen with the theoretically calculated contents of oxygen. Finally, the polyacrylate/graphene oxide/silver nanoparticles (PA/GO/AgNPs) composite emulsion was applied onto a leather surface using a layer-by-layer spraying method to improve the leather's antibacterial properties. The results showed that ultraviolet irradiation could better maintain the antibacterial property of AgNPs, while GO could improve the dispersibility of AgNPs and prevent their oxidation. The leather finished with the PA/GO/AgNPs-2 wt% composite emulsion showed the highest bacteriostatic rate of 74%, demonstrating its great potential in the application of antibacterial leather products.

Influence of Different Sterilization Methods on the Surface Chemistry and Electrochemical Behavior of Biomedical Alloys

Sterilization is a prerequisite for biomedical devices before contacting the human body. It guarantees the lack of infection by eliminating microorganisms (i.e., bacteria, spores and fungi). It constitutes the last fabrication process of a biomedical device. The aim of this paper is to understand the effect of different sterilization methods (ethanol-EtOH, autoclave-AC, autoclave + ultraviolet radiation-ACUV and gamma irradiation-G) on the surface chemistry and electrochemical reactivity (with special attention on the kinetics of the oxygen reduction reaction) of CoCrMo and titanium biomedical alloys used as prosthetic materials. To do that, electrochemical measurements (open circuit potential, polarization resistance, cathodic potentiodynamic polarization and electrochemical impedance spectroscopy) and surface analyses (Auger Electron Spectroscopy) of the sterilized surfaces were carried out. The obtained results show that the effect of sterilization on the corrosion behavior of biomedical alloys is material-dependent: for CoCrMo alloys, autoclave treatment increases the thickness and the chromium content of the passive film increasing its corrosion resistance compared to simple sterilization in EtOH, while in titanium and its alloys, autoclave and UV-light accelerates its corrosion rate by accelerating the kinetics of oxygen reduction.

Transcriptomic hallmarks of in vitro TiO2 nanotubes toxicity in Chlamydomonas reinhardtii

Recently, more accessible transcriptomic approaches have provided a new and deeper understanding of environmental toxicity. The present study focuses on the transcriptomic profiles of green microalgae Chlamydomonas reinhardtii exposed to new industrially promising material, TiO₂ nanotubes (NTs), as an example of a widely used one-dimensional nanomaterial. The first algal in vitro assay included 2.5 and 7.5 mg/L TiO₂ NTs, resulting in a dose-dependent negative effect on biological endpoints. At a working concentration of 7.5 mg/L, RNA-sequencing showed a mainly negative effect on the cells. In summary, the results indicated metabolic disruption, ^{such as ATP loss, damage to mitochondria and chloroplasts, loss of solutes due to permeated membranes,} and cell wall damage. Moreover, apoptosis-induced transcripts were detected. Interestingly, reactivation of transposons was observed. In signalling and transcription pathways, including chromatin remodelling and locking, the annotated genes were downregulated.

Fabrication of Antibacterial TiO2 Nanostructured Surfaces Using the Hydrothermal Method

Implant-associated infections (IAI) are a common cause for implant failure, increased medical costs, and critical for patient healthcare. Infections are a result of bacterial colonization, which leads to biofilm formation on the implant surface. Nanostructured surfaces have been shown to have the potential to inhibit bacterial adhesion mainly due to antibacterial efficacy of their unique surface nanotopography. The change in topography affects the physicochemical properties of their surface such as surface chemistry, morphology, wettability, surface charge, and even electric field which influences the biological response. In this study, a conventional and cost-effective hydrothermal method was used to fabricate nanoscale protrusions of various dimensions on the surface of Ti, Ti₆Al₄V, and NiTi materials, commonly used in biomedical applications. The morphology, surface chemistry, and wettability were analyzed using scanning electron microscopy (SEM), X-ray photoemission spectroscopy (XPS), and water contact angle analysis. The antibacterial efficacy of the synthesized nanostructures was analyzed by the use of Escherichia coli bacterial strain. XPS analysis revealed that the concentration of oxygen and titanium increased on Ti and Ti₆Al₄V, which indicates that TiO₂ is formed on the surface. The concentration of oxygen and titanium however decreased on the NiTi surface after hydrothermal treatment, and also a small amount of Ni was detected. SEM analysis showed that by hydrothermal treatment alterations in the surface topography of the TiO₂ layer could be achieved. The oxide layer on the NiTi prepared by the hydrothermal method contains a low amount of Ni (2.8 atom %), which is especially important for implantable materials. The results revealed that nanostructured surfaces significantly reduced bacterial adhesion on the Ti, Ti₆Al₄V, and NiTi surface compared to the untreated surfaces used as a control. Furthermore, two sterilization techniques were also studied to evaluate the stability of the nanostructure and its influence on the antibacterial activity. Sterilization with UV light seems to more efficiently inhibit bacterial growth on the hydrothermally modified Ti₆Al₄V surface, which was further reduced for hydrothermally treated Ti and NiTi. The developed nanostructured surfaces of Ti and its alloys can pave a way for the fabrication of antibacterial surfaces that reduce the likelihood of IAI.

Cytoprotection of Human Progenitor and Stem Cells through Encapsulation in Alginate Templated, Dual Crosslinked Silk and Silk-Gelatin Composite Hydrogel Microbeads

Susceptibility of mammalian cells against harsh processing conditions limit their use in cell transplantation and tissue engineering applications. Besides modulation of the cell microenvironment, encapsulation of mammalian cells within hydrogel microbeads attract attention for cytoprotection through physical isolation of the encapsulated cells. The hydrogel formulations used for cell microencapsulation are largely dominated by ionically crosslinked alginate (Alg), which suffer from low structural stability under physiological culture conditions and poor cell-matrix interactions. Here the fabrication of Alg templated silk and silk/gelatin composite hydrogel microspheres with permanent or on-demand cleavable enzymatic crosslinks using simple and cost-effective centrifugation-based droplet processing are demonstrated. The composite microbeads display structural stability under ion exchange conditions with improved mechanical properties compared to ionically crosslinked Alg microspheres. Human mesenchymal stem and neural progenitor cells are successfully encapsulated in the composite beads and protected against environmental factors, including exposure to polycations, extracellular acidosis, apoptotic cytokines, ultraviolet (UV) irradiation, anoikis, immune recognition, and particularly mechanical stress. The microbeads preserve viability, growth, and differentiation of encapsulated stem and progenitor cells after extrusion in viscous polyethylene oxide solution through a 27-gauge fine needle, suggesting potential applications in injection-based delivery and three-dimensional bioprinting of mammalian cells with higher success rates.

Topographical changes and bactericidal efficacy of antimicrobial photodynamic therapy on titanium implant surface

BACKGROUND

A lot of research has been done on various disinfection modalities used to achieve an aseptic implant surface. However, the bacterial efficacy and the topographical alterations resulting from the use of these techniques have never been compared.

OBJECTIVE

This study aimed to evaluate and compare the disinfection efficacy and surface changes on a bacteria contaminated titanium block following application of various disinfectants.

METHOD

Ultrasonically cleaned titanium blocks were contaminated with Porphyromonas gingivalis and Tannerella forsythia. The infected titanium implants were randomly divided into four experimental groups and decontaminated using antimicrobial photodynamic therapy (aPDT), laser therapy, chlorhexidine and hydrogen peroxide. Bacterial viability and surface changes following decontamination were analyzed.

RESULT

Bacterial viability decreased in all the groups with aPDT having the highest reduction. Surface roughness remained unchanged whereas the contact angle lessened in the aPDT group.

CONCLUSION

aPDT could possibly be a suitable alternative to other disinfection regimen to treat periimplantitis.

Nanostructured Modifications of Titanium Surfaces Improve Vascular Regenerative Properties of Exosomes Derived from Mesenchymal Stem Cells: Preliminary In Vitro Results

(1) Background: Implantation of metal-based scaffolds is a common procedure for treating several diseases. However, the success of the long-term application is limited by an insufficient endothelialization of the material surface. Nanostructured modifications of metal scaffolds represent a promising approach to faster biomaterial osteointegration through increasing of endothelial commitment of the mesenchymal stem cells (MSC). (2) Methods: Three different nanotubular Ti surfaces (TNs manufactured by electrochemical anodization with diameters of 25, 80, or 140 nm) were seeded with human MSCs (hMSCs) and their exosomes were isolated and tested with human umbilical vein endothelial cells (HUVECs) to assess whether TNs can influence the secretory functions of hMSCs and whether these in turn affect endothelial and osteogenic cell activities in vitro. (3) Results: The hMSCs adhered on all TNs and significantly expressed angiogenic-related factors after 7 days of culture when compared to untreated Ti substrates. Nanomodifications of Ti surfaces significantly improved the release of hMSCs exosomes, having dimensions below 100 nm and expressing CD63 and CD81 surface markers. These hMSC-derived exosomes were efficiently internalized by HUVECs, promoting their migration and differentiation. In addition, they selectively released a panel of miRNAs directly or indirectly related to angiogenesis. (4) Conclusions: Preconditioning of hMSCs on TNs induced elevated exosomes secretion that stimulated in vitro endothelial and cell activity, which might improve in vivo angiogenesis, supporting faster scaffold integration.

Validation of a cariogenic biofilm model by evaluating the effect of fluoride on enamel demineralization

In vitro biofilm models have been extensively used, but only few of the models available to date had been validated in terms of the dose-response effect of anti-caries and/or antimicrobial substances. Additionally, none of the validated models allow the use of microliter volumes of the treatment solutions, needed mainly to test (screen) novel but expensive substances under development. This study aimed at modifying an in vitro cariogenic Streptococcus mutans biofilm model and validating it by assessing the dose-response effect of fluoride on enamel demineralization. S. mutans cariogenic biofilms were developed on saliva-coated enamel slabs previously bonded to acrylic holders fixed to a lid of a culture plate. Biofilms were incubated 8 h/day in culture medium supplemented with 1% sucrose and then overnight in culture medium with glucose 0.1 mM. Biofilms were also treated 2×/day with 2.0 mL of solutions containing 0, 125, 275 and 1250 μg F/mL (n = 10/group). The replaced culture medium was used to: determine the biofilm acidogenicity; estimate the demineralization of enamel; and monitor the fluoride concentration. At 144 h, biofilms were collected for fluoride concentration analyses, and the fluoride uptake by enamel was determined in each slab. The model showed a dose-response effect of fluoride (R² = 0.96, p < 0.001) between enamel demineralization and the fluoride concentration of the treatments. Water-soluble and bound biofilm fluoride concentrations (p < 0.007), as well as the firmly-bound fluoride concentration found in enamel (p < 0.0001), increased in a dose-dependent manner. Our model constitutes a validated approach that would allow the assessment of the anticaries potential of novel biotechnological strategies, as in the case of expensive salivary peptides, because it would allow to test the treatment solutions using smaller volumes.

Weissella confusa with thermostable β-hemolytic exopolysaccharide

Consuming cooked meat contaminated with bacteria that carry thermostable hemolytic exopolysaccharide (ESP), could lead to severe diseases. Culture of a 5- h boiled sample of meat goulash on blood agar showed growth of a gram positive rod-shaped, mucoid and hemolytic bacterium. Biochemical tests and amplification of 1500 bp product of 16S rDNA and sequencing revealed bacterial identity as Weissella confusa. After 1 h boiling of bacterial suspension, they were alive and hemolytic, increased in volume and aggregated. After 8 h boiling of bacterial suspension with coverslip, live bacteria showed hemolysis, clustered and adhered to coverslip. Bacterial bacteriocin and hemolytic activities remained unchanged upon autoclaving. Purified bacterial EPS retained hemolytic activity after autoclaving. Boiling contaminated meat had no negative impact on viability of heat-stable W. confusa and its hemolytic EPS. Thermostable hemolytic EPS protected W. confusa from excessive heat. Hygienic practice in butcheries and kitchens are necessary to eliminate bacterial contaminants.

Microbial Decontamination and Antibacterial Activity of Nanostructured Titanium Dental Implants: A Narrative Review

Peri-implantitis is the major cause of the failure of dental implants. Since dental implants have become one of the main therapies for teeth loss, the number of patients with peri-implant diseases has been rising. Like the periodontal diseases that affect the supporting tissues of the teeth, peri-implant diseases are also associated with the formation of dental plaque biofilm, and resulting inflammation and destruction of the gingival tissues and bone. Treatments for peri-implantitis are focused on reducing the bacterial load in the pocket around the implant, and in decontaminating surfaces once bacteria have been detached. Recently, nanoengineered titanium dental implants have been introduced to improve osteointegration and provide an osteoconductive surface; however, the increased surface roughness raises issues of biofilm formation and more challenging decontamination of the implant surface. This paper reviews treatment modalities that are carried out to eliminate bacterial biofilms and slow their regrowth in terms of their advantages and disadvantages when used on titanium dental implant surfaces with nanoscale features. Such decontamination methods include physical debridement, chemo-mechanical treatments, laser ablation and photodynamic therapy, and electrochemical processes. There is a consensus that the efficient removal of the biofilm supplemented by chemical debridement and full access to the pocket is essential for treating peri-implantitis in clinical settings. Moreover, there is the potential to create ideal nano-modified titanium implants which exert antimicrobial actions and inhibit biofilm formation. Methods to achieve this include structural and surface changes via chemical and physical processes that alter the surface morphology and confer antibacterial properties. These have shown promise in preclinical investigations.

Research to Clinics: Clinical Translation Considerations for Anodized Nano-Engineered Titanium Implants

Titania nanotubes (TNTs) fabricated on titanium orthopedic and dental implants have shown significant potential in "proof of concept" in vitro, ex vivo, and short-term in vivo studies. However, most studies do not focus on a clear direction for future research towards clinical translation, and there exists a knowledge gap in identifying key research challenges that must be addressed to progress to the clinical setting. This review focuses on such challenges with respect to anodized titanium implants modified with TNTs, including optimized fabrication on clinically utilized microrough surfaces, clinically relevant bioactivity assessments, and controlled/tailored local release of therapeutics. Further, long-term in vivo investigations in compromised animal models under loading conditions are needed. We also discuss and detail challenges and progress related to the mechanical stability of TNT-based implants, corrosion resistance/electrochemical stability, optimized cleaning/sterilization, packaging/aging, and nanotoxicity concerns. This extensive, clinical translation focused review of TNTs modified Ti implants aims to foster improved understanding of key research gaps and advances, informing future research in this domain.

Insights into Terminal Sterilization Processes of Nanoparticles for Biomedical Applications

Nanoparticles possess a huge potential to be employed in numerous biomedical purposes; their applications may include drug delivery systems, gene therapy, and tissue engineering. However, the in vivo use in biomedical applications requires that nanoparticles exhibit sterility. Thus, diverse sterilization techniques have been developed to remove or destroy microbial contamination. The main sterilization methods include sterile filtration, autoclaving, ionizing radiation, and nonionizing radiation. Nonetheless, the sterilization processes can alter the stability, zeta potential, average particle size, and polydispersity index of diverse types of nanoparticles, depending on their composition. Thus, these methods may produce unwanted effects on the nanoparticles' characteristics, affecting their safety and efficacy. Moreover, each sterilization method possesses advantages and drawbacks; thus, the suitable method's choice depends on diverse factors such as the formulation's characteristics, batch volume, available methods, and desired application. In this article, we describe the current sterilization methods of nanoparticles. Moreover, we discuss the advantages and drawbacks of these methods, pointing out the changes in nanoparticles' biological and physicochemical characteristics after sterilization. Our main objective was to offer a comprehensive overview of terminal sterilization processes of nanoparticles for biomedical applications.

Mixed oxide nanotubes in nanomedicine: A dead-end or a bridge to the future?

Nanomedicine has seen a significant rise in the development of new research tools and clinically functional devices. In this regard, significant advances and new commercial applications are expected in the pharmaceutical and orthopedic industries. For advanced orthopedic implant technologies, appropriate nanoscale surface modifications are highly effective strategies and are widely studied in the literature for improving implant performance. It is well-established that implants with nanotubular surfaces show a drastic improvement in new bone creation and gene expression compared to implants without nanotopography. Nevertheless, the scientific and clinical understanding of mixed oxide nanotubes (MONs) and their potential applications, especially in biomedical applications are still in the early stages of development. This review aims to establish a credible platform for the current and future roles of MONs in nanomedicine, particularly in advanced orthopedic implants. We first introduce the concept of MONs and then discuss the preparation strategies. This is followed by a review of the recent advancement of MONs in biomedical applications, including mineralization abilities, biocompatibility, antibacterial activity, cell culture, and animal testing, as well as clinical possibilities. To conclude, we propose that the combination of nanotubular surface modification with incorporating sensor allows clinicians to precisely record patient data as a critical contributor to evidence-based medicine.

Effect of surface characteristics on the antibacterial properties of titanium dioxide nanotubes produced in aqueous electrolytes with carboxymethyl cellulose

Nanotubular structures were produced on a commercially pure titanium surface by anodization in an aqueous electrolyte that contained carboxymethyl cellulose and sodium fluoride. The internal diameters obtained were about 100, 48, and 9.5 nm, respectively. Several heat treatments at 200, 350, and 600°C were made to produce nanotubes with different titanium dioxide polymorphs (anatase, rutile). All tested surfaces were superhydrophilic, this behavior was maintained after at least 30 days, regardless of the heat treatment. Although in previous works the nanotube features effect on the bacteria behavior had been studied; this item still unclear. For the best of our knowledge, the effect of small internal diameters (about 10 nm) with and without heat treatment and with and without ultraviolet (UV) irradiation on the bacteria strains comportment has not been reported. From our results, both the internal diameter and the postanodized treatments have an effect on the bacteria strains comportment. All nanotubular coatings UV treated and heat treated at 350 and 600°C; despite they have different inner diameters, inhibit the bacteria growth of both Staphylococcus aureus and Pseudomonas aeruginosa strains. The nanotubular coatings obtained at 20 V and heat treated at 350°C produced the lower bacteria adhesion against both strains evaluated.

Drug Delivery Systems Based on Titania Nanotubes and Active Agents for Enhanced Osseointegration of Bone Implants

TiO2 nanotubes (TNTs) are attractive nanostructures for localized drug delivery. Owing to their excellent biocompatibility and physicochemical properties, numerous functionalizations of TNTs have been attempted for their use as therapeutic agent delivery platforms. In this review, we discuss the current advances in the applications of TNT-based delivery systems with an emphasis on the various functionalizations of TNTs for enhancing osteogenesis at the bone-implant interface and for preventing implant-related infection. Innovation of therapies for enhancing osteogenesis still represents a critical challenge in regeneration of bone defects. The overall concept focuses on the use of osteoconductive materials in combination with the use of osteoinductive or osteopromotive factors. In this context, we highlight the strategies for improving the functionality of TNTs, using five classes of bioactive agents: growth factors (GFs), statins, plant derived molecules, inorganic therapeutic ions/nanoparticles (NPs) and antimicrobial compounds.

In-vitro study of hierarchical structures: Anodic oxidation and alkaline treatments onto highly rough titanium cold gas spray coatings for biomedical applications

Hierarchical structures were obtained applying two different nanotexturing surface treatments onto highly rough commercial pure titanium coatings by cold spray: (i) anodic oxidation and (ii) alkaline treatments. An extended surface characterization in terms of topography, composition, and wettability has been performed to understand how those parameters affect to cell response. Primary human osteoblasts extracted from knee were seeded onto the as-sprayed titanium surface before and after the nanotexturing treatments. Cell viability was tested by using MTS and LIVE/DEAD assays, as well as osteoblasts differentiation by alkaline phosphatase (ALP) quantification at 3 and 10 days of cell culture. The combination of micro-/nano-roughness results in a significantly increase of cell proliferation, as well as cell differentiation after 10 days of cell culture in comparison with the non-treated coatings.

Application of quality by design for 3D printed bone prostheses and scaffolds

3D printing is an emergent manufacturing technology recently being applied in the medical field for the development of custom bone prostheses and scaffolds. However, successful industry transformation to this new design and manufacturing approach requires technology integration, concurrent multi-disciplinary collaboration, and a robust quality management framework. This latter change enabler is the focus of this study. While a number of comprehensive quality frameworks have been developed in recent decades to ensure that the manufacturing of medical devices produces reliable products, they are centred on the traditional context of standardised manufacturing techniques. The advent of 3D printing technologies and the prospects for mass customisation provides significant market opportunities, but also presents a serious challenge to regulatory bodies tasked with managing and assuring product quality and safety. Before 3D printing bone prostheses and scaffolds can gain traction, industry stakeholders, such as regulators, clients, medical practitioners, insurers, lawyers, and manufacturers, would all require a high degree of confidence that customised manufacturing can achieve the same quality outcomes as standardised manufacturing. A Quality by Design (QbD) approach to custom 3D printed prostheses can help to ensure that products are designed and manufactured correctly from the beginning without errors. This paper reports on the adaptation of the QbD approach for the development process of 3D printed custom bone prosthesis and scaffolds. This was achieved through the identification of the Critical Quality Attributes of such products, and an extensive review of different design and fabrication methods for 3D printed bone prostheses. Research outcomes include the development of a comprehensive design and fabrication process flow diagram, and categorised risks associated with the design and fabrication processes of such products. An extensive systematic literature review and post-hoc evaluation survey with experts was completed to evaluate the likely effectiveness of the herein suggested QbD framework.

Surface Texture-Based Surface Treatments on Ti6Al4V Titanium Alloys for Tribological and Biological Applications: A Mini Review

Surface texture (ST) has been confirmed as an effective and economical surface treatment technique that can be applied to a great range of materials and presents growing interests in various engineering fields. Ti6Al4V which is the most frequently and successfully used titanium alloy has long been restricted in tribological-related operations due to the shortcomings of low surface hardness, high friction coefficient, and poor abrasive wear resistance. Ti6Al4V has benefited from surface texture-based surface treatments over the last decade. This review begins with a brief introduction, analysis approaches, and processing methods of surface texture. The specific applications of the surface texture-based surface treatments for improving surface performance of Ti6Al4V are thoroughly reviewed from the point of view of tribology and biology.

Understanding and augmenting the stability of therapeutic nanotubes on anodized titanium implants

Titanium is an ideal material choice for orthopaedic and dental implants, and hence a significant amount of research has been focused towards augmenting the therapeutic efficacy of titanium surfaces. More recently the focus has shifted to nano-engineered implants fabricated via anodization to generate self-ordered nanotubular structures composed of titania (TiO₂). These structures (titania nanotubes/TNTs) enable local drug delivery and tailorable cellular modulation towards achieving desirable effects like enhanced osseointegration and antibacterial action. However, the mechanical stability of such modifications is often ignored and remains underexplored, and any delamination or breakage in the TNTs modification can initiate toxicity and lead to severe immuno-inflammatory reactions. This review details and critically evaluates the progress made in relation to this aspect of TNT based implants, with a focus on understanding the interface between TNTs and the implant surface, treatments aimed at augmenting mechanical stability and strategies for advanced mechanical testing within the bone micro-environment ex vivo and in vivo. This review article extends the existing knowledge in this domain of TNTs implant technology and will enable improved understanding of the underlying parameters that contribute towards mechanically robust nano-engineered implants that can withstand the forces associated with implant surgical placement and the load bearing experienced at the bone/implant interface.

Progress in TiO2 nanotube coatings for biomedical applications: a review

Titanium dioxide nanotubes (TNTs) have drawn wide attention and been extensively applied in the field of biomedicine, due to their large specific surface area, good corrosion resistance, excellent biocompatibility, and enhanced bioactivity. This review describes the preparation of TNTs and the surface modification that entrust the nanotubes with better antibacterial property and enhanced osteoblast adhesion, proliferation, and differentiation. Considering the contact between TNTs' surface and surrounding tissues after implantation, the interactions between TNTs (with properties including their diameter, length, wettability, and crystalline phase) and proteins, platelets, bacteria, and cells are illustrated. The state of the art in the applications of TNTs in dentistry, orthopedic implants, and cardiovascular stents are introduced. In particular, the application of TNTs in biosensing has attracted much attention due to its ability for the rapid diagnosis of diseases. Finally, the difficulties and challenges in the practical application of TNTs are also discussed.

Effects of different sterilization methods on surface characteristics and biofilm formation on zirconia in vitro

OBJECTIVE

The current laboratory study was to investigate the effect of different sterilization treatments on surface characteristics of zirconia, and biofilm formation on zirconia surface after exposure to these sterilization treatments.

METHODS

Commercially available zirconia discs (Cerconbase, Degu-Dent, Hanau, Germany) were prepared and polished to the same value of surface roughness. The discs were treated with one of the following sterilization methods steam autoclave sterilization, dry heat sterilization, ultraviolet C (UVC) irradiation, and gamma (γ) ray irradiation. The characteristics of zirconia surfaces were evaluated by scanning electron microscopy (SEM), surface roughness, surface free energy (SFE), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD) measurements. Then, Staphylococcus aureus (S.a.) and Porphyromonas gingivalis (P.g.) bacteria were used and cultured on the respective sterilized zirconia surfaces. The amount of biofilm formation on zirconia surface was quantified by colony forming unit (CFU) counts.

RESULTS

Significant modifications were detected on the colour and SFE of zirconia. The colour of zirconia samples after UVC irradiation became light yellow whilst dark brown colour was observed after gamma ray irradiation. Moreover, UVC and gamma ray irradiation increased the hydrophilicity of zirconia surface. Overall, dry heat sterilized samples showed the significantly lowest amount of bacteria growth on zirconia, while UVC and gamma ray irradiation resulted in the highest.

SIGNIFICANCE

It is evident that various sterilization methods could change the surface which contribute to different biofilm formation and colour on zirconia.

Enhancement in Sustained Release of Antimicrobial Peptide from Dual-Diameter-Structured TiO2 Nanotubes for Long-Lasting Antibacterial Activity and Cytocompatibility

Novel films on Ti-based orthopedic implants for localized antimicrobial delivery, which comprises dual-diameter TiO₂ nanotubes with the inner layers of compact and fluorine-free oxide tightly bonding to Ti, were formed by voltage-increased anodization with F^- sedimentation procedure. The nanotubes were closely aligned and structured with upper 35 and 70 nm diametric tubes as nanocaps, respectively, and the underlying 140 nm diametric tubes as nanoreservoirs. Followed by loading ponericin G1 (a kind of antimicrobial peptide (AMP)) into the dual-diameter nanotubes with vacuum-assisted physisorption, the resultant films were investigated for loading efficiency and release kinetics of AMP, antibacterial activity against Staphylococcus aureus, and osteoblastic compatibility, together with the AMP-loaded single-diameter (140 nm) nanotube film. The loaded films had no statistical difference in the loading efficiency of AMP and revealed burst release within 6 h followed by steady release of AMP in phosphate-buffered solution. At day 42, almost all of AMP was released from the single-diameter nanotube film. However, the dual-diameter nanotube films loaded with AMP still showed sustained release at least up to 60 days, and the sustained efficacy was enhanced with decreasing diameter of nanocaps. In the case of nominal AMP loading amount of 125 μg, the resultant 35 nm capped dual-diameter nanotube film exhibited significant short- and long-term (even for 49 days) antibacterial activity not only against planktonic bacteria, which is ascribed to the release-killing efficacy of AMP, but also against adhered bacteria, which is ascribed to the AMP-derived killing efficacy and the nanocaps-derived adhesion resistance. Moreover, this loaded film presented cytocompatibility comparative to that of Ti but higher than that of the other AMP-loaded films. Increasing the nominal loading amount of AMP to 200 μg improved antibacterial activity but gave rise to obvious cytotoxicity of the loaded films.

Poly(methyl methacrylate) with TiO2 nanoparticles inclusion for stereolitographic complete denture manufacturing - the fututre in dental care for elderly edentulous patients?

OBJECTIVES

The aim of this study was to obtain a Poly(methylmethacrylate) (PMMA)-TiO₂ nanocomposite material with improved antibacterial characteristics, suitable for manufacturing 3D printed dental prosthesis.

METHODS

0.2, 0.4, 0.6, 1, 2.5 by weight% of TiO₂ nanoparticles have been added to the commercially available stereolithographic PMMA material and the obtained nanocomposites have been analyzed using FTIR, SEM and also tested for antimicrobial efficacy against bacterial cultures from Candida species (C. scotti).

RESULTS

SEM images and EDX results highlighted the presence of TiO₂ in PMMA nanocomposites. The elemental composition (EDX) also showed the presence of other fillers included in stereolithographic PMMA solution. FTIR analysis clearly revealed changes in polymeric matrix structure when adding TiO₂ nanoparticles. Sample containing 0.4, 1 and 2.5wt% TiO₂ nanoparticles inhibited the growth of Candida scotti strain in standard conditions according to the toxicity control method (DHA). Increasing quantity of nano-titania has resulted in particles fooling, forming new aggregates instead of the homogenous dispersion of nanoparticles with modified viscosity characteristics and expected lower mechanical parameters.

CONCLUSIONS

Significant improvements in polymer characteristics and nice dispersion of the TiO₂ nanoparticles have been noticed for 0.4wt%, therefore it was used for stereolitographic complete denture prototyping.

CLINICAL SIGNIFICANCE

Incorporation of TiO₂ nanoparticles in PMMA polymer matrix was proved to have antibacterial effects, specifically on Candida species. The newly obtained 0.4% nanocomposite was successfully used with stereolitographic technique for complete denture manufacturing. However, mechanical and biocompatibility tests need to be performed in order to extend the clinical usage.

Highly efficient visible-light-driven photocatalytic degradation of tetracycline by a Z-scheme g-C3N4/Bi3TaO7 nanocomposite photocatalyst

Highly efficient visible-light-driven photocatalytic degradation of tetracycline by a fabricated Z-scheme g-C₃N₄/Bi₃TaO₇ nanocomposite photocatalyst.

Human Mesenchymal Stem Cell Morphology and Migration on Microtextured Titanium

The implant used in spinal fusion procedures is an essential component to achieving successful arthrodesis. At the cellular level, the implant impacts healing and fusion through a series of steps: first, mesenchymal stem cells (MSCs) need to adhere and proliferate to cover the implant; second, the MSCs must differentiate into osteoblasts; third, the osteoid matrix produced by the osteoblasts needs to generate new bone tissue, thoroughly integrating the implant with the vertebrate above and below. Previous research has demonstrated that microtextured titanium is advantageous over smooth titanium and PEEK implants for both promoting osteogenic differentiation and integrating with host bone tissue; however, no investigation to date has examined the early morphology and migration of MSCs on these surfaces. This study details cell spreading and morphology changes over 24 h, rate and directionality of migration 6–18 h post-seeding, differentiation markers at 10 days, and the long-term morphology of MSCs at 7 days, on microtextured, acid-etched titanium (endoskeleton), smooth titanium, and smooth PEEK surfaces. The results demonstrate that in all metrics, the two titanium surfaces outperformed the PEEK surface. Furthermore, the rough acid-etched titanium surface presented the most favorable overall results, demonstrating the random migration needed to efficiently cover a surface in addition to morphologies consistent with osteoblasts and preosteoblasts.

Influence of various sterilization procedures on TiO2 nanotubes used for biomedical devices

Sterilization is the final surface treatment procedure of all implantable devices and is one of the key factors which have to be considered before implementation. Since different sterilization procedures for all implantable devices influence mechanical properties as well as biological response, the influence of different sterilization techniques on titanium nanotubes was studied. Commonly used sterilization techniques such as autoclaving, ultra-violet light sterilization, hydrogen peroxide plasma sterilization as well as the not so frequently used gaseous oxygen plasma sterilization were used. Three different nanotube diameters; 15 nm, 50 nm and 100 nm were employed to study the effects of various sterilization techniques. It was observed that autoclave sterilization resulted in destruction of nanotubular features on all three studied nanotube diameters, while UV-light and both kinds of plasma sterilization did not cause any significant morphological changes on the surfaces. Differences between the sterilization techniques employed influenced cytocompatibility, especially in the case of nanotubes with 100 nm diameter.

Disinfection of titanium dioxide nanotubes using super-oxidized water decrease bacterial viability without disrupting osteoblast behavior

Amorphous titanium dioxide (TiO2) nanotubes (NTs) on Ti6Al4V alloy were synthesized by anodization using a commercially available super-oxidized water (SOW). The NT surfaces were sterilized by ultraviolet (UV) irradiation and disinfected using SOW. The adhesion and cellular morphology of pig periosteal osteoblast (PPO) cells and the behavior of Staphylococcus aureus (S. aureus) cultured on the sterilized and disinfected surfaces were investigated. A non-anodized Ti6Al4V disc sterilized by UV irradiation (without SOW) was used as control. The results of this study reveal that the adhesion, morphology and filopodia development of PPO cells in NTs are dramatically improved, suggesting that SOW cleaning may not disrupt the benefits obtained by NTs. Significantly decreased bacterial viability in NTs after cleaning with SOW and comparing with non-cleaned NTs was seen. The results suggest that UV and SOW could be a recommendable method for implant sterilization and disinfection without altering osteoblast behavior while decreasing bacterial viability.

Increased Mesenchymal Stem Cell Response and Decreased Staphylococcus aureus Adhesion on Titania Nanotubes without Pharmaceuticals

Titanium (Ti) implants with enhanced biocompatibility and antibacterial property are highly desirable and characterized by improved success rates. In this study, titania nanotubes (TNTs) with various tube diameters were fabricated on Ti surfaces through electrochemical anodization at 10, 30, and 60 V (denoted as NT10, NT30, and NT60, resp.). Ti was also investigated and used as a control. NT10 with a diameter of 30 nm could promote the adhesion and proliferation of bone marrow mesenchymal stem cells (BMSCs) without noticeable differentiation. NT30 with a diameter of 100 nm could support the adhesion and proliferation of BMSCs and induce osteogenesis. NT60 with a diameter of 200 nm demonstrated the best ability to promote cell spreading and osteogenic differentiation; however, it clearly impaired cell adhesion and proliferation. As the tube diameter increased, bacterial adhesion on the TNTs decreased and reached the lowest value on NT60. Therefore, NT30 without pharmaceuticals could be used to increase mesenchymal stem cell response and decrease Staphylococcus aureus adhesion and thus should be further studied for improving the efficacy of Ti-based orthopedic implants.

Staphylococcus aureus and MRSA Growth and Biofilm Formation after Treatment with Antibiotics and SeNPs

Methicillin-resistant Staphylococcus aureus (MRSA) is a dangerous pathogen resistant to β-lactam antibiotics. Due to its resistance, it is difficult to manage the infections caused by this strain. We examined this issue in terms of observation of the growth properties and ability to form biofilms in sensitive S. aureus and MRSA after the application of antibiotics (ATBs)-ampicillin, oxacillin and penicillin-and complexes of selenium nanoparticles (SeNPs) with these ATBs. The results suggest the strong inhibition effect of SeNPs in complexes with conventional ATBs. Using the impedance method, a higher disruption of biofilms was observed after the application of ATB complexes with SeNPs compared to the group exposed to ATBs without SeNPs. The biofilm formation was intensely inhibited (up to 99%±7% for S. aureus and up to 94%±4% for MRSA) after application of SeNPs in comparison with bacteria without antibacterial compounds whereas ATBs without SeNPs inhibited S. aureus up to 79%±5% and MRSA up to 16%±2% only. The obtained results provide a basis for the use of SeNPs as a tool for the treatment of bacterial infections, which can be complicated because of increasing resistance of bacteria to conventional ATB drugs.

Low-temperature liquid phase reduced TiO2 nanotube arrays: synergy of morphology manipulation and oxygen vacancy doping for enhancement of field emission

The partially reduced TiO(2) nanotube arrays (TNAs) are prepared via an uncomplicated and low-cost liquid phase reduction strategy using NaBH(4) as the reducing agent. By controlling and adjusting the reduction temperatures from 30 to 90 °C, the reduction treatment can not only change their surface morphology but also introduce oxygen vacancies into them, resulting in an optimized morphology, elevated Fermi-level, reduced effective work function and improved conductivity of the TNAs. Meanwhile, the thermal and long-term stability of oxygen vacancy are also investigated, indicating that the oxygen vacancies retain long-term stability from room temperature up to 150 °C. More interesting, partially reduced TNAs show drastically enhanced field emission (FE) performances including substantially decreased turn-on field from 18.86 to 1.53 V μm(-1), a high current density of 4.00 mA cm(-2) at 4.52 V μm(-1), and an excellent FE stability and repeatability. These very promising results are attributed to the combination of the optimized morphology and introduced oxygen vacancies, which can increase FE sites, reduce effective work function and increase conductivity.

Titanium nanostructures for biomedical applications

Titanium and titanium alloys exhibit a unique combination of strength and biocompatibility, which enables their use in medical applications and accounts for their extensive use as implant materials in the last 50 years. Currently, a large amount of research is being carried out in order to determine the optimal surface topography for use in bioapplications, and thus the emphasis is on nanotechnology for biomedical applications. It was recently shown that titanium implants with rough surface topography and free energy increase osteoblast adhesion, maturation and subsequent bone formation. Furthermore, the adhesion of different cell lines to the surface of titanium implants is influenced by the surface characteristics of titanium; namely topography, charge distribution and chemistry. The present review article focuses on the specific nanotopography of titanium, i.e. titanium dioxide (TiO2) nanotubes, using a simple electrochemical anodisation method of the metallic substrate and other processes such as the hydrothermal or sol-gel template. One key advantage of using TiO2 nanotubes in cell interactions is based on the fact that TiO2 nanotube morphology is correlated with cell adhesion, spreading, growth and differentiation of mesenchymal stem cells, which were shown to be maximally induced on smaller diameter nanotubes (15 nm), but hindered on larger diameter (100 nm) tubes, leading to cell death and apoptosis. Research has supported the significance of nanotopography (TiO2 nanotube diameter) in cell adhesion and cell growth, and suggests that the mechanics of focal adhesion formation are similar among different cell types. As such, the present review will focus on perhaps the most spectacular and surprising one-dimensional structures and their unique biomedical applications for increased osseointegration, protein interaction and antibacterial properties.

Nanotexturing of PC/n-HA nanocomposites by innovative and advanced spray system

Nanoscale texturing of n-HA filler on PC matrix is ameliorated by advanced engineered spray techniques viz. spary gun and centrifuged spray dryer, modifying properties of biomedical grade screw/plate coating application.

Antibacterial activities of TiO2 nanotubes on Porphyromonas gingivalis

The potential impacts of TiO₂ nanotubes on Porphyromonas gingivalis growth and drug resistance were investigated. TiO₂ nanotubes antibacterial performance can be manipulated with the photocatalytic activity as well as the geometry characteristic.

Enhanced osseointegration of titanium implants with nanostructured surfaces: an experimental study in rabbits

Titanium and its alloys are commonly used for dental implants because of their good mechanical properties and biocompatibility. The surface properties of titanium implants are key factors for rapid and stable bone tissue integration. Micro-rough surfaces are commonly prepared by grit-blasting and acid-etching. However, proteins and cells interact with implant surfaces in the nanometer range. The aim of this study was to compare the osseointegration of machined (MA), standard alumina grit-blasted and acid-etched (MICRO) and nanostructured (NANO) implants in rabbit femurs. The MICRO surface exhibited typical random cavities with an average roughness of 1.5 μm, while the NANO surface consisted of a regular array of titanium oxide nanotubes 37±11 nm in diameter and 160 nm thick. The MA and NANO surfaces had a similar average roughness of 0.5 μm. The three groups of implants were inserted into the femoral condyles of New Zealand White rabbits. After 4 weeks, the pull-out test gave higher values for the NANO than for the other groups. Histology corroborated a direct apposition of bone tissue on to the NANO surface. Both the bone-to-implant contact and bone growth values were higher for the NANO than for the other implant surfaces. Overall, this study shows that the nanostructured surface improved the osseointegration of titanium implants and may be an alternative to conventional grit-blasted and acid-etched surface treatments.

Multi-scale strategy to eradicate Pseudomonas aeruginosa on surfaces using solid lipid nanoparticles loaded with free fatty acids

Infections are both frequent and costly in hospitals around the world, leading to longer hospital stays, overuse of antibiotics, and excessive costs to the healthcare system. Moreover, antibiotic resistant organisms, such as Pseudomonas aeruginosa are increasing in frequency, leading to 1.7 million infections per year in USA hospitals, and 99,000 deaths, both due to the evolution of antibiotic resistance and the formation of biofilms on medical devices. In particular, respiratory infections are costly, deadly to 4.5 million persons per year worldwide, and can spread to the lungs through the placement of endotracheal tubing. In this study, towards a reduction in infections, solid lipid nanoparticles were formulated from free fatty acids, or natural lipophilic constituents found in tissues of the body. A strategy was developed to target infections by producing coatings made of non-toxic chemistries lauric acid and oleic acid delivered by core-shell solid lipid nanoparticles that act against bacteria by multiple mechanisms at the nanoscale, including disruption of bacteria leading to DNA release, and reducing the adhesion of dead bacteria to ~1%. This is the first such study to explore an anti-infection surface relying on these multi-tier strategies at the nanoscale.