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Liu D, Li H, Yang Y, Xu S, Zheng X, Liu J, Miyazaki T, Zhu Y. Preparation and characterizations of antibacterial poly(methyl methacrylate) bone cement via copolymerization with a quaternary ammonium monomer of dimethylaminotriclosan methacrylate. J Mech Behav Biomed Mater 2024; 151:106367. [PMID: 38194787 DOI: 10.1016/j.jmbbm.2023.106367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/30/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024]
Abstract
Poly (methyl methacrylate) (PMMA) bone cement relies on the loaded antibiotic to realize the antibacterial purpose. But the exothermic behavior during setting often makes temperature-sensitive antibiotics inactivated. It is necessary to develop new material candidates to replace antibiotics. In this study, a new quaternary ammonium methacrylate (QAM) monomer called dimethylaminetriclosan methacrylate (DMATCM) was designed by the quaternization between 2-(Dimethylamino)ethyl methacrylate and triclosan, then employed as the modifier to explore the feasibility of equipping bone cement with antibacterial activity, and to investigate the variations on the physical and biological performances brought by the substitution ratio of DMATCM to MMA. Results showed that DMATCM opened its C=C bonding to participate in the MMA polymerization, and the quaternary ammonium group helped it to perform broad-spectrum antibacterial property against both Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. With an increased substitution ratio of DMATCM to MMA, the glass transition temperatures, the maximum exothermic temperatures, and the contact angles of bone cements declined, but the residual monomer contents, the fluid uptakes, and the setting times under Vical indentation increased. Long-term soaking made almost no changes to the weight loss and the mechanical properties of DMATCM-modified cements with lower substitution ratios of 0∼20%, and the activation rather enhanced the strengths of uncured AMBC-4 and AMBC-5 samples. Owing to more DMATCM exposed on the cement surface, the inhibition ring diameter produced by modified cement was improved to a maximum of 28.09 mm, and MC3T3-E1 cells performed the cell viabilities all beyond 70% and healthy adhesion after 72 h co-culturing. Taking all measured properties and ISO standards into account, the antibacterial bone cement under the ratio of 10% performed better, besides its good bactericidal effect, the other properties satisfied the requirements for clinical application.
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Affiliation(s)
- Dong Liu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Haoyang Li
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Yunping Yang
- Spine Surgery Department, Affiliated Hospital of Yunnan University, No.176 Qingnian Road, Wuhua District, Kunming, Yunnan, 650021, China.
| | - Shan Xu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Xihao Zheng
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Jinkun Liu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Toshiki Miyazaki
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2-4, Hibikino, Wakamatsu-ku, Kitakyushu-shi, 808-0196, Japan.
| | - Yan Zhu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
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Tan QC, Jiang XS, Chen L, Huang JF, Zhou QX, Wang J, Zhao Y, Zhang B, Sun YN, Wei M, Zhao X, Yang Z, Lei W, Tang YF, Wu ZX. Bioactive graphene oxide-functionalized self-expandable hydrophilic and osteogenic nanocomposite for orthopaedic applications. Mater Today Bio 2022; 18:100500. [DOI: 10.1016/j.mtbio.2022.100500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/30/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022] Open
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Ayre WN, Scully N, Elford C, Evans BA, Rowe W, Rowlands J, Mitha R, Malpas P, Manti P, Holt C, Morgan-Jones R, Birchall JC, Denyer SP, Evans SL. Alternative radiopacifiers for polymethyl methacrylate bone cements: Silane-treated anatase titanium dioxide and yttria-stabilised zirconium dioxide. J Biomater Appl 2021; 35:1235-1252. [PMID: 33573445 PMCID: PMC8058833 DOI: 10.1177/0885328220983797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Poly (methyl methacrylate) (PMMA) bone cement is widely used for anchoring joint arthroplasties. In cement brands approved for these procedures, micron-sized particles (usually barium sulphate, BaSO4) act as the radiopacifier. It has been postulated that these particles act as sites for crack initiation and subsequently cement fatigue. This study investigated whether alternative radiopacifiers, anatase titanium dioxide (TiO2) and yttria-stabilised zirconium dioxide (ZrO2), could improve the in vitro mechanical, fatigue crack propagation and biological properties of polymethyl methacrylate (PMMA) bone cement and whether their coating with a silane could further enhance cement performance. Cement samples containing 0, 5, 10, 15, 20 and 25%w/w TiO2 or ZrO2 and 10%w/w silane-treated TiO2 or ZrO2 were prepared and characterised in vitro in terms of radiopacity, compressive and bending strength, bending modulus, fatigue crack propagation, hydroxyapatite forming ability and MC3T3-E1 cell attachment and viability. Cement samples with greater than 10%w/w TiO2 and ZrO2 had a similar radiopacity to the control 10%w/w BaSO4 cement and commercial products. The addition of TiO2 and ZrO2 to bone cement reduced the bending strength and fracture toughness and increased fatigue crack propagation due to the formation of agglomerations and voids. Silane treating TiO2 reversed this effect, enhancing the dispersion and adhesion of particles to the PMMA matrix and resulted in improved mechanical properties and fatigue crack propagation resistance. Silane-treated TiO2 cements had increased nucleation of hydroxyapatite and MC3T3-E1 cell attachment in vitro, without significantly compromising cell viability. This research has demonstrated that 10%w/w silane-treated anatase TiO2 is a promising alternative radiopacifier for PMMA bone cement offering additional benefits over conventional BaSO4 radiopacifiers.
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Affiliation(s)
| | | | | | | | - Wendy Rowe
- School of Dentistry, Cardiff University, Cardiff, UK
| | - Jeff Rowlands
- School of Engineering, Cardiff University, Cardiff, UK
| | - Ravi Mitha
- School of Engineering, Cardiff University, Cardiff, UK
| | - Paul Malpas
- School of Engineering, Cardiff University, Cardiff, UK
| | | | - Cathy Holt
- School of Engineering, Cardiff University, Cardiff, UK
| | - Rhidian Morgan-Jones
- Department of Trauma & Orthopaedics, Cardiff & Vale University Health Board, Cardiff, UK
| | - James C Birchall
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Stephen P Denyer
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Sam L Evans
- School of Engineering, Cardiff University, Cardiff, UK
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Nevares G, Queiroz de Melo Monteiro G, Veras Sobral AP, Lemos de Campello S, Cristiny Figueredo Cassimiro da Silva M, Bezerra A, Xavier Bezerra da Silva F, Musso Scheneider C, Santana Albuquerque D. Hardened exogenous material after extrusion of calcium hydroxide with barium sulfate: Case study and histopathologic and laboratory analyses. J Am Dent Assoc 2019; 149:59-66. [PMID: 29304911 DOI: 10.1016/j.adaj.2017.07.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/17/2017] [Accepted: 07/31/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OVERVIEW Although calcium hydroxide (Ca[OH]2) paste associated with barium sulfate (BaSO4) is considered a safe agent, there is a lack of clinical research on its effects on periodontal and submucosal tissues. The aim of the authors was to report the effects of extrusion of Ultracal XS paste (Ultradent Products) in 2 cases. The authors also analyzed the paste constituents and compared them with the proportion reported by the manufacturer and the material extruded. CASE DESCRIPTION The authors present 2 cases in which root canals were restored with Ultracal XS paste after cleaning and shaping, and there was unintentional overextension of the paste into periradicular tissues, with a hardened exogenous material observed associated with inflammatory signs and symptoms. A biopsy was performed, and the material was subjected to histopathologic analysis and characterization through scanning electron microscopy, energy dispersive x-ray spectroscopy, Fourier transform infrared spectroscopy, and x-ray diffraction. CONCLUSIONS BaSO4 and calcium carbonate (CaCO3) were associated with a hardened material after Ultracal XS paste extrusion. The Ca(OH)2 percentage on the Ultracal XS paste was approximately 2 times greater than the proportion reported by the manufacturer. PRACTICAL IMPLICATIONS Ca(OH)2 with BaSO4 paste application should be performed carefully, and its extrusion to periradicular and submucosal tissues should not occur. Its extrusion may result in the formation of a persistent exogenous material of hardened consistency associated with inflammatory signs and symptoms.
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Wang C, Yu B, Fan Y, Ormsby RW, McCarthy HO, Dunne N, Li X. Incorporation of multi-walled carbon nanotubes to PMMA bone cement improves cytocompatibility and osseointegration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 103:109823. [DOI: 10.1016/j.msec.2019.109823] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 05/04/2019] [Accepted: 05/27/2019] [Indexed: 02/07/2023]
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Martínez-Moreno J, Merino V, Nácher A, Rodrigo JL, Climente M, Merino-Sanjuán M. Antibiotic-loaded Bone Cement as Prophylaxis in Total Joint Replacement. Orthop Surg 2018; 9:331-341. [PMID: 29178309 DOI: 10.1111/os.12351] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/10/2017] [Indexed: 12/14/2022] Open
Abstract
One of its most serious complications associated with arthroplasty is the development of infections. Although its prevalence is only between 0.5% and 3%, in some cases it can lead to death. Therefore, an important challenge in joint surgery is the prevention of infections when an arthroplasty is performed. The use of antibiotic-loaded cements could be a suitable tool due to numerous advantages. The main advantage of the use of antibiotic loading into bone cement derives directly from antibiotic release in the effect site, allowing achievement of high concentrations at the site of action, and minimal or no systemic toxicity. This route of administration was first described by Buchholz and Engelbrecht. In the case of infection treatment, this is an established method and its good results have been confirmed. However, its role in infection prevention, and, therefore, the use of these systems in clinical practice, has proved controversial because of the uncertainty about the development of possible antibiotic resistance after prolonged exposure time, their effectiveness, the cost of the systems, toxicity and loosening of mechanical properties. This review discusses all these topics, focusing on effectiveness and safety, antibiotic decisions, cement type, mixing method, release kinetics and future perspectives. The final objective is to provide the orthopaedic surgeons the right information in their clinical practice based on current evidence.
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Affiliation(s)
- Javier Martínez-Moreno
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Institute of Molecular Recognition and Technological Development, Mixed Center Polytechnic University of Valencia, University of Valencia, Valencia, Spain.,Pharmacy Service, University Hospital Doctor Peset of Valencia, Valencia, Spain
| | - Virginia Merino
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Institute of Molecular Recognition and Technological Development, Mixed Center Polytechnic University of Valencia, University of Valencia, Valencia, Spain
| | - Amparo Nácher
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Institute of Molecular Recognition and Technological Development, Mixed Center Polytechnic University of Valencia, University of Valencia, Valencia, Spain
| | - José Luis Rodrigo
- Traumatology Service, University Hospital Doctor Peset of Valencia, Valencia, Spain
| | - Mónica Climente
- Pharmacy Service, University Hospital Doctor Peset of Valencia, Valencia, Spain
| | - Matilde Merino-Sanjuán
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Institute of Molecular Recognition and Technological Development, Mixed Center Polytechnic University of Valencia, University of Valencia, Valencia, Spain
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Orthopaedic implant failure: aseptic implant loosening–the contribution and future challenges of mouse models in translational research. Clin Sci (Lond) 2014; 127:277-93. [DOI: 10.1042/cs20130338] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aseptic loosening as a result of wear debris is considered to be the main cause of long-term implant failure in orthopaedic surgery and improved biomaterials for bearing surfaces decreases significantly the release of micrometric wear particles. Increasingly, in-depth knowledge of osteoimmunology highlights the role of nanoparticles and ions released from some of these new bearing couples, opening up a new era in the comprehension of aseptic loosening. Mouse models have been essential in the progress made in the early comprehension of pathophysiology and in testing new therapeutic agents for particle-induced osteolysis. However, despite this encouraging progress, there is still no valid clinical alternative to revision surgery. The present review provides an update of the most commonly used bearing couples, the current concepts regarding particle–cell interactions and the approaches used to study the biology of periprosthetic osteolysis. It also discusses the contribution and future challenges of mouse models for successful translation of the preclinical progress into clinical applications.
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Slane J, Vivanco J, Meyer J, Ploeg HL, Squire M. Modification of acrylic bone cement with mesoporous silica nanoparticles: Effects on mechanical, fatigue and absorption properties. J Mech Behav Biomed Mater 2014; 29:451-61. [DOI: 10.1016/j.jmbbm.2013.10.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 10/01/2013] [Accepted: 10/07/2013] [Indexed: 11/24/2022]
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Fang C, Hou R, Zhou K, Hua F, Cong Y, Zhang J, Fu J, Cheng YJ. Surface functionalized barium sulfate nanoparticles: controlled in situ synthesis and application in bone cement. J Mater Chem B 2014; 2:1264-1274. [DOI: 10.1039/c3tb21544j] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Controlled in situ synthesis of MSAH-coated BaSO4 nanoparticles improves the mechanical properties and in vitro biocompatibility of the bone cements.
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Affiliation(s)
- Chao Fang
- Polymers and Composites Division
- Ningbo Institute of Materials Technology and Engineering
- Chinese Academy of Sciences
- Ningbo, P. R. China
- Faculty of Materials Science and Chemical Engineering
| | - Ruixia Hou
- Polymers and Composites Division
- Ningbo Institute of Materials Technology and Engineering
- Chinese Academy of Sciences
- Ningbo, P. R. China
| | - Kefeng Zhou
- Department of Radiology
- Nanjing Drum Tower Hospital
- The Affiliated Hospital of Nanjing University Medical School
- Nanjing, P. R. China
| | - Feibin Hua
- School of Chemical Engineering
- Ningbo University of Technology
- Ningbo, P. R. China
| | - Yang Cong
- School of Chemical Engineering
- Ningbo University of Technology
- Ningbo, P. R. China
| | - Jianfeng Zhang
- Faculty of Materials Science and Chemical Engineering
- Ningbo University
- Ningbo, P. R. China
| | - Jun Fu
- Polymers and Composites Division
- Ningbo Institute of Materials Technology and Engineering
- Chinese Academy of Sciences
- Ningbo, P. R. China
| | - Ya-Jun Cheng
- Polymers and Composites Division
- Ningbo Institute of Materials Technology and Engineering
- Chinese Academy of Sciences
- Ningbo, P. R. China
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