Mechanical testing of antimicrobial biocomposite coating on metallic medical implants as drug delivery system

How Is Bone Regeneration Influenced by Polymer Membranes? Insight into the Histological and Radiological Point of View in the Literature

The aim of this study was to analyze published works that investigate the in vivo bone regeneration capacity of polymeric membranes loaded with active substances and growth factors. This scoping review's purpose was to highlight the histological and radiological interpretation of the locally produced effects of the polymer membranes studied so far. For the selection of the articles, a search was made in the PubMed and ScienceDirect databases, according to the PRISMA algorithm, for research/clinical trial type studies. The search strategy was represented by the formula "((biodegradable scaffolds AND critical bone defect) OR (polymers AND mechanical properties) OR (3Dmaterials AND cytotoxicity) AND bone tissue regeneration)" for the PubMed database and "((biodegradable scaffolds AND polymers) OR (polymers AND critical bone defects) OR (biodegradable scaffolds AND mechanical properties) AND bone tissue regeneration)" for the ScienceDirect database. Ethical approval was not required. Eligibility criteria included eight clinical studies published between 2018 and 2023. Our analysis showed that polymer membranes that met most histopathological criteria also produced the most remarkable results observed radiologically. The top effective scaffolds were those containing active macromolecules released conditionally and staged. The PLGA and polycaprolactone scaffolds were found in this category; they granted a marked increase in bone density and improvement of osteoinduction. But, regardless of the membrane composition, all membranes implanted in created bone defects induced an inflammatory response in the first phase.

Advanced Procedure of Simultaneous Electrodeposition from a Natural Deep Eutectic Solvent of a Drug and a Polymer Used to Improve TiZr Alloy Behavior

This paper presents research about the embedding and release of gentamicin from an electrochemical deposition of polypyrrole from ionic liquids such as choline chloride on TiZr bioalloy. The electrodeposited films were morphologically investigated using scanning electron microscopy (SEM) with an EDX module, and polypyrrole and gentamicin were both identified using structural FT-IR analysis. The film's characterization was completed with an evaluation of hydrophilic-hydrophobic balance, with electrochemical stability measurements in PBS and with antibacterial inhibition. A decrease in the value of the contact angle was observed from 47.06° in the case of the uncoated sample to 8.63° in the case of the sample covered with PPy and GS. Additionally, an improvement in the anticorrosive properties of the coating was observed by increasing the efficiency to 87.23% in the case of TiZr-PPy-GS. A kinetic study of drug release was performed as well. The drug molecule might be provided by the PPy-GS coatings for up to 144 h. The highest amount released was calculated to be 90% of the entire drug reservoir capacity, demonstrating the effectiveness of the coatings. A non-Fickian behavior was established as a mechanism for the release profiles of the gentamicin from the polymer layer.

Computational Study of the Influence of α/β-Phase Ratio and Porosity on the Elastic Modulus of Ti-Based Alloy Foams

This work aims to perform a computational analysis on the influence that microstructure and porosity have on the elastic modulus of Ti-6Al-4V foams used in biomedical applications with different α/β-phase ratios. The work is divided into two analyses, first the influence that the α/β-phase ratio has and second the effects that porosity and α/β-phase ratio have on the elastic modulus. Two microstructures were analyzed: equiaxial α-phase grains + intergranular β-phase (microstructure A) and equiaxial β-phase grains + intergranular α-phase (microstructure B). The α/β-phase ratio was variated from 10 to 90% and the porosity from 29 to 56%. The simulations of the elastic modulus were carried out using finite element analysis (FEA) using ANSYS software v19.3. The results were compared with experimental data reported by our group and those found in the literature. The β-phase amount and porosity have a synergic effect on the elastic modulus, for example, when the foam has a porosity of 29 with 0% β-phase, and it has an elastic modulus of ≈55 GPa, but when the β-phase amount increases to 91%, the elastic modulus decreases as low as 38 GPa. The foams with 54% porosity have values smaller than 30 GPa for all the β-phase amounts.

Overview of Antimicrobial Biodegradable Polyester-Based Formulations

As the clinical complications induced by microbial infections are known to have life-threatening side effects, conventional anti-infective therapy is necessary, but not sufficient to overcome these issues. Some of their limitations are connected to drug-related inefficiency or resistance and pathogen-related adaptive modifications. Therefore, there is an urgent need for advanced antimicrobials and antimicrobial devices. A challenging, yet successful route has been the development of new biostatic or biocide agents and biomaterials by considering the indisputable advantages of biopolymers. Polymers are attractive materials due to their physical and chemical properties, such as compositional and structural versatility, tunable reactivity, solubility and degradability, and mechanical and chemical tunability, together with their intrinsic biocompatibility and bioactivity, thus enabling the fabrication of effective pharmacologically active antimicrobial formulations. Besides representing protective or potentiating carriers for conventional drugs, biopolymers possess an impressive ability for conjugation or functionalization. These aspects are key for avoiding malicious side effects or providing targeted and triggered drug delivery (specific and selective cellular targeting), and generally to define their pharmacological efficacy. Moreover, biopolymers can be processed in different forms (particles, fibers, films, membranes, or scaffolds), which prove excellent candidates for modern anti-infective applications. This review contains an overview of antimicrobial polyester-based formulations, centered around the effect of the dimensionality over the properties of the material and the effect of the production route or post-processing actions.

Recent Advancements in Metallic Drug-Eluting Implants

Over the past decade, metallic drug-eluting implants have gained significance in orthopedic and dental applications for controlled drug release, specifically for preventing infection associated with implants. Recent studies showed that metallic implants loaded with drugs were substituted for conventional bare metal implants to achieve sustained and controlled drug release, resulting in a desired local therapeutic concentration. A number of secondary features can be provided by the incorporated active molecules, including the promotion of osteoconduction and angiogenesis, the inhibition of bacterial invasion, and the modulation of host body reaction. This paper reviews recent trends in the development of the metallic drug-eluting implants with various drug delivery systems in the past three years. There are various types of drug-eluting implants that have been developed to meet this purpose, depending on the drug or agents that have been loaded on them. These include anti-inflammatory drugs, antibiotics agents, growth factors, and anti-resorptive drugs.

In vitro testing and efficacy of poly-lactic acid coating incorporating antibiotic loaded coralline bioceramic on Ti6Al4V implant against Staphylococcus aureus

Biofilm formation on an implant surface is most commonly caused by the human pathogenic bacteria Staphylococcus aureus, which can lead to implant related infections and failure. It is a major problem for both implantable orthopedic and maxillofacial devices. The current antibiotic treatments are typically delivered orally or in an injectable form. They are not highly effective in preventing or removing biofilms, and they increase the risk of antibiotic resistance of bacteria and have a dose-dependent negative biological effect on human cells. Our aim was to improve current treatments via a localized and controlled antibiotic delivery-based implant coating system to deliver the antibiotic, gentamicin (Gm). The coating contains coral skeleton derived hydroxyapatite powders (HAp) that act as antibiotic carrier particles and have a biodegradable poly-lactic acid (PLA) thin film matrix. The system is designed to prevent implant related infections while avoiding the deleterious effects of high concentration antibiotics in implants on local cells including primary human adipose derived stem cells (ADSCs). Testing undertaken in this study measured the rate of S. aureus biofilm formation and determined the growth rate and proliferation of ADSCs. After 24 h, S. aureus biofilm formation and the percentage of live cells found on the surfaces of all 5%-30% (w/w) PLA-Gm-(HAp-Gm) coated Ti6Al4V implants was lower than the control samples. Furthermore, Ti6Al4V implants coated with up to 10% (w/w) PLA-Gm-(HAp-Gm) did not have noticeable Gm related adverse effect on ADSCs, as assessed by morphological and surface attachment analyses. These results support the use and application of the antibacterial PLA-Gm-(HAp-Gm) thin film coating design for implants, as an antibiotic release control mechanism to prevent implant-related infections.

Inorganic Nanoparticles in Bone Healing Applications

Modern biomedicine aims to develop integrated solutions that use medical, biotechnological, materials science, and engineering concepts to create functional alternatives for the specific, selective, and accurate management of medical conditions. In the particular case of tissue engineering, designing a model that simulates all tissue qualities and fulfills all tissue requirements is a continuous challenge in the field of bone regeneration. The therapeutic protocols used for bone healing applications are limited by the hierarchical nature and extensive vascularization of osseous tissue, especially in large bone lesions. In this regard, nanotechnology paves the way for a new era in bone treatment, repair and regeneration, by enabling the fabrication of complex nanostructures that are similar to those found in the natural bone and which exhibit multifunctional bioactivity. This review aims to lay out the tremendous outcomes of using inorganic nanoparticles in bone healing applications, including bone repair and regeneration, and modern therapeutic strategies for bone-related pathologies.

Progress in Niobium Oxide-Containing Coatings for Biomedical Applications: A Critical Review

Typically, pure niobium oxide coatings are deposited on metallic substrates, such as commercially pure Ti, Ti6Al4 V alloys, stainless steels, niobium, TiNb alloy, and Mg alloys using techniques such as sputter deposition, sol-gel deposition, anodizing, and wet plasma electrolytic oxidation. The relative advantages and limitations of these coating techniques are considered, with particular emphasis on biomedical applications. The properties of a wide range of pure and modified niobium oxide coatings are illustrated, including their thickness, morphology, microstructure, elemental composition, phase composition, surface roughness and hardness. The corrosion resistance, tribological characteristics and cell viability/proliferation of the coatings are illustrated using data from electrochemical, wear resistance and biological cell culture measurements. Critical R&D needs for the development of improved future niobium oxide coatings, in the laboratory and in practice, are highlighted.

Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications

An increase in the world population and its life expectancy, as well as the ongoing concern about our physical appearance, have elevated the relevance of dental implantology in recent decades. Engineering strategies to improve the survival rate of dental implants have been widely investigated, focusing on implant material composition, geometry (usually guided to reduce stiffness), and interface surrounding tissues. Although efforts to develop different implant surface modifications are being applied in commercial dental prostheses today, the inclusion of surface coatings has gained special interest, as they can be tailored to efficiently enhance osseointegration, as well as to reduce bacterial-related infection, minimizing peri-implantitis appearance and its associated risks. The use of biomaterials to replace teeth has highlighted the need for the development of reliable analytical methods to assess the therapeutic benefits of implants. This literature review considers the state-of-the-art strategies for surface modification or coating and analytical methodologies for increasing the survival rate for teeth restoration.

Enhancement of Biofunctionalization by Loading Manuka Oil on TiO2 Nanotubes

Metallic implants (mesh) for guided bone regeneration can result in foreign body reactions with surrounding tissues, infection, and inflammatory reactions caused by micro-organisms in the oral cavity after implantation. This study aimed to reduce the possibility of surgical failure caused by microbial infection by loading antibacterial manuka oil in a biocompatible nanostructure surface on Ti and to induce stable bone regeneration in the bone defect. The manuka oil from New Zealand consisted of a rich β-triketone chemotype, leptospermone, which showed strong inhibitory effects against several bacteria, even at very low oil concentrations. The TiO₂ nanotubular layer formed by anodization effectively enhanced the surface hydrophilicity, bioactivity, and fast initial bone regeneration. A concentration of manuka oil in the range of 0.02% to less than 1% can have a synergistic effect on antibacterial activity and excellent biocompatibility. A manuka oil coating (especially with a concentration of 0.5%) on the TiO₂ nanotube layer can be expected not only to prevent stenosis of the connective tissue around the mesh and inflammation by microbial infection but also to be effective in stable and rapid bone regeneration.

Bioactive Coatings Loaded with Osteogenic Protein for Metallic Implants

Osteoconductive and osteoinductive coatings represent attractive and tunable strategies towards the enhanced biomechanics and osseointegration of metallic implants, providing accurate local modulation of bone-to-implant interface. Composite materials based on polylactide (PLA) and hydroxyapatite (HAp) are proved beneficial substrates for the modulation of bone cells' development, being suitable mechanical supports for the repair and regeneration of bone tissue. Moreover, the addition of osteogenic proteins represents the next step towards the fabrication of advanced biomaterials for hard tissue engineering applications, as their regulatory mechanisms beneficially contribute to the new bone formation. In this respect, laser-processed composites, based on PLA, Hap, and bone morphogenetic protein 4(BMP4), are herein proposed as bioactive coatings for metallic implants. The nanostructured coatings proved superior ability to promote the adhesion, viability, and proliferation of osteoprogenitor cells, without affecting their normal development and further sustaining the osteogenic differentiation of the cells. Our results are complementary to previous studies regarding the successful use of chemically BMP-modified biomaterials in orthopedic and orthodontic applications.

Bioactive Coatings Based on Hydroxyapatite, Kanamycin, and Growth Factor for Biofilm Modulation

The occurrence of opportunistic local infections and improper integration of metallic implants results in severe health conditions. Protective and tunable coatings represent an attractive and challenging selection for improving the metallic devices' biofunctional performances to restore or replace bone tissue. Composite materials based on hydroxyapatite (HAp), Kanamycin (KAN), and fibroblast growth factor 2 (FGF2) are herein proposed as multifunctional coatings for hard tissue implants. The superior cytocompatibility of the obtained composite coatings was evidenced by performing proliferation and morphological assays on osteoblast cell cultures. The addition of FGF2 proved beneficial concerning the metabolic activity, adhesion, and spreading of cells. The KAN-embedded coatings exhibited significant inhibitory effects against bacterial biofilm development for at least two days, the results being superior in the case of Gram-positive pathogens. HAp-based coatings embedded with KAN and FGF2 protein are proposed as multifunctional materials with superior osseointegration potential and the ability to reduce device-associated infections.

Corrosion Behavior and Biological Activity of Micro Arc Oxidation Coatings with Berberine on a Pure Magnesium Surface

Bone tissue repair materials can cause problems such as inflammation around the implant, slow bone regeneration, and poor repair quality. In order to solve these problems, a coating was prepared by ultrasonic micro-arc oxidation and self-assembly technology on a pure magnesium substrate. We studied the effect of berberine on the performance of the ultrasonic micro-arc oxidation/polylactic acid and glycolic acid copolymer/berberine (UMAO/PLGA/BR) coating. The chemical and morphological character of the coating was analyzed using scanning electron microscopy, X-ray diffraction, and X-ray photoelectron spectroscopy. The corrosion properties were studied by potentiodynamic polarization and electrochemical impedance spectroscopy in a simulated body fluid. The cumulative release of drugs was tested by high-performance liquid chromatography. The results indicate that different amounts of BR can seal the corrosion channel to different extents. These coatings have a self-corrosion current density (Icorr) at least one order of magnitude lower than the UMAO coatings. When the BR content is 3.0 g/L, the self-corrosion current density of the UMAO/PLGA/BR coatings is the lowest (3.14 × 10−8 A/cm2) and the corrosion resistance is improved. UMAO/PLGA/BR coatings have excellent biological activity, which can effectively solve the clinical problem of rapid degradation of pure magnesium and easy infection.

Customized Therapeutic Surface Coatings for Dental Implants

Dental implants are frequently used to support fixed or removable dental prostheses to replace missing teeth. The clinical success of titanium dental implants is owed to the exceptional biocompatibility and osseointegration with the bone. Therefore, the enhanced therapeutic effectiveness of dental implants had always been preferred. Several concepts for implant coating and local drug delivery had been developed during the last decades. A drug is generally released by diffusion-controlled, solvent-controlled, and chemical controlled methods. Although a range of surface modifications and coatings (antimicrobial, bioactive, therapeutic drugs) have been explored for dental implants, it is still a long way from designing sophisticated therapeutic implant surfaces to achieve the specific needs of dental patients. The present article reviews various interdisciplinary aspects of surface coatings on dental implants from the perspectives of biomaterials, coatings, drug release, and related therapeutic effects. Additionally, the various types of implant coatings, localized drug release from coatings, and how released agents influence the bone–implant surface interface characteristics are discussed. This paper also highlights several strategies for local drug delivery and their limitations in dental implant coatings as some of these concepts are yet to be applied in clinical settings due to the specific requirements of individual patients.

Modification of PLA-Based Films by Grafting or Coating

Recently, the demand for the use of natural polymers in the cosmetic, biomedical, and sanitary sectors has been increasing. In order to meet specific functional properties of the products, usually, the incorporation of the active component is required. One of the main problems is enabling compatibility between hydrophobic and hydrophilic surfaces. Therefore, surface modification is necessary. Poly(lactide) (PLA) is a natural polymer that has attracted a lot ofattention in recent years. It is bio-based, can be produced from carbohydrate sources like corn, and it is biodegradable. The main goal of this work was the functionalization of PLA, inserting antiseptic and anti-inflammatory nanostructured systems based on chitin nanofibrils-nanolignin complexes ready to be used in the biomedical, cosmetics, and sanitary sectors. The specific challenge of this investigation was to increase the interaction between the hydrophobic PLA matrix with hydrophilic chitin-lignin nanoparticle complexes. First, chemical modification via the "grafting from" method using lactide oligomers was performed. Then, active coatings with modified and unmodified chitin-lignin nanoparticle complexes were prepared and applied on extruded PLA-based sheets. The chemical, thermal, and mechanical characterization of prepared samples was carried out and the obtained results were discussed.

Bioactive Surfaces of Polylactide and Silver Nanoparticles for the Prevention of Microbial Contamination

Thanks to its peculiar interactions with biological molecules and structures, metallic silver in the form of silver nanoparticles achieved a remarkable comeback as a potential antimicrobial agent. The antimicrobial use of silver nanoparticles is of clinical importance, as several pathogenic microorganisms developed resistance against various conventional drug treatments. Hence, given the extensive efficiency of silver nanoparticles against drug-sensitive and drug-resistant pathogens, their therapeutic implications were demonstrated in multiple medical applications, such as silver-based dressings, silver-coated biomedical devices and silver-containing nanogels. Bacterial strains possess an intrinsic ability to form well-organized microbial communities, capable of developing adaptive mechanisms to environmental aggression and self-protective pathways against antibiotics. The formation of these mono- or poly-microbial colonies, called biofilms, is closely related with the occurrence of infectious processes which result in severe and chronic pathologies. Therefore, substantial efforts were oriented to the development of new protective coatings for biomedical surfaces, capable of sustaining the physiological processes within human-derived normal cells and to disrupt the microbial contamination and colonization stages. Nanostructured materials based on polylactic acid and silver nanoparticles are herein proposed as bioactive coatings able to prevent the formation of microbial biofilms on biomedical relevant surfaces.