Polymeric nanoarchitectures on Ti-based implants for antibacterial applications

Modification of Ti-Al-V Alloys with Layers Containing TiN Particles Obtained via the Electrophoretic Deposition Process: Surface and Structural Properties

The aim of this work was to obtain homogenous coatings containing chitosan with different concentrations of titanium nitride particles (TiN). The coatings were deposited via an electrophoretic process on an etched medically pure Ti-6Al-4V alloy. As part of the study, the zeta potential of the suspensions used for EPD coating deposition was measured, allowing for the optimization of process parameters and the assessment of suspension stability. Subsequently, the research focused on evaluating the microstructure (SEM + EDS), structure (XRD), and surface characteristics (roughness, contact angle, surface energy, microhardness, coating adhesion) of the deposited layers. SEM microscopy confirmed the effective deposition of titanium nitride particles onto the titanium alloy surface. XRD analysis proved the assumed phase composition of the coating. The increase in TiN phase content in the individual layers was confirmed. The chitosan/TiN layer's introduction altered the alloy surface, increasing its roughness and static water contact angle. The highest roughness and hydrophobic properties were observed in the coating with a 2 wt.% concentration of titanium nitride particles. Additionally, the coating containing the highest concentration of ceramic particles (2 wt.%) exhibited the highest hardness (197 HV) among all the tested layers. However, the TiN particles incorporation in the layer decreased the adhesion strength, from 2.36 MPa (0.5 wt.% TiN) to 1.04 MPa (2 wt.% TiN). The coatings surface and structural properties demonstrate potential as protective layers for implants and are suitable for further biological studies to assess their applicability in medical and veterinary fields.

Emerging Strategies to Prevent Bacterial Infections on Titanium-Based Implants

Titanium and titanium alloys remain the gold standard for dental and orthopedic implants. These materials are heavily used because of their bioinert nature, robust mechanical properties, and seamless integration with bone. However, implant-associated infections (IAIs) remain one of the leading causes of implant failure. Eradicating an IAI can be difficult since bacteria can form biofilms on the medical implant, protecting the bacterial cells against systemic antibiotics and the host's immune system. If the infection is not treated promptly and aggressively, device failure is inevitable, leading to costly multi-step revision surgeries. To circumvent this dire situation, scientists and engineers continue to develop novel strategies to protect the surface of medical implants from bacteria. In this review, details on emerging strategies to prevent infection in titanium implants are reported. These strategies include anti-adhesion properties provided by polymers, superhydrophobic, superhydrophilic, and liquid-infused surface coatings, as well as strategies and coatings employed to lyse the bacteria. Additionally, commercially available technologies and those under preclinical trials are examined while discussing current and future trends.

Physical characterization, biocompatibility, and antimicrobial activity of polyvinyl alcohol/sodium alginate blend doped with TiO2 nanoparticles for wound dressing applications

The ability of wound dressing materials to tackle skin pathogens colonization that is associated with open wound infections is limited. Recently, green-synthesized metal oxide nanoparticles has received a lot of attention to overcome this limitation. However, titanium dioxide nanoparticles (TiO2-NPs) exhibit exceptional antibacterial properties. In this work, several concentrations (0, 1, 3, and 5 wt.%) of TiO2 NPs prepared using Aloe vera leaf extract were added to a blend of polyvinyl alcohol and sodium alginate (PVA:SA). This nanocomposite was designed to enhance the healing process of wounds. The interaction between the PVA:SA composite and the TiO2 NPs was confirmed by FTIR. The thermal behavior of the nanocomposite films was investigated using DSC and TGA. The experimental results indicate that the glass transition temperatures of the nanocomposites increased by increasing the added amount of TiO2 NPs to be 53.7 °C (1 wt.%), 55.8 °C (3 wt.%), and 60.6 °C (5 wt.%), which were consistently lower than the glass transition temperature of the matrix material (69.6 °C). The Dynamic Mechanical Analysis was examined. The nanocomposite doped with 5 wt.% of TiO2 NPs detected a high storage modulus (21.6 × 108). Based on swelling and degradation studies, the prepared PVA:SA:TiO2 nanocomposite films have an excellent swelling rate, and the inclusion of TiO2 NPs increases the stability of the polymeric matrix. The PVA:SA:TiO2 nanocomposite films exhibited a superior antibacterial efficacy against Gram-positive bacteria such as Bacillus cereus and Staphylococcus aureus, compared to their effectiveness against Gram-negative bacteria like Escherichia coli. Moreover, the nanocomposite films were biocompatible with Human Skin Fibroblast. Therefore, the developed PVA:SA:TiO2 nanocomposite films suit wound dressing applications.

Near-infrared Ⅱ light-assisted Cu-containing porous TiO2 coating for combating implant-associated infection

Treatment implant-associated infections remains a severe challenge in the clinical practice. This work focuses on the fabrication of Cu-containing porous TiO2 coatings on titanium (Ti) by a combination of magnetron sputtering and dealloying techniques. Additionally, photothermal therapy is employed to enhance the effect of Cu ions in preventing bacterial infection. After the dealloying, most of Cu element was removed from the magnetron sputtered Cu-containing films, and porous TiO2 coatings were prepared on Ti. The formation of porous nanostructures significantly enhanced the photothermal conversion performance under NIR-II light irradiation. The combined effect of hyperthermia and Cu ions demonstrated enhanced antibacterial activity in both in vitro and in vivo experiments, and the antibacterial efficiency can reach 99% against Streptococcus mutans. Moreover, the porous TiO2 coatings also exhibited excellent biocompatibility. This modification of the titanium surface structure through dealloying changes may offer a novel approach to enhance the antimicrobial properties of titanium implants.

Efficient titanium surface modified using bifunctional chimeric peptides to prevent biofilm formation by multiple microorganisms

It is still a challenge to prevent the formation of bacterial biofilms on the surfaces of oral implants. A chemical peptide with binding and antibacterial properties may be a promising agent if used to modify titanium (Ti) surfaces to inhibit biofilm formation. In this study, peptides were designed by linking the antimicrobial sequence derived from human β-defensin-3 (hBD-3) to the Ti-binding peptide-1 (TBP-1) sequence by using a triple glycine (G) linker. The antimicrobial activity and biocompatibility characteristics of the chemical-peptide-modified Ti surface were then evaluated and the potential antibacterial mechanism was investigated. This study demonstrated that the chemical-peptide-modified surface exhibited satisfactory bactericidal activities against Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis. In addition to its potent bacteria-killing efficacy, the surface-immobilised chemical peptide also demonstrated excellent biocompatibility to L929 cells. Moreover, the disruption of the integrity of the bacterial membrane partially revealed the antibacterial mechanism of the peptide. This study demonstrated the potential of chemical-peptide-modified Ti surfaces for preventing the occurrence of peri-implant diseases, thereby providing a promising approach to improving the survival rate of oral implants.

Antibacterial Activity of PVA Hydrogels Embedding Oxide Nanostructures Sensitized by Noble Metals and Ruthenium Dye

Nanostructured oxides (SiO2, TiO2) were synthesized using the sol-gel method and modified with noble metal nanoparticles (Pt, Au) and ruthenium dye to enhance light harvesting and promote the photogeneration of reactive oxygen species, namely singlet oxygen (1O2) and hydroxyl radical (•OH). The resulting nanostructures were embedded in a transparent polyvinyl alcohol (PVA) hydrogel. Morphological and structural characterization of the bare and modified oxides was performed using scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force microscopy (AFM), UV-Vis spectroscopy, and X-ray photoelectron spectroscopy (XPS). Additionally, electrokinetic potential measurements were conducted. Crystallinity data and elemental analysis of the investigated systems were obtained through X-ray diffraction and X-ray fluorescence analyses, while the chemical state of the elements was determined using XPS. The engineered materials, both as simple powders and embedded in the hydrogel, were evaluated for their ability to generate reactive oxygen species (ROS) under visible and simulated solar light irradiation to establish a correlation with their antibacterial activity against Staphylococcus aureus. The generation of singlet oxygen (1O2) by the samples under visible light exposure can be of significant importance for their potential use in biomedical applications.

Simultaneous deposition of tannic acid derivative and covalent conjugation of poly(2-methyl-2-oxazoline) for the construction of antifouling coatings

Bacterial adhesion and subsequent colonization play an important role in the failure of biomedical implants and devices. Thus, development of a simple surface modification strategy to combat bacterial adhesion is highly desirable. In this work, "one-pot" fabrication of antifouling coatings based on simultaneous surface adhesion of trihydroxyphenyl and dihydroxyphenyl moieties of tannic acid (TA) derivative and covalent conjugation of hydrophilic poly(2-methyl-2-oxazoline) (PMOXA) was demonstrated. Surface co-depositions of TA/PMOXA hybrids of different TA derivative to PMOXA weight ratios and different molecular weights of PMOXA were conducted. The surface hydrophilicity and deposition universality on various substrates were investigated. The anti-bacterial and anti-platelet adhesion, as well as anti-biofilm formation abilities, of the TA/PMOXA-based coating were also studied. In vitro hemolysis and cytotoxicity, and in vivo biocompatibility of the TA/PMOXA-based coating were further evaluated. All the results indicate that the TA/PMOXA-based coating could be employed as an antifouling additive on biomedical implants and devices.

Antibacterial Ti-Cu implants: A critical review on mechanisms of action

Titanium (Ti) has been widely used for manufacturing of bone implants because of its mechanical properties, biological compatibility, and favorable corrosion resistance in biological environments. However, Ti implants are prone to infection (peri-implantitis) by bacteria which in extreme cases necessitate painful and costly revision surgeries. An emerging, viable solution for this problem is to use copper (Cu) as an antibacterial agent in the alloying system of Ti. The addition of copper provides excellent antibacterial activities, but the underpinning mechanisms are still obscure. This review sheds light on such mechanisms and reviews how incorporation of Cu can render Ti-Cu implants with antibacterial activity. The review first discusses the fundamentals of interactions between bacteria and implanted surfaces followed by an overview of the most common engineering strategies utilized to endow an implant with antibacterial activity. The underlying mechanisms for antibacterial activity of Ti-Cu implants are then discussed in detail. Special attention is paid to contact killing mechanisms because the misinterpretation of this mechanism is the root of discrepancies in the literature.

Recent progress in Tannic Acid-driven antimicrobial/antifouling surface coating strategies

Medical devices and surgical implants are a necessary part of tissue engineering and regenerative medicines. However, the biofouling and microbial colonization on the implant surface continues to be a major...

Tribological, cytotoxicity and antibacterial properties of graphene oxide/carbon fibers/polyetheretherketone composite coatings on Ti-6Al-4V alloy as orthopedic/dental implants

In this work, graphene oxide/carbon fibers/polyetheretherketone (GO/CF/PEEK) composite coatings on Ti-6Al-4V (TC4) alloy were fabricated by electrostatic powder spraying method. The coatings with 0.02 wt% GO and 25 wt% CF were made to improve the wear resistance, cytocompatibility and antibacterial properties of the TC4 as orthopedic/dental implants. The physicochemical properties involving coating thickness, Vickers hardness, micromorphology, phase structures and contact angles were investigated. The results indicated that the GO/CF/PEEK coatings can significantly decrease the coefficient of friction (COF) (from 0.433 ± 0.017 to 0.085 ± 0.008) and enhance the wear resistance of TC4 alloy during the wet friction process in sliding contact with a Si₃N₄ ball. The results showed that few scratches appeared on the GO/CF/PEEK coating. As the in vitro cytotoxicity test by murine fibroblast L929 cells shown, the GO/CF/PEEK coating revealed good cytocompatibility. More importantly, GO/CF/PEEK coating exhibited excellent suppression toward Staphylococcus aureus (S. aureus) owing to the antibacterial nature of GO. Therefore, the GO/CF/PEEK composite coated TC4 could be considered as a prospective orthopedic/dental implant material for bone tissue engineering.

Chitosan-sodium alginate-based coatings for self-strengthening anticorrosion and antibacterial protection of titanium substrate in artificial saliva

A self-strengthening coating with silver nanoparticles (Ag NPs) doped chitosan (CHI) and sodium alginate (SA) polyelectrolytes was constructed on the surface of polydopamine (PDA) coated Ti substrate by a layer-by-layer assembly method. The PDA coating exhibited an excellent bond with Ti substrate, and also can uniformly deposit Ag NPs via a mild method without introducing any exogenous reductant. The CHI coating was assembled through a spin-coating method for controlling Ag⁺ release. The SA was introduced to enhance the anticorrosion performance by forming calcium alginate (CA) in a corrosive medium. The corrosion protection was investigated with electrochemical impedance spectroscopy and polarization curves tests in fluorine-containing artificial saliva. During immersion, the charge-transfer resistance and the protection efficiency (ŋ) presented a continuous increase with the immersion time, demonstrating that this coating possessed a remarkable self-strengthening capability, and the compositions of the outermost film changed from SA to CA with the Ca²⁺ cations of the corrosive medium as a crosslinker by SEM and EDS analysis. Furthermore, the ŋ remained up to 96.8% after immersion of 30 days, and then the coating also displayed a distinct inhibition zone on S. mutans. These results prove this coating possesses an excellent anticorrosion performance and antibacterial property.

Anti-Periprosthetic Infection Strategies: From Implant Surface Topographical Engineering to Smart Drug-Releasing Coatings

Despite advanced implant sterilization and aseptic surgical techniques, periprosthetic bacterial infection remains a major challenge for orthopedic and dental implants. Bacterial colonization/biofilm formation around implants and their invasion into the dense skeletal tissue matrices are difficult to treat and could lead to implant failure and osteomyelitis. These complications require major revision surgeries and extended antibiotic therapies that are associated with high treatment cost, morbidity, and even mortality. Effective preventative measures mitigating risks for implant-related infections are thus in dire need. This review focuses on recent developments of anti-periprosthetic infection strategies aimed at either reducing bacterial adhesion, colonization, and biofilm formation or killing bacteria directly in contact with and/or in the vicinity of implants. These goals are accomplished through antifouling, quorum-sensing interfering, or bactericidal implant surface topographical engineering or surface coatings through chemical modifications. Surface topographical engineering of lotus leaf mimicking super-hydrophobic antifouling features and cicada wing-mimicking, bacterium-piercing nanopillars are both presented. Conventional physical coating/passive release of bactericidal agents is contrasted with their covalent tethering to implant surfaces through either stable linkages or linkages labile to bacterial enzyme cleavage or environmental perturbations. Pros and cons of these emerging anti-periprosthetic infection approaches are discussed in terms of their safety, efficacy, and translational potentials.

Silver-Deposited Nanoparticles on the Titanium Nanotubes Surface as a Promising Antibacterial Material into Implants

The main disadvantage of the implants is the associated infections. Therefore, in the long term, the possibility of improving the antibacterial capacity of different types of implants (dental, orthopedic) is being researched. The severity of the problem lies in the increasing bacterial resistance and finding appropriate alternative treatments for infectious diseases, which is an important research field nowadays. The purpose of this review is to draw a parallel between different studies analyzing the antibacterial activity and mechanism of silver nanoparticles (NP Ag) deposited on the titanium nanotubes (NTT), as well as the analysis of the NP Ag toxicity. This review also provides an overview of the synthesis and characterization of TiO2-derived nanotubes (NT). Thus, the analysis aims to present the existing knowledge to better understand the NP Ag implants benefits and their antibacterial activity.

Antibacterial and anti-inflammatory ultrahigh molecular weight polyethylene/tea polyphenol blends for artificial joint applications

Periprosthetic joint infection (PJI) is one of the main causes for the failure of joint arthroplasty. In view of the limited clinical effect of oral/injectable antibiotics and the drug resistance problem, there is a pressing need to develop antibacterial implants with therapeutic antimicrobial properties. In this work, we prepared a highly antibacterial ultrahigh molecular weight polyethylene (UHMWPE) implant by incorporating tea polyphenols. The presence of tea polyphenols not only improved the oxidation stability of irradiated UHMWPE, but also gave it the desirable antibacterial property. The potent antibacterial activity was attributed to the tea polyphenols that produced excess intracellular reactive oxygen species and destroyed the bacterial membrane structure. The tea polyphenol-blended UHMWPE had no biological toxicity to human adipose-derived stem cells and effectively reduced bacteria-induced inflammation in vivo. These results indicate that tea polyphenol-blended UHMWPE is promising for joint replacement prostheses with multifunctionality to meet patient satisfaction.

Antibacterial infection and immune-evasive coating for orthopedic implants

Bacterial infection and infection-induced immune response have been a life-threatening risk for patients having orthopedic implant surgeries. Conventional biomaterials are vulnerable to biocontamination, which causes bacterial invasion in wounded areas, leading to postoperative infection. Therefore, development of anti-infection and immune-evasive coating for orthopedic implants is urgently needed. Here, we developed an advanced surface modification technique for orthopedic implants termed lubricated orthopedic implant surface (LOIS), which was inspired by slippery surface of Nepenthes pitcher plant. LOIS presents a long-lasting, extreme liquid repellency against diverse liquids and biosubstances including cells, proteins, calcium, and bacteria. In addition, we confirmed mechanical durability against scratches and fixation force by simulating inevitable damages during surgical procedure ex vivo. The antibiofouling and anti-infection capability of LOIS were thoroughly investigated using an osteomyelitis femoral fracture model of rabbits. We envision that the LOIS with antibiofouling properties and mechanical durability is a step forward in infection-free orthopedic surgeries.

Enhancing ZnO-NP Antibacterial and Osteogenesis Properties in Orthopedic Applications: A Review

Prosthesis-associated infections and aseptic loosening are major causes of implant failure. There is an urgent need to improve the antibacterial ability and osseointegration of orthopedic implants. Zinc oxide nanoparticles (ZnO-NPs) are a common type of zinc-containing metal oxide nanoparticles that have been widely studied in many fields, such as food packaging, pollution treatment, and biomedicine. The ZnO-NPs have low toxicity and good biological functions, as well as antibacterial, anticancer, and osteogenic capabilities. Furthermore, ZnO-NPs can be easily obtained through various methods. Among them, green preparation methods can improve the bioactivity of ZnO-NPs and strengthen their potential application in the biological field. This review discusses the antibacterial abilities of ZnO-NPs, including mechanisms and influencing factors. The toxicity and shortcomings of anticancer applications are summarized. Furthermore, osteogenic mechanisms and synergy with other materials are introduced. Green preparation methods are also briefly reviewed.

Universal Antibacterial Surfaces Fabricated from Quaternary Ammonium Salt-Based PNIPAM Microgels

Because of the excellent film-forming ability of poly(N-isopropylacrylamide) (PNIPAM) microgel and high-efficient bactericidal property of quaternary ammonium salt (QAS), QAS-based PNIPAM (QAS-PNIPAM) microgels are synthesized and employed to modify the surface of a range of commonly used materials including metal, plastic, and elastomer. Bacterial culture is carried out on such QAS-PNIPAM microgel-modified surfaces to examine the viability of the attached bacteria. It is found that the bactericidal efficiency is nearly 100% on the modified surfaces of all the studied materials. We attribute the high-efficient bactericidal performance of QAS-PNIPAM microgel film to the QAS component rather than the topography of the microgel film itself. In addition, the microgel film is robust and shows great integrity even after culture of the bacteria and repeated rinses, and the cell experiment demonstrates that this microgel film is cyto-compatible. Therefore, such a simple, versatile method of preparing antibacterial films paves the way for future bactericidal applications.

Dual-Function Antibacterial Micelle via Self-Assembling Block Copolymers with Various Antibacterial Nanoparticles

Antibacterial biomaterials with kill-resist dual functions by combining multiple active components have been constructed, with a final aim at decreasing the incidence of biomaterial-centered infection. Self-assemblies of bactericidal ZnO or Ag-ZnO nanoparticles (NPs) with triblock copolymers, poly(ethylene glycol)-b-poly(3-hydroxybutyrate-co-3-hydroxyvalerate)-poly(ethylene glycol) (PEG-PHBV-PEG), showed a hydrophobic PHBV layer on NPs with PEG segments exposed outside via hydrogen bonding, resulting in long PEG (M _w = 2000) aggregation and short PEG (M _w = 1000) aggregation, respectively. These nanocomposite aggregations released ZnO or Ag-ZnO rapidly within initial few hours, and about 42-45% of NPs were left in the nanocomposites in deionized water for 16 d to improve the long-term antibacterial activity further. At the concentration below 50 μg/mL, the nanocomposite aggregation was cell-compatible with ATDC5 and showed sterilization rates over 91% against Escherichia coli and 98% against Staphylococcus aureus. Long PEG aggregation showed greater cell proliferation capacity than short PEG aggregation, as well as better bacterial resistance and bactericidal activity against both E. coli and S. aureus. The flexible self-assembling antibacterial NPs with antifouling block copolymers via adjusting the component ratio or the segment length have shown premise in the construction of the dual-function antibacterial materials.

Bioinspired Surface Functionalization of Titanium Alloy for Enhanced Lubrication and Bacterial Resistance

In clinics it is extremely important for implanted devices to achieve the property of enhanced lubrication and bacterial resistance; however, such a strategy has rarely been reported in previous literature. In the present study, a surface functionalization method, motivated by articular cartilage-inspired superlubrication and mussel-inspired adhesion, was proposed to modify titanium alloy (Ti6Al4V) using the copolymer (DMA-MPC) synthesized via free radical copolymerization. The copolymer-coated Ti6Al4V (Ti6Al4V@DMA-MPC) was evaluated by X-ray photoelectron spectroscopy, water contact angle, and Raman spectra to confirm that the DMA-MPC copolymer was successfully coated onto the Ti6Al4V substrate. In addition, the tribological test, with the polystyrene microsphere and Ti6Al4V or Ti6Al4V@DMA-MPC as the tribopair, indicated that the friction coefficient was greatly reduced for Ti6Al4V@DMA-MPC. Furthermore, the bacterial resistance test showed that bacterial attachment was significantly inhibited for Ti6Al4V@DMA-MPC for the three types of bacteria tested. The enhanced lubrication and bacterial resistance of Ti6Al4V@DMA-MPC was due to the tenacious hydration shell formed surrounding the zwitterionic charges in the phosphorylcholine group of the DMA-MPC copolymer. In summary, a bioinspired surface functionalization strategy is developed in this study, which can act as a universal and promising method to achieve enhanced lubrication and bacterial resistance for biomedical implants.

Si, Sr, Ag co-doped hydroxyapatite/TiO2 coating: enhancement of its antibacterial activity and osteoinductivity

A multifaceted coating with favourable cytocompatibility, osteogenic activity and antibacterial properties would be of great significance and value due to its capability for improving osseointegration and alleviating prosthesis loosening. This study marks the first report on the coating of TiO2 nanotubular (TNT) arrays with Sr-and-Si-substituted hydroxyapatite (SSHA) endowed with antibacterial characteristics using silver ions. This TNT layer coated with Ag-substituted SSHA (SSAgHA) formed a composite coating with an interconnected microporous structure and a homogeneous distribution of Sr, Si and Ag; such a coating promoted cell adhesion and osteogenic potential. The anchoring effect of the TNT layer improved the adhesion strength of the SSAgHA/TNT coating to 16.9 ± 3.1 MPa, which was higher than the 15 MPa set in the ISO standard 13 779-4:2002. Moreover, the bio-corrosion resistance of the underlying Ti substrate was greatly enhanced by the composite coating. Hydroxyapatite (HA) and SSAgHA coatings provided a suitable environment for the adhesion, spreading and proliferation of mouse osteoblasts. The SSAgHA coating excellently inhibited bacterial activity and enhanced osteoinductivity with higher osteogenic differentiation compared with the HA coating. Sr and Si dopants increased the expression levels of the genes related to osteogenesis and successfully offset the potential cytotoxicity of Ag ions. Super-osteoinductivity was attributed to the rough and superhydrophilic surface of the composite coating. Therefore, the present study demonstrated the potential of the electrodeposited SSAgHA/TNT composite coating as a promising metallic implant with great intrinsic antibacterial activity and osteointegration ability.

Multifunctional Coatings and Nanotopographies: Toward Cell Instructive and Antibacterial Implants

In biomaterials science, it is nowadays well accepted that improving the biointegration of dental and orthopedic implants with surrounding tissues is a major goal. However, implant surfaces that support osteointegration may also favor colonization of bacterial cells. Infection of biomaterials and subsequent biofilm formation can have devastating effects and reduce patient quality of life, representing an emerging concern in healthcare. Conversely, efforts toward inhibiting bacterial colonization may impair biomaterial-tissue integration. Therefore, to improve the long-term success of medical implants, biomaterial surfaces should ideally discourage the attachment of bacteria without affecting eukaryotic cell functions. However, most current strategies seldom investigate a combined goal. This work reviews recent strategies of surface modification to simultaneously address implant biointegration while mitigating bacterial infections. To this end, two emerging solutions are considered, multifunctional chemical coatings and nanotopographical features.

Antibacterial Polymeric Films Fabricated by [2+2] Cycloaddition-Retroelectrocyclization and Ag+ Ion Coordination

The [2+2] cycloaddition-retroelectrocyclization (CA-RE) between N,N-dialkylaniline-substituted alkynes and 7,7,8,8-tetracyanoquinodimethane (TCNQ) is employed to fabricate functional cross-linked polymer films containing the intramolecular charge-transfer (CT) chromophores at the cross-linking points. Polystyrene bearing N,N-dialkylaniline-substituted alkynes (P1) and TCNQ polyester (P2) are mixed in tetrahydrofuran (THF), then this solution is spray-coated onto an indium tin oxide or glass plate. Heating to 100 °C initiates the [2+2] CA-RE reaction, resulting in the formation of cross-linked polymer films. The reaction progress and completion are evaluated by monitoring the CT absorption band and cyano vibration peaks. The resulting cross-linked polymer films show reversible cathodic electrochromism between the neutral and anion radical states. In addition, they also display the visual detection behavior of protic acids and Lewis acids, such as Ag⁺ ions. Accordingly, the Ag⁺ ion-loaded polymer films are prepared, and their antibacterial activities are studied. As more Ag⁺ ions are loaded, the CT band more bathochromically shifts and more potent antibacterial activities are obtained. Therefore, the antibacterial activity of the polymer films can be visually recognized by the film colors. Furthermore, the loaded Ag⁺ ions can be released from the polymer films by application of an electrochemical potential.

Construction of perfluorohexane/IR780@liposome coating on Ti for rapid bacteria killing under permeable near infrared light

Near infrared (NIR) light induced photodynamic antibacterial therapy (PDAT) is a promising antibacterial technique in rapid in situ disinfection of bacterially infected artificial implants due to its penetration ability into tissues. However, the lower oxygen content in vivo may restrict the yields of reactive oxygen species (ROS), thus reducing the antibacterial efficacy of PADT significantly. Herein, liposome encapsulated photosensitizers (PS), IR780 and perfluorohexane (PFH), have been constructed on the surface of Ti implants via a covalent linkage to overcome this issue. Thanks to the high oxygen capacity of PFH, more ROS can be generated during NIR irradiation regardless of the low content of oxygen in vivo. As a result, in vitro tests demonstrated that 15 minutes of 808 nm near-infrared irradiation could achieve a high antibacterial efficacy of 99.62% and 99.63% on the implant surface against Escherichia coli and Staphylococcus aureus, respectively. By contrast, the PDAT system without PFH modification shows a lower antibacterial efficacy (only 66.54% and 48.04%, respectively). In addition, this enhanced PDAT system also possesses great biocompatibility based on the in vitro and in vivo subcutaneous assays. This surface system makes it possible for rapid bacteria-killing in artificial implants that have been implanted in vivo under local conditions with lower oxygen content.

Modification of the surface of titanium with multifunctional chimeric peptides to prevent biofilm formation via inhibition of initial colonizers

Background

Prevention of bacterial colonization remains a major challenge in the field of oral implant devices. Chimeric peptides with binding, antimicrobial, and osteogenesis motifs may provide a promising alternative for the inhibition of biofilm formation on titanium (Ti) surfaces.

Methods

In this study, chimeric peptides were designed by connecting an antimicrobial sequence from human β-defensin-3 with a Ti-binding sequence and arginine-glycine-aspartic acid using a glycine-glycine-glycine linker. Binding to the Ti substrate and antimicrobial properties against streptococci were evaluated. Significant improvement in reduction of bacterial colonization onto the Ti surface was observed, with or without the presence of saliva or serum. The MC3T3-E1 cells grew well on the modified Ti surfaces compared with the control group.

Results

The data showed that the three peptide functional motifs maintained their respective functions, and that the antibiofilm mechanism of the chimeric peptide was via suppression of sspA and sspB gene expression.

Conclusion

These results indicated that the endogenous peptide fragments engineered on the Ti surface could provide an environmentally friendly approach for improving the biocompatibility of oral implants.

Self-assembling antimicrobial peptides on nanotubular titanium surfaces coated with calcium phosphate for local therapy

Bacterial infection is a serious medical problem leading to implant failure. The current antibiotic based therapies rise concerns due to bacterial resistance. The family of antimicrobial peptides (AMP) is one of the promising candidates as local therapy agents due to their broad-spectrum activity. Despite AMPs receive increasing attention to treat infection, their effective delivery to the implantation site has been limited. Here, we developed an engineered dual functional peptide which delivers AMP as a biomolecular therapeutic agent onto calcium phosphate (Ca-P) deposited nanotubular titanium surfaces. Dual functionality of the peptide was achieved by combining a hydroxyapatite binding peptide-1 (HABP1) with an AMP using a flexible linker. HABP functionality of the peptide provided a self-coating property onto the nano-topographies that are designed to improve osteointegration capability, while AMP offered an antimicrobial protection onto the implant surface. We successfully deposited calcium phosphate minerals on nanotubular titanium oxide surface using pulse electrochemical deposition (PECD) and characterized the minerals by XRD, FT-IR, FE-SEM. Antimicrobial activity of the engineered peptide was tested against S. mutans (gram- positive) and E. coli (gram-negative) both in solution and on the Ca-P coated nanotubular titanium surface. In solution activity of AMP and dual functional peptide have the same Minimum Inhibitory Concentration (MIC) (32 mg/mL). The peptide also resulted in the reduction of the number of bacteria both for E.coli and S. mutans compare to control groups on the surface. Antimicrobial features of dual functional peptides are strongly correlated with their structures suggesting tunability in design through linkers regions. The dual-function peptide offers single-step solution for implant surface functionalization that could be applicable to any implant surface having different topographies.

The immobilization of antibiotic-loaded polymeric coatings on osteoarticular Ti implants for the prevention of bone infections

Implant-associated infections in orthopaedic surgeries are very critical as they may hinder bone healing, cause implant failure and even progress to osteomyelitis. Drug-eluting implants for local delivery of antibiotics at surgical sites are thought to be promising in preventing infections. Herein, the antibiotic vancomycin was encapsulated in a poly(ethylene glycol) (PEG)-based hydrogel film that was covalently bound to Ti implants and subsequently covered by a PEG-poly(lactic-co-caprolactone) (PEG-PLC) membrane. Additionally, crosslinked starch (CSt) was mixed with the hydrogel because its porous microstructure is able to inhibit hydrogel swelling and thus slow down drug release. The release behavior could be regulated by the drug loading and the coating thickness. The vancomycin-loaded Ti implants showed no initial burst release, offering a sustained drug release for nearly 3 weeks in vitro and more than 4 weeks in vivo. In a rabbit model of S. aureus infection, the implants with a 4 mg vancomycin loading significantly reduced the inflammatory reaction and exhibited a good antimicrobial capability. The immobilization of the antibiotic-loaded polymeric coatings on orthopaedic implants can offer a sustainable drug release with no initial burst release and maintain an effective concentration for a longer time, so it is expected to be an effective strategy to treat and prevent local bone infections.

Electrophoretic Deposited Stable Chitosan@MoS2 Coating with Rapid In Situ Bacteria-Killing Ability under Dual-Light Irradiation

Developing in situ disinfection methods in vivo to avoid drug-resistant bacteria and tissue toxicity is an urgent need. Here, the photodynamic and photothermal properties of the chitosan-assisted MoS₂ (CS@MoS₂ ) hybrid coating are simultaneously inspired to endow metallic Ti implants with excellent surface self-antibacterial capabilities. This coating, irradiated by only 660 nm visible light (VL) for 10 min, exhibits an antibacterial efficacy of 91.58% and 92.52% against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), respectively. The corresponding value is 64.67% and 57.44%, respectively, after irradiation by a single 808 nm near infrared light for the same amount of time. However, the combined irradiation using both lights can significantly enhance the efficiency up to 99.84% and 99.65% against E. coli and S. aureus, respectively, which can be ascribed to the synergistic effects of photodynamic and photothermal actions. The former produces single oxygen species under 660 nm VL while the latter induces a rise in temperature of implants, which can inhibit the growth of both E. coli and S. aureus. The introduction of CS can also promote the biocompatibility of implants, which provides a facile, rapid, and safe in situ bacteria-killing method in vivo without needing a second surgery.

Biomimetic Domain-Active Electrospun Scaffolds Facilitating Bone Regeneration Synergistically with Antibacterial Efficacy for Bone Defects

To improve bone regeneration in oral microenvironment, we generated a novel biodegradable, antibacterial, and osteoconductive electrospun PLGA/PCL membrane as an ideal osteogenic scaffold. The novel three-layer membranes were structured with serial layers of electrospun chlorhexidine-doped-PLGA/PCL (PPC), PLGA/PCL (PP), and β-tricalcium phosphate-doped-PLGA/PCL (PPβ). To characterize osteoconductive properties of these membranes, MC3T3-E1 (MC) cultures were seeded onto the membranes for 14 days for evaluation of cell proliferation, morphology and gene/protein expression. In addition, MC cells were cultured onto different surfaces of the three-layer membranes, PPC layer facing MC cells (PPβ-PP-PPC) and PPβ layer facing MC cells (PPC-PP-PPβ) to evaluate surface-material effects. Membrane properties and structures were evaluated. Antibacterial properties against Streptococcus mutans and Staphylococcus aureus were determined. Scanning electron microscope demonstrated smaller interfiber spaces of PPC and PPβ-PP-PPC compared to PPβ, PPC-PP-PPβ, and PP. PPC and PPβ-PP-PPC exhibited hydrophilic property. The three-layer membranes (PPC-PP-PPβ and PPβ-PP-PPC) demonstrated significantly higher Young's modulus (94.99 ± 4.03 MPa and 92.88 ± 4.03 MPa) compared to PP (48.76 ± 18.15 MPa) or PPC (7.92 ± 3.97 MPa) (p < 0.05). No significant difference of cell proliferation was found among any groups at any time point (p > 0.05). Higher expression of integrins were detected at 12 h of cultures on PPC-PP-PPβ compared to the controls. Promoted osteoconductive effects of PPC-PP-PPβ were revealed by alkaline phosphatase assays and Western blot compared with the controls at 7 and 14 days. PPC, PPC-PP-PPβ and PPβ-PP-PPC exhibited a significantly wider antibacterial zone against the tested bacteria compared to PP and PPβ (p < 0.05). These results suggested that the three-layer electrospun membranes demonstrated superior properties: higher strength, better cell adhesion, and promoted osteoconductive properties compared to single-layer membrane: however, antibacterial properties were exhibited in three-layer electrospun membranes and chlorhexidine-doped single-layer membrane. We concluded that the novel three-layer membranes could be used as a biocompatible scaffold for intraoral bone regeneration due to its enhanced osteoconductive activity and antibacterial effect.

Nano Ag/ZnO-Incorporated Hydroxyapatite Composite Coatings: Highly Effective Infection Prevention and Excellent Osteointegration

Interfacial characteristics play an important role in infection prevention and osteointegration of artificial bone implants. In this work, both Ag nanoparticles (AgNPs) and ZnO NPs are incorporated into hydroxyapatite (HA) nanopowders and deposited onto Ti6Al4V (Ti6) implants by laser cladding. The composite coatings possess a hierarchical surface structure with homogeneous distributions of Ag and ZnO. The Ag and ZnO NPs that are immobilized by laser cladding ensure long-term and gradual release of Ag and Zn ions at low cumulative concentrations of 36.2 and 56.4 μg/L after immersion for 21 days. A large concentration of Ag released initially increases the cytotoxicity but the large initial ZnO content enhances the cell viability and osteogenetic ability. The nano Ag/ZnO-embedded HA coating (Ag/ZnO/HA = 7:3:90 wt %, namely Ag7ZnO3HA) exhibits optimal antibacterial efficacy and osteogenetic capability, as exemplified by the broad spectrum antibacterial efficacy of 96.5 and 85.8% against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), respectively, together with enhanced osteoinductivity with higher alkaline phosphatase (ALP) activity of 134.60 U/g protein compared to 70.79 U/g protein for the untreated implants after culturing for 7 days. The rabbit femoral implant model further confirms that the optimized composite coating accelerates the formation of new bone tissues indicating 87.15% of the newly formed bone area and osteointegration showing 83.75% of the bone-implant contact area even in the presence of injected S. aureus. The laser-cladded Ag7ZnO3HA composite coatings are promising metallic implants with excellent intrinsic antibacterial activity and osteointegration ability.

Construction of high surface potential polypyrrole nanorods with enhanced antibacterial properties

High surface potential polypyrrole nanorods with enhanced antibacterial properties.

(PtBA-co-PPEGMEMA-co-PDOMA)-g-PPFA polymer brushes synthesized by sequential RAFT polymerization and ATRP

This article reports the synthesis of semi-fluorinated (PtBA-co-PPEGMEMA-co-PDOMA)-g-PPFA polymer brushes for self-cleaning anti-fouling surfaces.

Tannic Acid/Fe3+/Ag Nanofilm Exhibiting Superior Photodynamic and Physical Antibacterial Activity

Silver nanoparticles (AgNPs) enwrapped in the biologically safe tannic acid (TA)/Fe³⁺ nanofilm are synthesized by an ultrafast, green, simple, and universal method. The physical antibacterial activity and photodynamic antibacterial therapy (PAT) efficacy of the TA/Fe³⁺/AgNPs nanofilm were investigated for the first time, which exhibited a strong physical antibacterial activity as well as great biocompatibility, through in vitro and in vivo studies. The results disclosed that this hybrid coating could possess high PAT capabilities upon irradiation under a visible light of 660 nm, which is longer than those of previously reported green and blue sensitization light, thus allowing deeper light penetration into biological tissues. Electron spin resonance (ESR) spectra proved that the PAT efficacy of the TA/Fe³⁺/AgNPs nanofilm was associated with the yields of singlet oxygen (¹O₂) under the irradiation of visible light (660 nm). A higher PAT efficiency of 100 and 94% against Escherichia coli and Staphylococcus aureus could be achieved within 20 min of illumination under 660 nm visible light, whereas the innate physical antibacterial activity of AgNPs could endow the implants with long-term prevention of bacterial infection. The mechanism of PAT may be associated with the formation of oxidative stress and oxidative damage to key biomolecules (proteins and lipids) in bacteria. Our results reveal that the synergistic action of both PAT and physical action of AgNPs in this hybrid nanofilm is an effective way to inactivate bacteria, with minimal side effects.

Engineered chimeric peptides with antimicrobial and titanium-binding functions to inhibit biofilm formation on Ti implants

Titanium (Ti) implants have been commonly used in oral medicine. However, despite their widespread clinical application, these implants are susceptible to failure induced by microbial infection due to bacterial biofilm formation. Immobilization of chimeric peptides with antibacterial properties on the Ti surface may be a promising antimicrobial approach to inhibit biofilm formation. Here, chimeric peptides were designed by connecting three sequences (hBD-3-1/2/3) derived from human β-defensin-3 (hBD-3) with Ti-binding peptide-l (TBP-l: RKLPDAGPMHTW) via a triple glycine (G) linker to modify Ti surfaces. Using X-ray photoelectron spectroscopy (XPS), the properties of individual domains of the chimeric peptides were evaluated for their binding activity toward the Ti surface. The antimicrobial and anti-biofilm efficacy of the peptides against initial settlers, Streptococcus oralis (S. oralis), Streptococcus gordonii (S. gordonii) and Streptococcus sanguinis (S. sanguinis), was evaluated with confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Transmission electron microscopy (TEM) and real-time quantitative PCR (qRT-PCR) were used to study cell membrane changes and the underlying antimicrobial mechanism. Compared with the other two peptides, TBP-1-GGG-hBD3-3 presented stronger antibacterial activity and remained stable in saliva and serum. Therefore, it was chosen as the best candidate to modify Ti surfaces in this study. This peptide inhibited the growth of initial streptococci and biofilm formation on Ti surfaces with no cytotoxicity to MC3T3-E1 cells. Disruption of the integrity of bacterial membranes and decreased expression of adhesion protein genes from S. gordonii revealed aspects of the antibacterial mechanism of TBP-1-GGG-hBD3-3. We conclude that engineered chimeric peptides with antimicrobial activity provide a potential solution for inhibiting biofilm formation on Ti surfaces to reduce or prevent the occurrence of peri-implant diseases.

Synergistic Bacteria Killing through Photodynamic and Physical Actions of Graphene Oxide/Ag/Collagen Coating

Researchers have widely agreed that the broad spectrum antibacterial activity of silver nanoparticles (AgNPs) can be predominantly ascribed to the action of Ag⁺. This study marks the first report detailing the rapid and highly efficient synergistic bacteria killing of AgNPs, which is achieved by inspiring AgNPs' strong photocatalytic capability to rapidly produce radical oxygen species using 660 nm visible light together with the innate antimicrobial ability of Ag⁺. These AgNPs were uniformly distributed into well-defined graphene oxide (GO) nanosheets through an in situ reduction of Ag⁺ and subsequently wrapped with a thin layer of type I collagen. In vivo subcutaneous tests demonstrated that 20 min irradiation of 660 nm visible light could achieve a high antibacterial efficacy of 96.3% and 99.4% on the implant surface against Escherichia coli and Staphylococcus aureus, respectively. In addition, the collagen could reduce the coatings' possible cytotoxicity. The results of this work can provide a highly effective and universal GO-based bioplatform for combination with inorganic antimicrobial NPs (i.e., AgNPs) with excellent photocatalytic properties, which can be utilized for facile and rapid in situ disinfection, as well as long-term prevention of bacterial infection through the synergistic bacteria killing of both 660-nm light-inspired photodynamic action and their innate physical antimicrobial ability.

Porous Iron-Carboxylate Metal-Organic Framework: A Novel Bioplatform with Sustained Antibacterial Efficacy and Nontoxicity

Sustained drug release plays a critical role in targeting the therapy of local diseases such as bacterial infections. In the present work, porous iron-carboxylate metal-organic framework [MOF-53(Fe)] nanoparticles (NPs) were designed to entrap the vancomycin (Van) drugs. This system exhibited excellent chemical stability under acidic conditions (pH 7.4, 6.5, and 5.5) and much higher drug-loading capability because of the high porosity and large surface area of MOF NPs. The results showed that the drug-loading ratio of Van could reach 20 wt % and that the antibacterial ratio of the MOF-53(Fe)/Van system against Staphylococcus aureus could reach up to 90%. In addition, this MOF-53(Fe)/Van system exhibited excellent biocompatibility because of its chemical stability and sustained release of iron ions. Hence, these porous MOF NPs are a promising bioplatform not only for local therapy of bacterial infections but also for other biomedical therapies for tissue regeneration.

Construction of poly(lactic-co-glycolic acid)/ZnO nanorods/Ag nanoparticles hybrid coating on Ti implants for enhanced antibacterial activity and biocompatibility

Poly(lactic-co-glycolic acid)/Ag/ZnO nanorods coating were successfully prepared on the surface of Ti metallic implants using a hydrothermal method and subsequent spin-coating of mixtures of poly(lactic-co-glycolic acid) and silver nanoparticles. The poly(lactic-co-glycolic acid)/Ag/ZnO nanorods coating exhibited excellent antibacterial efficacy of over 96% against both Staphylococcus aureus and Escherichia coli when the initial content of Ag nanoparticles was over 3wt%. In addition, the release of both silver and zinc could last for over a hundred days due to the enwrapping of poly(lactic-co-glycolic acid). Proliferation of mouse calvarial cells exhibited minimal cytotoxicity on the poly(lactic-co-glycolic acid)/Ag/ZnO coating with an initial content of Ag nanoparticles of 1wt% and 3wt%, while it inhibited cell proliferation once this value was increased to 6wt%. The results revealed that this poly(lactic-co-glycolic acid)/Ag/ZnO composite could provide a long-lasting antibacterial approach and good cytocompatibility, thus exhibiting considerable potential for biomedical application in orthopedic and dental implants with excellent self-antibacterial activity and good biocompatibility.

Semifluorinated Synergistic Nonfouling/Fouling-Release Surface

The preparation of a fluorine-containing synergistic nonfouling/fouling-release surface, using a b-PFMA-PEO asymmetric molecular brush possessing both poly(ethylene glycol) (PEO) and poly(2,2,2-trifluoroethyl methacrylate) (PFMA) side chains densely distributed on the same repeat unit along the polymeric backbone, is reported. On the basis of the poly(Br-acrylate-alkyne) macroagent comprising two functionalities (alkynyl and 2-bromopropionate), which is prepared by reversible addition-fragmentation chain transfer homopolymerization of a new trifunctional acrylate monomer of Br-acrylate-alkyne, b-PFMA-PEO asymmetric molecular brushes are obtained by concurrent atom transfer radical polymerization and Cu-catalyzed azide/alkyne cycloaddition "click" reaction in a one-shot system. A spin-cast thin film of the b-PFMA-PEO asymmetric molecular brush exhibits a synergistic antifouling property, in which PEO side chains endow the surface with a nonfouling characteristic, whereas PFMA side chains display the fouling-release functionality because of their low surface energy. Both protein adsorption and cell adhesion tests provided estimates of the antifouling activity of the asymmetric molecular brush surfaces, which was demonstrated to be influenced by the degree of polymerization of the backbone and the length of the PEO and PFMA side chains. With compositional heterogeneities, all asymmetric molecular brush surfaces show considerable antifouling performance with much less protein adsorption (at least 45% off, up to 75% off) and cell adhesion (at least 70% off, up to 90% off) in comparison with a bare surface.

Thiol-ol Chemistry for Grafting of Natural Polymers to Form Highly Stable and Efficacious Antibacterial Coatings

Bacterial contamination of surfaces and the associated infection risk is a significant threat to human health. Some natural antibacterial polymers with low toxicity are promising coating materials for alleviating pathogenic colonization on surfaces. However, widespread application of these polymers as antibacterial coatings is constrained by coating techniques which are not easily scalable due to stringent reaction conditions. Herein, thiol-ol reaction involving oxidative conjugation between thiol and hydroxyl groups is demonstrated as a facile technique to graft two natural polymer derivatives, agarose (AG) and quaternized chitosan (QCS), as antibacterial coatings on polymer and metal substrates. The substrate surfaces are first treated with oxygen plasma followed by UV-induced grafting of the polymers under atmospheric conditions. Dimercaprol, a FDA-approved drug, is used as both surface anchor and cross-linker of the polymer chains during grafting. The AG coating achieves >2 log reduction in Pseudomonas aeruginosa and Staphylococcus aureus biofilm formation, while the QCS coating reduces bacterial count from contaminated droplets on its surface by >95%. The coatings are noncytotoxic and exhibits a high degree of stability under conditions expected in their potential applications as antibacterial coating for biomedical devices (for AG), and for preventing pathogen transmission in the environment (for QCS).

Dopamine Modified Organic-Inorganic Hybrid Coating for Antimicrobial and Osteogenesis

A hybrid coating composed of hydroxyapatite (HA), Ag nanoparticles (NPs), and chitosan (CS) was successfully prepared on a Ti substrate by a layer-by-layer assembly process. A polydopamine-assisted (PDA-assisted) coating showed a good bond with HA. Ag NPs were uniformly distributed into the hybrid coating through a solution method and ultraviolet light reduction. A CS nanofilm was deposited via spin-coating to control the release of Ag⁺ from the hybrid coating. The results disclosed that the 3-layer CS coating could efficiently control the release of Ag⁺ from the hybrid coating via the Fickian diffusion mechanism and that the PDA/HA/Ag/CS-1 coating exhibited antibacterial ratios of 63.0% and 51.8% against E. coli and S. aureus, respectively. Furthermore, the normal structure of E. coli was obviously destroyed by two types of Ag doped coatings. The cell viability assay showed that CS effectively reduced the cytotoxicity of the hybrid coating after a 7 day incubation. The hybrid coating presented high ALP activities at days 3 and 14. The results reveal that hybrid coatings can endow Ti implants with good antibacterial capability as well as cell viability and osteogenic activity.