Chlorhexidine adsorption to anatase and rutile titanium dioxide

Antimicrobial efficiency and cytocompatibility of resveratrol and naringin as chemical decontaminants on SLA surface

Bacterial biofilms are the major etiology agent of peri-implant disease. Chemical decontamination is a promising treatment strategy against bacterial biofilms; however, its applications are limited by its low efficiency and poor biocompatibility. In contrast to three conventional cleaners (sterile saline, hydrogen peroxide, and chlorhexidine), this study used resveratrol and naringin solutions to remove mature Staphylococcus aureus and Porphyromonas gingivalis biofilm on sandblasted (with large grit and acid-etched (SLA) titanium surface. To determine changes in surface characteristics, the surface wettability and roughness were measured, and micromorphology was observed by scanning electron microscopy. With crystal violet (CV) and live/dead bacterial staining, residual plaque quantity and composition were measured. The biocompatibility was tested using pH and cytotoxicity, as well as by osteoblasts (MC3T3-E1) adhesion, proliferation, and differentiation, and fibroblasts (L-929) proliferation were also analyzed. It was found that resveratrol and naringin solutions were more effective in restoring surface characteristics and also showed that less plaque and viable bacteria were left. Naringin removed S. aureus biofilms better than chlorhexidine. Alkaline resveratrol and naringin solutions increased cell adhesion, proliferation, and osteogenic differentiation without any cytotoxicity. Resveratrol increased the expression of mRNA and protein associated with osteogenesis. In conclusion, resveratrol and naringin effectively restored SLA titanium surface characteristics and decontaminated the biofilm with good biocompatibility, suggesting their therapeutic potential as chemical decontaminants.

IMPORTANCE

Bacterial biofilms are considered the primary etiology of peri-implant disease. Physical cleaning is the most common way to remove bacterial biofilm, but it can cause grooving, melting, and deposition of chemicals that alter the surface of implants, which may hamper biocompatibility and re-osseointegration. Chemical decontamination is one of the most promising treatments but is limited by low efficiency and poor biocompatibility. Our study aims to develop safer, more effective chemical decontaminants for peri-implant disease prevention and treatment. We focus on resveratrol and naringin, two natural compounds, which have shown to be more effective in decontaminating biofilms on dental implant surfaces and exerting better biocompatibility. This research is groundbreaking as it is the first exploration of natural plant extracts' impact on mature bacterial biofilms on rough titanium surfaces. By advancing this knowledge, we seek to contribute to more effective and biocompatible strategies for combating peri-implant diseases, enhancing oral health, and prolonging implant lifespan.

Self-synthesized TiO2 nanoparticles-pH-mediated dispersive solid phase extraction coupled with high performance liquid chromatography for the determination of quinolones in biological matrices

A simple and efficient pH-mediated dispersive solid phase extraction (dSPE) based on terbium doped titanium dioxide nanoparticles (TiO₂-Tb NPs) combined with high performance liquid chromatography (HPLC) has been firstly developed for the determination of quinolones (QNs) in various biological samples. The adsorption kinetics and isotherms were investigated to indicate that the kinetic and equilibrium adsorption were well-described by pseudo-second order kinetic and Henry, Langmuir isotherm model, respectively. The parameters influencing the extraction performance were systematically investigated. The QNs are transferred into TiO₂-Tb NPs in the first step at pH = 6.0 and eluted into acidic aqueous phase at pH = 2.5 in the second step. Under the optimum extraction and determination conditions, a linearity range with the coefficient of determination (R²) from 0.9977 to 0.9991 were obtained in a range of 10-10,000 ng mL^-1. The limits of detection (LODs) based on a signal-to-noise ratio of 3 were 3.3 ng mL^-1. The recoveries of the three QNs in human urine, rabbit plasma and serum samples ranged from 69.3% to 117.6%, with standard deviations ranging from 2.4% to 9.9%. Therefore, this pH-mediated dSPE-HPLC method exhibited the advantages of remarkable sensitivity, ease of operation, rapidity, low cost and environmental friendliness.

Gradual hydrophobization of silica aerogel for controlled drug release

We report on the successful fine-tuning of silica aerogel hydrophobicity, through a gas-phase surface modification process. Aerogel hydrophobicity is a widely discussed matter, as it contributes to the aerogel's preservation and determines its functionality. Still, a general procedure for tuning the hydrophobicity, without affecting other aerogel properties was missing. In the developed procedure, silica aerogel was modified with trimethylchlorosilane vapor for varying durations, resulting in gradual hydrophobicity, determined by solid-state NMR and contact angle measurements. The generality of this post-synthesis treatment allows its application on a variety of aerogel materials, while having minimum effect on their porosity and transparency. We demonstrate the applicability of the gradual hydrophobization by tuning drug release rates from the silica aerogel. Two chlorhexidine salts - widely employed as antiseptic agents - were used as model drugs, one representing a soluble drug, and the other an insoluble drug; they were entrapped in silica aerogel, following hydrophobization to varying degrees. The drug release patterns showed that depending on the degree, hydrophobization can increase or decrease release kinetics, compared to the unmodified aerogel. This arises from the effect of the hydrophobic degree on pore structure, diffusional rates and wetting of the aerogel carrier. We suggest the use of the gradual hydrophobization process for other drug-aerogel systems, as well as for other aerogel applications, such as transparent insulation panels, contaminate sorbents or catalysis supports.

Saliva-coated titanium biosensor detects specific bacterial adhesion and bactericide caused mass loading upon cell death

Bacteria adhering to implanted medical devices can cause invasive microbial infections, of e.g. skin, lung or blood. In dentistry, Streptococcus gordonii is an early oral colonizer initiating dental biofilm formation and also being involved in life-threatening infective endocarditis. To treat oral biofilms, antibacterial mouth rinses are commonly used. Such initial biomaterial-bacteria interactions and the influence of antibacterial treatments are poorly understood and investigated here in situ by quartz crystal microbalance with dissipation monitoring (QCM-D). A saliva-coated titanium (Ti) biosensor is applied to analyze possible specific signal patterns indicating microbial binding mechanisms and bactericide-caused changes in bacterial film rigidity or cell leakage caused by a clinically relevant antibacterial agent (ABA), i.e., a mouth rinse comprising chlorhexidine (CHX) and cetylpyridinium chloride (CPC). Apparent missing mass effects during the formation of microscopically proven dense and vital bacterial films indicate punctual, specific binding of S. gordonii to the saliva-coated biosensor, compared to unspecific adhesion to pure Ti. Coincidentally to ABA-induced killing of surface-adhered bacteria, an increase of adsorbed dissipative mass can be sensed, contrary to the prior mass-loss. This suggests the acoustic sensing of the leakage of cellular content caused by bacterial cell wall rupturing and membrane damage upon the bactericidal attack. The results have significant implications for testing bacterial adhesion mechanisms and cellular integrity during interaction with antibacterial agents.

Glass ionomer cements with milled, dry chlorhexidine hexametaphosphate filler particles to provide long-term antimicrobial properties with recharge capacity

OBJECTIVE

Glass ionomer cements (GICs) are a versatile material, offering the opportunity for ion exchange with the oral environment. The aim of this study was to develop a GIC that delivers a controlled, rechargeable dose of chlorhexidine (CHX) over an extended period without compromising mechanical properties.

METHODS

GICs were supplemented with finely milled particles of chlorhexidine hexametaphosphate (CHX-HMP). CHX release into artificial saliva was measured over 660 days, and recharge with CHX and CHX-HMP was investigated. Mechanical properties were investigated, and an agar diffusion test was carried out to assess antimicrobial properties using Streptococcus mutans and Scardovia wiggsiae.

RESULTS

Dose-dependent CHX release was observed, and this was ongoing at 660 days. Compared with related studies of GICs containing CHX-HMP, the fine, dry particles resulted in fewer adverse effects on mechanical properties, including tensile, compressive and biaxial flexural strength, with 1% CHX-HMP GICs indistinguishable from control specimens. The GICs could be recharged with CHX using both a conventional CHX digluconate solution comparable to commercial mouthrinses, and a suspension of CHX-HMP of equivalent concentration. Recharging with CHX digluconate increased subsequent CHX release by 50% compared with no recharge, and recharging with CHX-HMP increased subsequent CHX release by 100% compared with no recharge. The GICs inhibited growth of St. mutans and Sc. wiggsiae in a simple agar diffusion model.

SIGNIFICANCE

These materials, which provide sustained CHX release over clinically relevant timescales, may find application as a restorative material intended to inhibit secondary caries as well as in temporary restorations and fissure sealants.

Osteoblast growth, after cleaning of biofilm-covered titanium discs with air-polishing and cold plasma

AIM

To investigate the effects of a combined biofilm removal with an optimized air polishing and a cold plasma device on cells in vitro.

MATERIALS AND METHODS

A 7-day-old biofilm was removed from rough titanium discs with an air-polishing device with erythritol powder (AP) or with a cold atmospheric pressure argon plasma (CAP) device or in combination of both (AP + CAP). The removal efficacy was evaluated by subsequent cell seeding of osteoblast-like cells (MG-63). The cell spreading was analysed after 5 days of incubation by scanning electron microscopy. Separately, the surface hydrophilicity was analysed by measuring the water contact angle (WCA) of the disc for each treatment method.

RESULTS

The mechanical plaque removal with AP rendered specimen conducive for cell growth, 85% of the surface was covered with cells. An advantage of the combination of AP + CAP was not detectable compared to AP (cell coverage ranged from 57% up to 75%). After sole CAP treatment, microorganisms re-grew and destroyed all cells. The WCA was reduced by all treatment methods.

CONCLUSION

An AP treatment has the potential to remove biofilm from rough implant surfaces completely. In contrast to our hypothesis, the combination of plasma and AP treatment did not enhance osteoblast spreading.

A highly efficient, low-toxic, wide-spectrum antibacterial coating designed for 3D printed implants with tailorable release properties

A broad spectrum antibacterial coatings with tailorable release properties were developed for 3D printed implants.

Chlorhexidine hexametaphosphate nanoparticles as a novel antimicrobial coating for dental implants

Dental implants are an increasingly popular solution to missing teeth. Implants are prone to colonisation by pathogenic oral bacteria which can lead to inflammation, destruction of bone and ultimately implant failure. The aim of this study was to investigate the use of chlorhexidine (CHX) hexametaphosphate (HMP) nanoparticles (NPs) with a total CHX concentration equivalent to 5 mM as a coating for dental implants. The CHX HMP NPs had mean diameter 49 nm and composition was confirmed showing presence of both chlorine and phosphorus. The NPs formed micrometer-sized aggregated surface deposits on commercially pure grade II titanium substrates following immersion-coating for 30 s. When CHX HMP NP-coated titanium specimens were immersed in deionised water, sustained release of soluble CHX was observed, both in the absence and presence of a salivary pellicle, for the duration of the study (99 days) without reaching a plateau. Control specimens exposed to a solution of aqueous 25 µM CHX (equivalent to the residual aqueous CHX present with the NPs) did not exhibit CHX release. CHX HMP NP-coated surfaces exhibited antimicrobial efficacy against oral primary colonising bacterium Streptococcus gordonii within 8 h. The antimicrobial efficacy was greater in the presence of an acquired pellicle which is postulated to be due to retention of soluble CHX by the pellicle.

Experimental study of strontium adsorption on anatase nanoparticles as a function of size with a density functional theory and CD model interpretation

The effect of particle size on the adsorption of Sr(2+) onto monodisperse nanometer diameter (4, 20, and 40 nm) anatase samples has been evaluated quantitatively with macroscopic experimental studies. The adsorption of Sr(2+) onto the anatase particles was evaluated by potentiometric titrations in NaCl media, at two ionic strengths (0.03 and 0.3 m), and over a wide range of pH (3-11) and surface loadings, at a temperature of 25 °C. Adsorption of Sr(2+) to the surface of the 20 and 40 nm diameter samples was similar, whereas the Sr(2+) adsorption titration curves were shallower for the 4 nm diameter samples. At high pH, the smallest particles adsorbed slightly less Sr(2+) than was adsorbed by the larger particles. At the molecular scale, density functional theory (DFT) calculations were used to evaluate the most stable Sr(2+) surface species on the (101) anatase surface (the predominant crystal face). An inner-sphere Sr-tridentate surface species was found to be the most stable. The experimental data were described with a charge distribution (CD) and multisite complexation (MUSIC) model, with a Basic Stern layer description of the electric double layer. The resulting surface complexation model explicitly incorporated the molecular-scale information from the DFT simulation results. For 20 and 40 nm diameter anatase, the CD value for the Sr-tridentate species was calculated using a bond valence interpretation of the DFT-optimized geometry. The CD value for the 4 nm sample was smaller than that for the 20 and 40 nm samples, reflecting the shallower Sr(2+) adsorption titration curves. The adsorption differences between the smallest and larger anatase particles can be rationalized by water being more highly structured near the 4 nm anatase sample and/or the Sr-tridentate surface species may require more well-developed surface terraces than are present on the 4 nm particles.

Titanium as a Reconstruction and Implant Material in Dentistry: Advantages and Pitfalls

Commercial pure titanium (cpTi) has been the material of choice in several disciplines of dentistry due to its biocompatibility, resistance to corrosion and mechanical properties. Despite a number of favorable characteristics, cpTi as a reconstruction and oral implant material has several shortcomings. This paper highlights current knowledge on material properties, passive oxidation film formation, corrosion, surface activation, cell interactions, biofilm development, allergy, casting and machining properties of cpTi for better understanding and potential improvement of this material for its clinical applications.

Chlorhexidine delivery system from titanium/polybenzyl acrylate coating: evaluation of cytotoxicity and early bacterial adhesion

OBJECTIVES

The formation of biofilms on titanium dental implants is one of the main causes of failure of these devices. Streptococci are considered early colonizers that alter local environment favouring growing conditions for other colonizers. Chlorhexidine (CHX) is so far the most effective antimicrobial treatment against a wide variety of Gram-positive and Gram-negative organisms as well as fungi. This study was designed to develop a CHX delivery system appropriate for healing caps and abutments, with suitable drug release rate, effective as antimicrobial agent, and free of cytotoxic effects.

METHODS

Polybenzyl acrylate (PBA) coatings with and without CHX (Ti/PBA and Ti/PBA-CHX, respectively) and different drug loads (0.35, 0.70, and 1.40%, w/w) were assayed. The cytotoxic effect of CHX released from the different substrates on UMR106 cells was tested by alkaline phosphatase specific activity (ALP), and microscopic evaluation of the cells. Non-cytotoxic drug load (0.35%, w/w) was selected to evaluate the antimicrobial effectiveness of the system using a microbial consortium of Streptococcus species.

RESULTS

The kinetic profile of CHX delivered by Ti/PBA-CHX showed an initial fast release rate followed by a monotonic increase of delivered mass over 48 h. The number of attached bacteria decreased in the following order: Ti>Ti/PBA>Ti/PBA-0.35.

CONCLUSIONS

PBA-0.35 coating is effective to inhibit the adhesion of early colonizers on Ti without any cytotoxic effect on UMR-106 cells.

PbSe nanocrystal growth as nanocubes and nanorods on peptide nanotubes via different directed-assembly pathways

Pb-binding TAR-1 peptides (Ile-Ser-Leu-Leu-His-Ser-Thr) were covalently conjugated on a bolaamphiphile peptide nanotube substrate and the precursors of PbSe were incubated at room temperature. This resulted in the growth of highly crystalline PbSe nanocubes on this biomimetic cylindrical substrate. The growth mechanism to generate nanocubes occurs via the directed self-assembly of nanoparticles and then nanoparticle fusion. The peptide conformation and the cylindrical peptide nanotube substrate play important roles in the mesoscopic crystallization of PbSe nanocubes. Changing the buffer for the peptide immobilization process from 2-(N-morpholino)ethanesulfonic acid to phosphate induces a transformation in the nanocrystal shape from nanocube to nanorods. The conformational change of the TAR-1 peptide on the nanotubes due to the change in the buffer seems to be responsible for aggregating intermediate nanoparticles in different directions for the directed fusion and mesoscopic crystallization of PbSe into the different shapes.

Effects on titanium implant surfaces of chemical agents used for the treatment of peri-implantitis

The treatment of peri-implantitis, which causes tissue deterioration surrounding osseointegrated implants, involves surface decontamination and cleaning. However, chemical cleaning agents may alter the structure of implant surfaces. We investigated three such cleaning solutions. Commercially pure (grade 4) machined titanium discs (CAMLOG Biotechnologies AG, Switzerland) were treated with 3% H(2)O(2) (5 min), saturated citric acid (pH = 1) (1 min) or chlorhexidine gel (5 min), and their surface properties were examined by atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). Human epithelial cell attachment (24-h observation) and proliferation (72-h observation) were investigated via dimethylthiazolyl-diphenyltetrazolium bromide (MTT) and bicinchoninic acid (BCA) protein content assays. AFM revealed no significant difference in roughness of the three treated surfaces. XPS confirmed the constant presence of typical surface elements and an intact TiO(2) layer on each surface. The XPS peaks after chlorhexidine gel treatment demonstrated C-O and/or C=O bond formation, due to chlorhexidine digluconate infiltrating the surface. MTT and BCA assays indicated similar epithelial cell attachments in the three groups; epithelial cell proliferation being significantly higher after H(2)O(2) than after chlorhexidine gel treatment (not shown by BCA assays). These agents do not harm the Ti surface. Cleaning with H(2)O(2) slightly enhances human epithelial cell growth, in contrast to chlorhexidine gel.

Differential adhesion of Streptococcus gordonii to anatase and rutile titanium dioxide surfaces with and without functionalization with chlorhexidine

The majority of dental implants are composed primarily of titanium and have an outer layer of titanium dioxide. Crystalline titanium dioxide most commonly exists in one of the two structures, anatase and rutile, and both of these have been observed on commercially available dental implants. Early implant failure can be associated with postoperative infection due to implant contamination during or immediately after surgery. The impetus of this study was to investigate whether functionalization of anatase and rutile titanium dioxide surfaces with chlorhexidine-reduced subsequent colonization of the surface by Streptococcus gordonii. Exposure to 100 mg x L(-1) chlorhexidine for 60 s resulted in a fivefold reduction in S. gordonii coverage on anatase and a twofold reduction on rutile. This may be related to a preferential adsorption of chlorhexidine to anatase compared with rutile. The reduction in bacterial coverage was not due to desorption of chlorhexidine into solution. More bacteria were observed on anatase than rutile surfaces without chlorhexidine functionalization, indicating that crystal structure may have a significant effect on bacterial colonization. In conclusion, functionalization with chlorhexidine reduced bacterial coverage on titanium dioxide surfaces, and anatase surfaces may be more amenable to such treatment than rutile.