Polymer coatings based on sulfonated-poly-ether-ether-ketone films for implant dentistry applications

The ability of SPEEK to promote the proliferation and osteogenic differentiation of BMSCs on PEEK surfaces

To investigate the ability of sulfonated polyetheretherketone (SPEEK) to promote the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and compare the effects of different degrees of sulfonation (DS), SPEEK was made with two different DS. The L-SPEEK group had a lower DS, while the H-SPEEK group had a higher DS. The physicochemical properties of both species were evaluated by scanning electron microscopy (SEM), capitilize Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), X-ray diffraction (XRD) and differential scanning calorimetry (DSC). Then, proliferation and osteogenic differentiation between the two groups and with pure polyetheretherketone (PEEK) were compared after surface inoculation of bone marrow mesenchymal stem cells (BMSCs). Scanning electron microscopy (SEM) revealed that the surface of the PEEK substrates could be smooth or coarse, and the degree of roughness increased with increasing sulfonation. FTIR spectroscopy showed that both the L-SPEEK and H-SPEEK samples contained sulfonic acid. TGA and XRD revealed that the components in the two groups were the same, but the intensities were different. After BMSC inoculation, a CCK8 assay revealed that the cells proliferated more on the H-SPEEK surface and little on the L-SPEEK surface compared with the PEEK surface. Then, osteogenic differentiation was verified by immunofluorescence staining for OCN and Runx2, which indicated that H-SPEEK had the greatest effect on improving differentiation. The results of alizarin red staining (ARS) and alkaline phosphatase staining (APS) also revealed this trend. Sulfonation can change the microsurface of PEEK, which can improve both BMSC proliferation and osteogenic differentiation.

Role of Polyetheretherketone in Prosthodontics: A Literature Review

Implant prostheses and other fixed and removable metal prostheses have led to an increase in demand for the development of new and efficient materials such as high-performance polymers polyetheretherketone (PEEK) over titanium and other metals because of their further complications in the human body. PEEK is a polymer that is nontoxic and has a modulus of elasticity that is comparable to that of human bone. PEEK implants provide benefits over metal implants, such as reducing the stress shielding effect, simple processing, and color resemblance to natural teeth. And it is a fantastic alternative to titanium for dental and orthopedic implants. The current review is undertaken to understand the properties of this PEEK material to weigh its benefits and drawbacks for potential use in dental implants and other prostheses.

3D-Printed Polymer-Infiltrated Ceramic Network with Biocompatible Adhesive to Potentiate Dental Implant Applications

The aim of this work was to prepare and characterize polymer-ceramic composite material for dental applications, which must resist fracture and wear under extreme forces. It must also be compatible with the hostile environment of the oral cavity. The most common restorative and biocompatible copolymer, 2,2-bis(p-(2'-2-hydroxy-3'-methacryloxypropoxy)phenyl)propane and triethyleneglycol dimethacrylate, was combined with 3D-printed yttria-stabilized tetragonal zirconia scaffolds with a 50% infill. The proper scaffold deposition and morphology of samples with 50% zirconia infill were studied by means of X-ray computed microtomography and scanning electron microscopy. Samples that were infiltrated with copolymer were observed under compression stress, and the structure's failure was recorded using an Infrared Vic 2DTM camera, in comparison with empty scaffolds. The biocompatibility of the composite material was ascertained with an MG-63 cell viability assay. The microtomography proves the homogeneous distribution of pores throughout the whole sample, whereas the presence of the biocompatible copolymer among the ceramic filaments, referred to as a polymer-infiltrated ceramic network (PICN), results in a safety "damper", preventing crack propagation and securing the desired material flexibility, as observed by an infrared camera in real time. The study represents a challenge for future dental implant applications, demonstrating that it is possible to combine the fast robocasting of ceramic paste and covalent bonding of polymer adhesive for hybrid material stabilization.

Design and development of electrospun SPEEK incorporated with aminated zirconia and curcumin nanofibers for periodontal regeneration

Periodontal disease disturbs the supportive tissues around the teeth such as connective tissue, gingival tissue, periodontal ligaments and alveolar bone. Previously, treatment of periodontitis was embattled by repopulating the affected site with cells that has capacity to regenerate damaged tissue by endorsing the perception of guided tissue regeneration but it entails additional surgery owing to non-biodegradability. Biodegradable polymeric nanofibrous scaffold imitating extracellular matrix (ECM) delivering functionalized nanoparticles loaded with therapeutic drug have the ability to support cellular functions thereby enhancing regeneration. Present study explores novel amine functionalized zirconia nanoparticle loaded curcumin incorporated SPEEK nanofibrous scaffolds to address periodontal regeneration. Zirconia - crown of dental therapeutics, its amine functionalization further enhanced the strength and cyto-compatibility. Carbon-Silica NMR (59.9 and 69.8 ppm), FT-IR (3426 cm^-1), EDAX and XRD (28.9°_, 31.6° and 38.2° pertaining to [-1 1 1], [1 1 1] and [1 2 0] planes) analysis confirmed the effective functionalization of the zirconia nanoparticle with the amine group. Electrospinning was carried out at a voltage of 20 kV and flow rate of 0.05 ml/h. Fabricated nanofibers were highly dense, porous with interconnected fibrous structures that bio-mimic ECM. They exhibited an average diameter of 187 ± 2 nm (SPEEK), 192 ± 2 nm (SPEEK + NH₂-ZrO₂), and 256 ± 17 nm (SPEEK + NH₂-ZrO₂+Cur). Extensively discovered anti-bacterial traits of curcumin supplemented the advantage for the treatment of periodontitis. Incorporated materials improve the physico-chemical, mechanical and biological characteristics of nanofibers. FT-IR, EDAX and XRD analysis of the fabricated nanofibrous scaffold demonstrated the effective incorporation of aminated zirconia loaded curcumin. Results of cyto-compatibility analysis of SPEEK + NH₂-ZrO₂+Cur nanofibrous scaffold depicted a cell viability of 100 ± 1.62%. Results of anti-bacterial assay with zone of inhibition was 6.5 ± 0.5 mm (SPEEK), 7.5 ± 1 mm (SPEEK + NH₂-ZrO₂), and 8 ± 1 mm (SPEEK + NH₂-ZrO₂+Cur). Thus, the fabricated bio-material is cyto-compatible, non-toxic and effective against pathogens exploiting higher potential for periodontal regeneration applications.

On the synergistic effect of sulfonic functionalization and acidic adhesive conditioning to enhance the adhesion of PEEK to resin-matrix composites

OBJECTIVE

The objective of this study was to evaluate the combined effect of the sulfuric acid etching and an acidic adhesive conditioning on the shear bond strength of PEEK to a resin-matrix composite.

MATERIALS AND METHODS

Forty PEEK specimens were assigned randomly to 4 groups for H₂SO₄ etching followed by universal adhesive (pH at 2.5) conditioning for 0, 1, 3, and 5 min. Thirty PEEK specimens were divided into 3 groups for only acidic adhesive conditioning for 0, 1, 3, and 5 min. After the light-curing of the adhesive, a nanohybrid resin composite was applied onto the surfaces and then light-cured following the manufacturer`s guidelines. All specimens were stored in distilled water at 37 °C for 24 h mechanical testing. Shear bond strength tests were performed using a universal testing machine. Surfaces were analyzed by SEM, light interferometry, FTIR, and liquid contact angle measurement. Statistical analysis was performed by one-way ANOVA and Tukey's post hoc tests (p < 0.05).

RESULTS

No adhesion was achieved between untreated PEEK a resin-matrix composite, regardless of the adhesive conditioning time points. Shear bond strength of H₂SO₄-etched PEEK to resin-matrix composite increased with time (0 mmin. 4.95 ± 2.86 MPa < 1 min: 9.35 ± 2.26 MPa < 3 min: 17.84 ± 2.82 MPa < 5 min: 21.43 ± 5.00 MPa). SEM images revealed a significant modification of PEEK surface topography after the H₂SO₄ etching.

SIGNIFICANCE

The acidic adhesive was unable to modify the untreated PEEK surface to establish an effective adhesion although a synergistic effect was noticed when the universal (acidic) adhesive was applied over a H₂SO₄-etched PEEK surface, thus improving the PEEK to resin-matrix composite adhesion.

Microstructure, mechanical properties and heat-resistance properties of bismaleimide composites modified synergistically by alumina and two kinds of thermoplastic resins

Al2O3-PES-SPEEK/MBAE composites has been prepared, polymer matrix (MBAE) was obtained with 4,4’-diamino diphenyl methane bismaleimide (BMI) as reaction monomer, 3,3’-diallyl bisphenol A (BBA) and bisphenol A diallyl ether (BBE) as the reactive diluent, and two kinds of thermal plastic resins (polyether sulfone PES and sulfonated poly(ether ether ketone) SPEEK) as the reinforcements, nano-alumina (Al2O3) prepared by Sol–Gel method as the filler. The microstructure of SPEEK, Al2O3 and the composites were characterized, the mechanical properties and heat resistance of the composites were also studied and analyzed. The results reveal that there are sulfonic acid groups in SPEEK structure and the microstructure is more loose, and the degree of sulfonation is about 41.3%. Al2O3 is a nano-sized short-fibrous crystal with hydroxyl groups on its surface. The micromorphology of Al2O3-PES-SPEEK/MBAE composites show that the proper amount of PES, SPEEK and Al2O3 are uniformly dispersed in the matrix resin, which improves the fracture surface morphology of the composite, the shape of the section is fish scale and the fracture cracks are irregular and divergent, and the composites are ductile fracture. The mechanical properties indicate that the flexural strength, flexural modulus and impact strength of the composite is the maximum value 172.9 MPa, 4.7 GPa and 21.4 kJ/m2, which is 73.1%, 74.1% and 125.3%, higher than the matrix resin, respectively, when the PES content is 3 wt%, 2 wt% SPEEK and 3 wt% Al2O3 in the composite. At this time, the thermal decomposition temperature of the composite material is 453.5°C, which is 15.4°C higher than that of the matrix resin, and the mechanical properties and heat-resistance properties of the Al2O3-PES-SPEEK/MBAE composite are significantly improved.

Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry-A Comprehensive Review

Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were Escherichia coli and Staphylococcus aureus. Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.

Fabrication and evaluation of electrospun biomimetic sulphonated PEEK nanofibrous scaffold for human skin cell proliferation and wound regeneration potential

Regeneration of skin wound is a challenging process since functional and architectural restoration of the damaged skin tissue is an arduous task. The use of springing up biomaterials with nano-topographic and bio-mimicking characteristics resembling natural skin's extra cellular matrix (ECM) would be a favorable approach to regenerate such an injured skin tissue. In this study an attempt has been carried out to design and develop sulphonated polyether ether ketone (SPEEK) nanofibrous scaffold to explore its role on skin cell proliferation potential. 2 h-SPEEK portrayed the highest proliferative potential for HaCaT keratinocytes and fibroblasts. It was aimed for the tailored release of bio-actives from the spatiotemporally designed Aloe vera incorporated 2 h-SPEEK nanoscaffold to accelerate the skin wound regeneration. FTIR, EDX and XRD analyses revealed the effective incorporation of Aloe vera in the electrospun nanofibers. SEM analysis revealed the nano-topographical morphology with highly porous, dense and interconnected fibrous structures mimicking the skin ECM. The regulated delivery of Aloe vera demonstrated the biocompatibility of the nanofibrous scaffold in skin keratinocytes (HaCaT) and fibroblasts (3T3) cells through in vitro analysis proving its non-toxic properties. Further, the fabricated nanoscaffolds exhibited excellent anti-microbial efficacy towards the tested human skin pathogenic microbes. The results of in vivo studies in Wistar rat model exhibited scar-less wound healing with complete wound closure. Thus, this nanofiber based drug delivery system implicitly acts as a skin like ECM, bio-mimicking the topographical and chemical cues of the natural skin tissues paving way for a complete regeneration and integration of the injured area strengthening the functional restoration of insulted cells around the wound area.

Porous Titanium Surfaces to Control Bacteria Growth: Mechanical Properties and Sulfonated Polyetheretherketone Coatings as Antibiofouling Approaches

Here, titanium porous substrates were fabricated by a space holder technique. The relationship between microstructural characteristics (pore equivalent diameter, mean free-path between pores, roughness and contact surface), mechanical properties (Young’s modulus, yield strength and dynamic micro-hardness) and bacterial behavior are discussed. The bacterial strains evaluated are often found on dental implants: Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. The colony-forming units increased with the size of the spacer for both types of studied strains. An antibiofouling synthetic coating based on a sulfonated polyetheretherketone polymer revealed an effective chemical surface modification for inhibiting MRSA adhesion and growth. These findings collectively suggest that porous titanium implants designed with a pore size of 100–200 µm can be considered most suitable, assuring the best biomechanical and bifunctional anti-bacterial properties.

Improvements on biological and antimicrobial properties of titanium modified by AgNPs-loaded chitosan-heparin polyelectrolyte multilayers

Microbial infection around dental implants is a major cause for the loss of devices, including soft tissue infection in early period, post-operation peri-implantitis, and osseointegration failure. Silver nanoparticles (AgNPs) with wide antimicrobial spectrum, strong antimicrobial effect and hypotoxicity, as well as low incidence of antibiotic resistance, are widely involved in biomedical applications. Herein, firmly anchoring AgNPs onto the surface of implants through physical-chemical reaction is likely to relieve the above issues. In this study, AgNPs were biosynthesized by a simple and "green" method with chitosan (CS) as stabilizing and reducing agents. Then, AgNPs-loaded CS-heparin polyelectrolyte multilayers (PEMs) were constructed on alkali-heat treated titanium (Ti) substrates via layer-by-layer (LbL) self-assembly technique. The successful surface modification could be confirmed by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS), and the constructed system could provide the continuous release of Ag⁺ over 28 days till mucosa healing. In short, this work revealed that the construction of multilayer coatings containing AgNPs on Ti substrates promoted adhesion and proliferation of human gingival fibroblasts (HGFs) and also enhanced the antimicrobial properties. This manifests the LbL technique is a viable and promising method for forming continuous antimicrobial coatings, to reduce microbial infection and improve the quality of peri-implant soft tissue seal. The preparation process of AgNPs-loaded CS-heparin PEMs on Ti substrate.