Antibiotic-decorated titanium with enhanced antibacterial activity through adhesive polydopamine for dental/bone implant

Chitosan-based materials for dental implantology: A comprehensive review

Chitosan, a versatile biopolymer, has gained recognition in the discipline of dental implantology due to possessing salient properties. This comprehensive review explores the potential of chitosan in dental implants, focusing on its biocompatibility, bioactivity, and the various chitosan-based materials that have been utilized for dental implant therapy. The review also highlights the importance of surface treatment in dental implants to enhance osseointegration and inhibit bacterial biofilm formation. Additionally, the chemical structure, properties, and sources of chitosan are described, along with its different structural forms. The characteristics of chitosan particularly color, molecular weight, viscosity, and degree of deacetylation are discussed about their influence on its applications. This review provides valuable insights into the promising utilization of polymeric chitosan in enhancing the success and functionality of dental implants. This study highlights the potential applications of chitosan in oral implantology. Chitosan possesses various advantageous properties, including muco-adhesiveness, hemostatic action, biocompatibility, biodegradability, bioactivity, and antibacterial and antifungal activities, which enhance its uses in dental implantology. However, it has limited aqueous solubility at the physiological pH, which sometimes restricts its biological application, but this problem can be overcome by using modified chitosan or chitosan derivatives, which have also shown encouraging results. Recent research suggests that chitosan may act as a promising material for coating titanium-based implants, improving osteointegration together with antibacterial properties.

Aspirin/amoxicillin loaded chitosan microparticles and polydopamine modified titanium implants to combat infections and promote osteogenesis

It is known that titanium (Ti) implant surfaces exhibit poor antibacterial properties and osteogenesis. In this study, chitosan particles loaded with aspirin, amoxicillin or aspirin + amoxicillin were synthesized and coated onto implant surfaces. In addition to analysing the surface characteristics of the modified Ti surfaces, the effects of the modified Ti surfaces on the adhesion and viability of rat bone marrow-derived stem cells (rBMSCs) were evaluated. The metabolic activities of Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) biofilms on the modified Ti surfaces were also measured in vitro. Moreover, S. aureus was tested for its antibacterial effect by coating it in vivo. Using water as the droplet medium, the contact angles of the modified Ti surfaces increased from 44.12 ± 1.75° to 58.37 ± 4.15°. In comparison to those of the other groups tested, significant increases in rBMSC adhesion and proliferation were observed in the presence of aspirin + amoxicillin-loaded microspheres, whereas a significant reduction in the metabolic level of biofilms was observed in the presence of aspirin + amoxicillin-loaded microspheres both in vitro and in vivo. Aspirin and amoxicillin could be used in combination to coat implant surfaces to mitigate bacterial activities and promote osteogenesis.

Biomaterials coated with zwitterionic polymer brush demonstrated significant resistance to bacterial adhesion and biofilm formation in comparison to brush coatings incorporated with antibiotics

A critical problem with the use of biomaterial implants is associated with bacterial adhesion on the surface of implants and in turn the biofilm formation. Among different strategies that have been reported to resolve this dilemma, surface design combined with both antiadhesive and antimicrobial properties has proven to be highly effective. Physiochemical properties of polymer brush coatings possess non-adhesive capability against bacterial adhesion and create a niche for further functionalization. The current study aims to evaluate the effect of antibiotics incorporated into the polymer brush on bacterial adhesion and biofilm formation. Brushes made of zwitterionic polymers were synthesized, functionalized with vancomycin via both physical and chemical conjugation, and grafted onto the silicon rubber surfaces. Antibacterial and antiadhesive measurements of designed coated biomaterials were mediated through the use of a parallel plate flow chamber against biofilm growth developed by Staphylococcus aureus and Escherichia coli over a period of 24 h. The analysis of biofilm growth on designed coated biomaterials showed that the pristine coated zwitterionic brushes are significantly resistant to bacterial adhesion and biofilm formation but not in the polymer brush coating incorporated with antibiotics.

Research progress on antibacterial activity of medical titanium alloy implant materials

Titanium and its alloys are the preferred materials for medical implants. However, easy infection is a fatal shortcoming of Ti implants. Fortunately, the ongoing development of antibacterial implant materials is a promising solution, and Ti alloys with antibacterial properties hold immense potential for medical applications. In this review, we briefly outline the mechanisms of bacterial colonization and biofilm formation on implants; discuss and classify the major antimicrobials currently in use and development, including inorganic and organic antimicrobials; and describe the important role of antimicrobials in the development of implant materials for clinical applications. Strategies and challenges related to improving the antimicrobial properties of implant materials as well as the prospects of antibacterial Ti alloys in the medical field are also discussed.

Surface Modification and Functionalities for Titanium Dental Implants

Dental implants have become the mainstream strategy for oral restoration, and implant materials are the most important research hot spot in this field. So far, Ti implants dominate all kinds of implants. The surface properties of the Ti implant play decisive roles in osseointegration and antibacterial performance. Surface modifications can significantly change the surface micro/nanotopography and composition of Ti implants, which will effectively improve their hydrophilicity, mechanical properties, osseointegration performance, antibacterial performance, etc. These optimizations will thus improve implant success and service life. In this paper, the latest surface modification techniques of Ti dental implants are systematically and comprehensively reviewed. The various biomedical functionalities of surface modifications are discussed in-depth. Finally, a profound comment on the challenges and opportunities of this frontier is proposed, and the most promising directions for the future were explored.

Biopolymeric Coatings for Local Release of Therapeutics from Biomedical Implants

The deployment of structures that enable localized release of bioactive molecules can result in more efficacious treatment of disease and better integration of implantable bionic devices. The strategic design of a biopolymeric coating can be used to engineer the optimal release profile depending on the task at hand. As illustrative examples, here advances in delivery of drugs from bone, brain, ocular, and cardiovascular implants are reviewed. These areas are focused to highlight that both hard and soft tissue implants can benefit from controlled localized delivery. The composition of biopolymers used to achieve appropriate delivery to the selected tissue types, and their corresponding outcomes are brought to the fore. To conclude, key factors in designing drug-loaded biopolymeric coatings for biomedical implants are highlighted.

Hydrothermally synthesized titanium/hydroxyapatite as photoactive and antibacterial biomaterial

The present work investigated hydrothermal synthesis of titanium/hydroxyapatite (Ti/HA) nanocomposite at varied Ti content. The synthesis was performed by coprecipitation method using CaO, ammonium dihydrogen phosphate and titanium oxide chloride precursor with the additional cetyl trimethyl ammonium chloride as templating agent, followed by hydrothermal treatment at 150 °C. The derived materials were characterized by x-ray diffraction, x-ray photoelectron spectroscopy, scanning electron microscopy, transmission electron microscopy analyses. The photocatalytic properties of materials were tested on methyl violet (MV) photocatalytic oxidation, meanwhile the antibacterial testing was performed against Escherichia coli, Staphylococcus aureus, Klebsiella pneumonia, and Streptococcus pyogenes. In addition, cytotoxicity evaluation of the materials as potential biomaterial was also conducted. The results showed that physicochemical character of Ti/HA exhibits exhibit the excellent properties to be photocatalyst along with antibacterial activity. From the detail study of effect of varied titanium content ranging from 5 to 10 %wt., the increasing crystallite size of anatase phase of about 25.81 nm and 38.22 nm for Ti content of 5 and 10 % wt., respectively. In other side, the band gap energy value increases as the increasing Ti content, i.e. the values are 3.08; 3.18; and 3.20 eV for Ti content of 5, 10, 20 % wt., respectively. The band gap energy is correlated with the photocatalytic activity which the highest MV degradation was 96.46% over Ti/HA with 20% wt. of Ti (Ti20/HA). The nanocomposites also express the antibacterial activity with comparable minimum inhibitory concentration (MIC) with other similar Ti/HA nanocomposites. The MIC values of Ti20/HA against E. coli, S. aureus, K. pneumonia, and S. pyogenes are 25; 25; 50 and 50 μg/mL, respectively. In addition, the cytotoxicity test revealed the potency to be a biomimetic material as shown by severe toxicity.

A novel antibacterial and fluorescent coating composed of polydopamine and carbon dots on the surface of orthodontic brackets

Many kinds of antibacterial coatings have been designed to prevent the adherence of bacteria onto the surface of a fixed orthodontic device of brackets. However, the problems such as weak binding force, undetectable, drug resistance, cytotoxicity and short duration needed to be solved. Thus, it has great value in developing novel coating methods with long-term antibacterial and fluorescence properties according to the clinical application of brackets. In this study, we synthesized blue fluorescent carbon dots (HCDs) using the traditional Chinese medicinal honokiol, which could cause irreversible killing effects on both gram-positive and gram-negative bacteria through positive charges on the surface and inducing reactive oxygen species (ROS) production. Based on this, the surface of brackets was serially modified with polydopamine and HCDs, taking advantage of the strong adhesive properties as well as the negative surface charge of polydopamine particles. It is found that this coating exhibits stable antibacterial properties in 14 days with good biocompatibility, which can provide a new solution and strategy to solve the series of hazards caused by bacterial adhesion on the surface of orthodontic brackets.

Design of Cefotaxime Sodium-Loaded Polydopamine Coatings with Controlled Surface Roughness for Titanium Implants

The success rate of dental implants is limited by peri-implant infection and insufficient osseointegration. Therefore, reducing the occurrence of peri-implantitis and promoting osseointegration are in demand. A roughened surface has commonly been applied to improve the osseointegration of implants, but it will accelerate the attachment of bacteria. We have developed novel antibiotic-decorated titanium (Ti) surfaces by the immobilization of dopamine and cefotaxime sodium (CS) simultaneously. Moreover, the surface roughness of the polydopamine (PDA)/CS coating was controlled by the changes in polymerization times as determined by atomic force microscopy. Then, all antibiotic-grafted Ti surfaces could effectively prevent the adhesion and proliferation of both Escherichia coli and Streptococcus mutans in comparison to the pristine control. For the culture and osteogenic differentiation of human umbilical mesenchymal stem cells (hUMSCs) on the substrate surface, PDA/CS coating with polymerization times less than 30 min showed acceptable biocompatibility, but the upregulation of marker genes and proteins was detected when the polymerization time was more than 30 min. Moreover, the best calcium deposition results were found in the 30 min PDA/CS group with or without the addition of osteogenic factors. Therefore, our PDA/CS coating with a polymerization time of 30 min holds great potential to design dental implants with dual bacteriostatic and osteogenic properties.

Recent Development of Polydopamine Anti-Bacterial Nanomaterials

Polydopamine (PDA), as a mussel-inspired material, exhibits numerous favorable performance characteristics, such as a simple preparation process, prominent photothermal transfer efficiency, excellent biocompatibility, outstanding drug binding ability, and strong adhesive properties, showing great potential in the biomedical field. The rapid development of this field in the past few years has engendered substantial progress in PDA antibacterial materials. This review presents recent advances in PDA-based antimicrobial materials, including the preparation methods and antibacterial mechanisms of free-standing PDA materials and PDA-based composite materials. Furthermore, the urgent challenges and future research opportunities for PDA antibacterial materials are discussed.

Surface Modification of Carbon Fiber-Reinforced Polyetheretherketone with MXene Nanosheets for Enhanced Photothermal Antibacterial Activity and Osteogenicity

Ideal bone implant materials need to provide multiple functions such as biocompatibility, non-cytotoxicity, and bone tissue regeneration guidance. To tackle this challenge, according to our previous work, carbon fiber (40 mm)-reinforced polyetheretherketone (CFPEEK) composites were developed by using 3D needle-punched CFPEEK preform molding technology. Because of the excellent mechanical properties, the CFPEEK needled felt matrix composites have a broad application prospect in orthopedic internal fixation and implant materials. In order to expand the application range of composite materials, it is very necessary to improve the surface bioactivity of composite materials. The surface modification of CFPEEK with 2D titanium carbide (MXene) nanosheets (sulfonated CFPEEK (SCFPEEK)-polydopamine (PDA)-Ti₃C₂T_x) for enhanced photothermal antibacterial activity and osteogenicity was explored in this study. Here, the new composites we constructed are composed of Ti₃C₂T_x nanosheets, PDA, and biologically inert SCFPEEK, which gave the bio-inert composites bimodal therapeutic features: photothermal antibacterial activity and in vivo osseointegration. To our knowledge, this is the first time that a CFPEEK implant with a bioactive surface modified by Ti₃C₂T_x nanosheets was demonstrated. Due to the synergistic photothermal therapy (PTT) treatment of Ti₃C₂T_x/PDA, SCFPEEK-PDA-Ti₃C₂T_x (SCP-PDA-Ti) absorbed heat and the temperature increased to 40.8-59.6 °C─the high temperature led to bacterial apoptosis. The SCP-PDA-Ti materials could effectively kill bacteria after 10 min of near-infrared (NIR) irradiation at 808 nm. SCP-PDA-Ti (2.5) and SCP-PDA-Ti (3.0) achieved a 100% bacteriostasis rate. More importantly, the multifunctional implant SCP-PDA-Ti shows good cytocompatibility and an excellent ability to promote bone formation in terms of cytotoxicity, diffusion, alkaline phosphatase activity, alizarin red activity, real-time polymerase chain reaction analysis, and in vivo bone defect osteogenesis experiments. This provides a more extendable development idea for the application of carbon fiber-reinforced composites as orthopedic implants.

Polydopamine, harness of the antibacterial potentials-A review

Antibiotic resistance is one of the major causes of morbidity and mortality, triggered by the adhesion of microbes and to some extent the formation of biofilms. This condition has been quite challenging in the health and industrial sector. Conditions and processes required to foil these infectious and resistance are of much concern. The synthesis of PDA material, inspired by the Mytilus edulis foot protein (MEFP)5 possesses unique characteristics that allow for, adhesion, photothermal therapy, synergistic effects with other materials, biocompatibility process, etc. Therefore, their usage holds great potential for dealing with both the infectious nature and the antibiotic resistance processes. Hence, this review provides an overview of the mechanism involved in accomplishing and eradicating bacteria, the recently harnessed antibacterial effect of the PDA through other properties they possess, a way forward in tapping the benefit embedded in the PDA, and the future perspective.

Loading of Polydimethylsiloxane with a Human ApoB-Derived Antimicrobial Peptide to Prevent Bacterial Infections

Background: medical device-induced infections affect millions of lives worldwide and innovative preventive strategies are urgently required. Antimicrobial peptides (AMPs) appear as ideal candidates to efficiently functionalize medical devices surfaces and prevent bacterial infections. In this scenario, here, we produced antimicrobial polydimethylsiloxane (PDMS) by loading this polymer with an antimicrobial peptide identified in human apolipoprotein B, r(P)ApoB_L^Pro. Methods: once obtained loaded PDMS, its structure, anti-infective properties, ability to release the peptide, stability, and biocompatibility were evaluated by FTIR spectroscopy, water contact angle measurements, broth microdilution method, time-killing kinetic assays, quartz crystal microbalance analyses, MTT assays, and scanning electron microscopy analyses. Results: PDMS was loaded with r(P)ApoB_L^Pro peptide which was found to be present not only in the bulk matrix of the polymer but also on its surface. ApoB-derived peptide was found to retain its antimicrobial properties once loaded into PDMS and the antimicrobial material was found to be stable upon storage at 4 °C for a prolonged time interval. A gradual and significant release (70% of the total amount) of the peptide from PDMS was also demonstrated upon 400 min incubation and the antimicrobial material was found to be endowed with anti-adhesive properties and with the ability to prevent biofilm attachment. Furthermore, PDMS loaded with r(P)ApoB_L^Pro peptide was found not to affect the viability of eukaryotic cells. Conclusions: an easy procedure to functionalize PDMS with r(P)ApoB_L^Pro peptide has been here developed and the obtained functionalized material has been found to be stable, antimicrobial, and biocompatible.

Nanomaterials: The New Antimicrobial Magic Bullet

Bacterial infections are a significant cause of mortality and morbidity worldwide, despite decades of use of numerous existing antibiotics and constant efforts by researchers to discover new antibiotics. The emergence of infections associated with antibiotic-resistant bacterial strains, has amplified the pressure to develop additional bactericidal therapies or new unorthodox approaches that can deal with antimicrobial resistance. Nanomaterial-based strategies, particularly those that do not rely on conventional small-molecule antibiotics, offer promise in part due to their ability to dodge existing mechanisms used by drug-resistant bacteria. Therefore, the use of nanomaterial-based formulations has attracted attention in the field of antibiotic therapy. In this Review, we highlight novel and emerging nanomaterial-based formulations along with details about the mechanisms by which nanoparticles can target bacterial infections and antimicrobial resistance. A detailed discussion about types and the activities of nanoparticles is presented, along with how they can be used as either delivery systems or as inherent antimicrobials, or a combination of both. Lastly, we highlight some toxicological concerns for the use of nanoparticles in antibiotic therapies.

Addressing the Needs of the Rapidly Aging Society through the Development of Multifunctional Bioactive Coatings for Orthopedic Applications

The unprecedented aging of the world's population will boost the need for orthopedic implants and expose their current limitations to a greater extent due to the medical complexity of elderly patients and longer indwelling times of the implanted materials. Biocompatible metals with multifunctional bioactive coatings promise to provide the means for the controlled and tailorable release of different medications for patient-specific treatment while prolonging the material's lifespan and thus improving the surgical outcome. The objective of this work is to provide a review of several groups of biocompatible materials that might be utilized as constituents for the development of multifunctional bioactive coatings on metal materials with a focus on antimicrobial, pain-relieving, and anticoagulant properties. Moreover, the review presents a summary of medications used in clinical settings, the disadvantages of the commercially available products, and insight into the latest development strategies. For a more successful translation of such research into clinical practice, extensive knowledge of the chemical interactions between the components and a detailed understanding of the properties and mechanisms of biological matter are required. Moreover, the cost-efficiency of the surface treatment should be considered in the development process.

Application of Antimicrobial Peptides on Biomedical Implants: Three Ways to Pursue Peptide Coatings

Biofilm formation and inflammations are number one reasons of implant failure and cause a severe number of postoperative complications every year. To functionalize implant surfaces with antibiotic agents provides perspectives to minimize and/or prevent bacterial adhesion and proliferation. In recent years, antimicrobial peptides (AMP) have been evolved as promising alternatives to commonly used antibiotics, and have been seen as potent candidates for antimicrobial surface coatings. This review aims to summarize recent developments in this field and to highlight examples of the most common techniques used for preparing such AMP-based medical devices. We will report on three different ways to pursue peptide coatings, using either binding sequences (primary approach), linker layers (secondary approach), or loading in matrixes which offer a defined release (tertiary approach). All of them will be discussed in the light of current research in this area.

Polydopamine-Assisted Surface Modification of Ti-6Al-4V Alloy with Anti-Biofilm Activity for Dental Implantology Applications

Coating the surfaces of implantable materials with various active principles to ensure inhibition of microbial adhesion, is a solution to reduce infections associated with dental implant. The aim of the study was to optimize the polydopamine films coating on the Ti-6Al-6V alloy surface in order to obtain a maximum of antimicrobial/antibiofilm efficacy and reduced cytotoxicity. Surface characterization was performed by evaluating the morphology (SEM, AFM) and structures (Solid-state 13C NMR and EPR). Antimicrobial activity was assessed by logarithmic reduction of CFU/mL, and the antibiofilm activity by reducing the adhesion of Escherichia coli, Staphylococcus aureus, and Candida albicans strains. The release of NO was observed especially for C. albicans strain, which confirms the results obtained for microbial adhesion. Among the PDA coatings, for 0.45:0.88 (KMnO4:dopamine) molar ratio the optimal compromise was obtained in terms of antimicrobial activity and cytotoxicity, while the 0.1:1.5 ratio (KMnO4:dopamine) led to higher NO release and implicitly the reduction of the adhesion capacities only for C. albicans, being slightly cytotoxic but with moderate release of LDH. The proposed materials can be used to reduce the adhesion of yeast to the implantable material and thus inhibit the formation of microbial biofilms.

Adhesive Antimicrobial Peptides Containing 3,4-Dihydroxy-L-Phenylalanine Residues for Direct One-Step Surface Coating

Bacterial colonization and transmission via surfaces increase the risk of infection. In this study, we design and employ novel adhesive antimicrobial peptides to prevent bacterial contamination of surfaces. Repeats of 3,4-dihydroxy-L-phenylalanine (DOPA) were added to the C-terminus of NKC, a potent synthetic antimicrobial peptide, and the adhesiveness and antibacterial properties of the resulting peptides are evaluated. The peptide is successfully immobilized on polystyrene, titanium, and polydimethylsiloxane surfaces within 10 min in a one-step coating process with no prior surface functionalization. The antibacterial effectiveness of the NKC-DOPA₅-coated polystyrene, titanium, and polydimethylsiloxane surfaces is confirmed by complete inhibition of the growth of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus within 2 h. The stability of the peptide coated on the substrate surface is maintained for 84 days, as confirmed by its bactericidal activity. Additionally, the NKC-DOPA₅-coated polystyrene, titanium, and polydimethylsiloxane surfaces show no cytotoxicity toward the human keratinocyte cell line HaCaT. The antimicrobial properties of the peptide-coated surfaces are confirmed in a subcutaneous implantation animal model. The adhesive antimicrobial peptide developed in this study exhibits potential as an antimicrobial surface-coating agent for efficiently killing a broad spectrum of bacteria on contact.

[In vivo study of liposome-modified polyetheretherketone implant on bacteriostasis and osseointegration]

OBJECTIVE

To develop dexamethasone plus minocycline-loaded liposomes (Dex/Mino liposomes) and apply them to improve bioinert polyetheretherketone (PEEK) surface, which could prevent post-operative bacterial contamination, enhance ossification for physiologic osseointegration, and finally reduce implant failure rates.

METHODS

Dex/Mino liposomes were covalently grafted onto the PEEK surface using polydopamine (pDA) coating as a medium. Confocal laser scanning microscopy was used to confirm the binding of fluorescently labeled liposomes onto the PEEK substrate, and a microplate reader was used to semiquantitatively measure the average fluorescence intensity of fluorescently labeled liposome-decorated PEEK surfaces. Moreover, the mouse subcutaneous infection model and the beagle femur implantation model were respectively conducted to verify the bioactivity of Dex/Mino liposome-modified PEEK in vivo, by means of micro computed tomography (micro-CT) and hematoxylin and eosin (HE) staining analysis.

RESULTS

The qualitative and quantitative results of fluorescently labeled liposomes showed that, the red fluorescence intensity of the PEEK-pDA-lipo group was stronger than that of the PEEK-NF-lipo group (P < 0.05); the liposomes were successfully and uniformly decorated on the PEEK surfaces due to the pDA coating. After mouse subcutaneous implantation of PEEKs for 24 hours, HE staining results showed that the number of inflammatory cells in the PEEK-Dex/Mino lipo group were lower than that in the inert PEEK group (P < 0.05), indicating a lower degree of infection in the test group. These results suggested that the Mino released from the liposome-functionalized surface provided an effective bacteriostasis in vivo. After beagle femoral implantation of PEEK for 8 weeks, micro-CT results showed that the PEEK-Dex/Mino lipo group newly formed more continuous bone when compared with the inert PEEK group; HE staining results showed that more new bones were formed in the PEEK-Dex/Mino lipo group than in the inert PEEK group, which were firmly bonded to the functionalized PEEK surface and extended along the PEEK interface. These results suggested that the Dex released from the liposome-functionalized surface induced effective bone regeneration in vivo.

CONCLUSION

Dex/Mino liposome modification enhanced the bioactivity of inert PEEK, the functionalized PEEK with enhanced antibacterial and osseointegrative capacity has great potential as an orthopedic/dental implant material for clinical application.

Advancements in release-active antimicrobial biomaterials: A journey from release to relief

Escalating medical expenses due to infectious diseases are causing huge socioeconomic pressure on mankind globally. The emergence of antibiotic resistance has further aggravated this problem. Drug-resistant pathogens are also capable of forming thick biofilms on biotic and abiotic surfaces to thrive in a harsh environment. To address these clinical problems, various strategies including antibacterial agent delivering matrices and bactericidal coatings strategies have been developed. In this review, we have discussed various types of polymeric vehicles such as hydrogels, sponges/cryogels, microgels, nanogels, and meshes, which are commonly used to deliver antibiotics, metal nanoparticles, and biocides. Compositions of these polymeric matrices have been elaborately depicted by elucidating their chemical interactions and potential activity have been discussed. On the other hand, various implant/device-surface coating strategies which exploit the release-active mechanism of bacterial killing are discussed in elaboration. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.

A Novel Strategy to Coat Dopamine-Functionalized Titanium Surfaces With Agarose-Based Hydrogels for the Controlled Release of Gentamicin

Introduction

The use of spinal implants for the treatment of back disorders is largely affected by the insurgence of infections at the implantation site. Antibacterial coatings have been proposed as a viable solution to limit such infections. However, despite being effective at short-term, conventional coatings lack the ability to prevent infections at medium and long-term. Hydrogel-based drug delivery systems may represent a solution controlling the release of the loaded antibacterial agents while improving cell integration. Agarose, in particular, is a biocompatible natural polysaccharide known to improve cell growth and already used in drug delivery system formulations. In this study, an agarose hydrogel-based coating has been developed for the controlled release of gentamicin (GS).

Methods

Sand blasted Ti6Al4V discs were grafted with dopamine (DOPA) solution. After, GS loaded agarose hydrogels have been produced and additioned with tannic acid (TA) and calcium chloride (CaCl₂) as crosslinkers. The different GS-loaded hydrogel formulations were deposited on Ti6Al4V-DOPA surfaces, and allowed to react under UV irradiation. Surface topography, wettability and composition have been analyzed with profilometry, static contact angle measurement, XPS and FTIR spectroscopy analyses. GS release was performed under pseudo-physiological conditions up to 28 days and the released GS was quantified using a specific ELISA test. The cytotoxicity of the produced coatings against human cells have been tested, along with their antibacterial activity against S. aureus bacteria.

Results

A homogeneous coating was obtained with all the hydrogel formulations. Moreover, the coatings presented a hydrophilic behavior and micro-scale surface roughness. The addition of TA in the hydrogel formulations showed an increase in the release time compared to the normal GS-agarose hydrogels. Moreover, the GS released from these gels was able to significantly inhibit S. aureus growth compared to the GS-agarose hydrogels. The addition of CaCl₂ to the gel formulation was able to significantly decrease cytotoxicity of the TA-modified hydrogels.

Conclusions

Due to their surface properties, low cytotoxicity and high antibacterial effects, the hereby proposed gentamicin-loaded agarose-hydrogels provide new insight, and represent a promising approach for the surface modification of spinal implants, greatly impacting their application in the orthopedic surgical scenario.

Polydopamine antibacterial materials

Recently, the development of polydopamine (PDA) has demonstrated numerous excellent performances in free radical scavenging, UV shielding, photothermal conversion, and biocompatibility. These unique properties enable PDA to be widely used as efficient antibacterial materials for various applications. Accordingly, PDA antibacterial materials mainly include free-standing PDA materials and PDA-based composite materials. In this review, an overview of PDA antibacterial materials is provided to summarize these two types of antibacterial materials in detail, including the fabrication strategies and antibacterial mechanisms. The future development and challenges of PDA in this field are also presented. It is hoped that this review will provide an insight into the future development of antibacterial functional materials based on PDA.

Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry

Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.

Bioinspired and eco-friendly high efficacy cinnamaldehyde antibacterial surfaces

Antimicrobial essential oils are incorporated into mussel-inspired and natural plant polyphenol coatings as part of a single-step fabrication process. Polydopamine-cinnamaldehyde, polyethyleneimine-cinnamaldehyde, and tannic acid-cinnamaldehyde coatings exhibit strong antibacterial activities against both Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus (with the polydopamine- and tannic acid-based systems displaying log₁₀ Reduction = 8). Cinnamaldehyde impregnation into porous non-woven polypropylene cloth, polytetrafluoroethylene membrane, and knitted cotton cloth also gives rise to high levels of antibacterial activity (log₁₀ Reduction = 8). No loss in antibacterial efficacy is observed for non-woven polypropylene cloth impregnated with cinnamaldehyde over 17 recycle tests.

Antibacterial metals and alloys for potential biomedical implants

Metals and alloys, including stainless steel, titanium and its alloys, cobalt alloys, and other metals and alloys have been widely used clinically as implant materials, but implant-related infection or inflammation is still one of the main causes of implantation failure. The bacterial infection or inflammation that seriously threatens human health has already become a worldwide complaint. Antibacterial metals and alloys recently have attracted wide attention for their long-term stable antibacterial ability, good mechanical properties and good biocompatibility in vitro and in vivo. In this review, common antibacterial alloying elements, antibacterial standards and testing methods were introduced. Recent developments in the design and manufacturing of antibacterial metal alloys containing various antibacterial agents were described in detail, including antibacterial stainless steel, antibacterial titanium alloy, antibacterial zinc and alloy, antibacterial magnesium and alloy, antibacterial cobalt alloy, and other antibacterial metals and alloys. Researches on the antibacterial properties, mechanical properties, corrosion resistance and biocompatibility of antibacterial metals and alloys have been summarized in detail for the first time. It is hoped that this review could help researchers understand the development of antibacterial alloys in a timely manner, thereby could promote the development of antibacterial metal alloys and the clinical application.

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This paper focuses the recent development of several antibacterial metals and alloys as biomedical materials.

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The possible antibacterial mechanisms of antibacterial metals and alloys are summarized in this paper.

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This review discusses the feasibility of antibacterial metals and alloys as biomedical implants in the future.

Recent Advances in a Polydopamine-Mediated Antimicrobial Adhesion System

The drug resistance developed by bacteria during antibiotic treatment has been a call to action for researchers and scientists across the globe, as bacteria and fungi develop ever increasing resistance to current drugs. Innovative antimicrobial/antibacterial materials and coatings to combat such infections have become a priority, as many infections are caused by indwelling implants (e.g., catheters) as well as improving postsurgical function and outcomes. Pathogenic microorganisms that can exist either in planktonic form or as biofilms in water-carrying pipelines are one of the sources responsible for causing water-borne infections. To combat this, researchers have developed nanotextured surfaces with bactericidal properties mirroring the topographical features of some natural antibacterial materials. Protein-based adhesives, secreted by marine mussels, contain a catecholic amino acid, 3,4-dihydroxyphenylalanine (DOPA), which, in the presence of lysine amino acid, empowers with the ability to anchor them to various surfaces in both wet and saline habitats. Inspired by these features, a novel coating material derived from a catechol derivative, dopamine, known as polydopamine (PDA), has been designed and developed with the ability to adhere to almost all kinds of substrates. Looking at the immense potential of PDA, this review article offers an overview of the recent growth in the field of PDA and its derivatives, especially focusing the promising applications as antibacterial nanocoatings and discussing various antimicrobial mechanisms including reactive oxygen species-mediated antimicrobial properties.

Polydopamine-based nanomaterials and their potentials in advanced drug delivery and therapy

Polydopamine (PDA) has shown great potentials in biomedical fields due largely to its unique physicochemical properties, including high photothermal transfer efficiency, excellent drug binding capacity, versatile adhesion ability, sensitive pH responsibility and great biocompatibility and biodegradability. These properties confer PDA-based nanoparticles the potentials either as the drug carriers for advanced drug delivery or as the bioactive agents for photothermal therapy, imaging and biosensing. This review aims to provide a comprehensive understanding of PDA, its polymerization mechanisms and the potentials of PDA-based nano-systems in treating various diseases, including cancer, diabetes, inflammation, bacterial infection and Parkinson's disease. In addition, the concerns of PDA in biomedical use are also discussed.

Surface functionalization of titanium substrates with Deoxyribonuclease I inhibit peri-implant bacterial infection

This study aimed to investigate the effect of Deoxyribonuclease I (DNase I) coating on initial adhesion and biofilm formation of peri-implant bacteria. Titanium (Ti), Ti-polydopamine (Ti-PDOP), Ti-PDOP-DNase I and Ti-PDOP-inactivated DNase I samples were studied. The FE-SEM, EDS and XPS were used to confirm that DNase I was coated onto Ti. The initial adhesion and biofilm formation of Aggregatibacter actinomycetemcomitans (A.a) and Fusobacterium nucleatum (F.n) were observed by CLSM. The osteogenic induction of Ti-PDOP-DNase I on MC3T3-E1 cells was investigated by ALP activity and RT-PCR. The adhesion clearance rate of viable bacteria on the surfaces of Ti-PDOP-DNase I was 91.95% for A.a, and 96.37% for F.n, and the 24 h biofilm formation of the bacteria was significantly inhibited. In addition, on DNase I coating, the mRNA level of osteogenic marker genes (alp, opn, bsp, sp7) and the activity of ALP were both up-regulated. Therefore, DNase I coating could be an alternative approach for preventing implant-related infection.

Surface Modified Techniques and Emerging Functional Coating of Dental Implants

Dental implants are widely used in the field of oral restoration, but there are still problems leading to implant failures in clinical application, such as failed osseointegration, marginal bone resorption, and peri-implantitis, which restrict the success rate of dental implants and patient satisfaction. Poor osseointegration and bacterial infection are the most essential reasons resulting in implant failure. To improve the clinical outcomes of implants, many scholars devoted to modifying the surface of implants, especially to preparing different physical and chemical modifications to improve the osseointegration between alveolar bone and implant surface. Besides, the bioactive-coatings to promote the adhesion and colonization of ossteointegration-related proteins and cells also aim to improve the osseointegration. Meanwhile, improving the anti-bacterial performance of the implant surface can obstruct the adhesion and activity of bacteria, avoiding the occurrence of inflammation related to implants. Therefore, this review comprehensively investigates and summarizes the modifying or coating methods of implant surfaces, and analyzes the ossteointegration ability and anti-bacterial characteristics of emerging functional coatings in published references.

SiCxNyOz Coatings Enhance Endothelialization and Bactericidal activity and Reduce Blood Cell Activation

For biomedical applications, a number of ceramic coatings have been investigated, but the interactions with the components of living system remain unexplored for oxycarbonitride coatings. While addressing this aspect, the present study aims to provide an understanding of the biocompatibility of novel SiC_xN_yO_z coatings that could validate the hypothesis that such coatings may not only enhance the cell-material interaction by re-endothelialization but also can help to reduce bacterial adhesion and activation of blood cells. This work reports the physicochemical properties, hemocompatibility, endothelialization, and antibacterial properties of novel amorphous SiC_xN_yO_z coatings deposited on commercial pure titanium (Ti) by radiofrequency (RF) magnetron sputtering at varied nitrogen (N₂) flow rates. A comparison is made with diamond-like carbon (DLC) coatings, which are clinically used. The surface roughness, surface wettability, nanoscale hardness, and surface energy of SiC_xN_yO_z coatings were found to be dependent on the nitrogen (N₂) flow rate. Importantly, the as-deposited SiC_xN_yO_z coatings exhibited much better nanoscale hardness and scratch resistance than DLC coatings. Furthermore, Raman spectroscopy analysis of the SiC_xN_yO_z coating deposited on Ti showed a change in the graphitic/disordered carbon content. Cytocompatibility and hemocompatibility properties of the as-deposited SiC_xN_yO_z coating were evaluated using the Mus musculus lymphoid endothelial cell line (SVEC4-10) and rabbit blood in vitro. WST-1 assay analysis showed that these coatings, when compared to DLC, exhibited a better proliferation of endothelial cells, which can potentially result in improved surface endothelialization. Furthermore, qualitative and quantitative analyses of immunofluorescence images revealed a dense cellular layer of SVEC4-10 on SiC_xN_yO_z coatings, deposited at 15 and 30 sccm nitrogen flow rates. As far as compatibility with rabbit blood is concerned, the hemolysis of the SiC_xN_yO_z coatings was less than 4%, with slightly lower values for coatings deposited without N₂ flow. The SiC_xN_yO_z coatings support less platelet adhesion and aggregation, with no signature of morphological deformation, as compared to the uncoated titanium substrate or DLC coatings. Furthermore, SiC_xN_yO_z coatings were also found to be effectively extending the blood coagulation time for a period of 60 min. The antimicrobial study of as-deposited SiC_xN_yO_z coatings on E. coli and S. aureus bacteria revealed the effective inhibition of bacterial proliferation after 24 h of culture. An attempt has been made to explain the cyto- and hemocompatibility properties with antimicrobial efficacy of coatings in terms of the variation in the coating composition and surface energy. Taken together, we conclude that SiC_1.3N_0.76O_0.87 coating having a roughness of 17 nm and a surface free energy of 54.0 ± 0.7 mN/m can exhibit the best combination of hardness, elastic modulus, scratch resistance, cytocompatibility, hemocompatibility, and bactericidal properties.

Pristine and Antibiotic-Loaded Nanosheets/Nanoneedles-Based Boron Nitride Films as a Promising Platform to Suppress Bacterial and Fungal Infections

In recent years, bacteria inactivation during their direct physical contact with surface nanotopography has become one of the promising strategies for fighting infection. Contact-killing ability has been reported for several nanostructured surfaces, e.g., black silicon, carbon nanotubes, zinc oxide nanorods, and copper oxide nanosheets. Herein, we demonstrate that Gram-negative antibiotic-resistant Escherichia coli (E. coli) bacteria are killed as a result of their physical destruction while contacting nanostructured h-BN surfaces. BN films, made of spherical nanoparticles formed by numerous nanosheets and nanoneedles with a thickness <15 nm, have been obtained through a reaction of ammonia with amorphous boron. The contact-killing bactericidal effect of BN nanostructures has been compared with a toxic effect of gentamicin released from them. For a wider protection against bacterial and fungal infection, the films have been saturated with a mixture of gentamicin and amphotericin B. Such BN films demonstrate a high antibiotic/antimycotic agent loading capacity and a fast initial and sustained release of therapeutic agents for 170-260 h depending on the loaded dose. The pristine BN films possess high antibacterial activity against E. coli K-261 strain at their initial concentration of 10⁴ cells/mL, attaining >99% inactivation of colony forming units after 24 h, same as gentamicin-loaded (150 μg/cm²) BN sample. The BN films loaded with a mixture of gentamicin (150 and 300 μg/cm²) and amphotericin B (100 μg/cm²) effectively inhibit the growth of E. coli K-261 and Neurospora crassa strains. During immersion in the normal saline solution, the BN film generates reactive oxygen species (ROS), which can lead to accelerated oxidative stress at the site of physical cell damage. The obtained results are valuable for further development of nanostructured surfaces having contact killing, ROS, and biocide release abilities.

Recent Advances in Surface Nanoengineering for Biofilm Prevention and Control. Part II: Active, Combined Active and Passive, and Smart Bacteria-Responsive Antibiofilm Nanocoatings

The second part of our review describing new achievements in the field of biofilm prevention and control, begins with a discussion of the active antibiofilm nanocoatings. We present the antibiofilm strategies based on antimicrobial agents that kill pathogens, inhibit their growth, or disrupt the molecular mechanisms of biofilm-associated increase in resistance and tolerance. These agents of various chemical structures act through a plethora of mechanisms targeting vital bacterial metabolic pathways or cellular structures like cell walls and cell membranes or interfering with the processes that underlie different stages of the biofilm life cycle. We illustrate the latter action mechanisms through inhibitors of the quorum sensing signaling pathway, inhibitors of cyclic-di-GMP signaling system, inhibitors of (p)ppGpp regulated stringent response, and disruptors of the biofilm extracellular polymeric substances matrix (EPS). Both main types of active antibiofilm surfaces, namely non-leaching or contact killing systems, which rely on the covalent immobilization of the antimicrobial agent on the surface of the coatings and drug-releasing systems in which the antimicrobial agent is physically entrapped in the bulk of the coatings, are presented, highlighting the advantages of each coating type in terms of antibacterial efficacy, biocompatibility, selective toxicity, as well as drawbacks and limitations. Developments regarding combined strategies that join in a unique platform, both passive and active elements are not omitted. In such platforms with dual functionality, passive and active strategies can be applied either simultaneously or sequentially. We especially emphasize those systems that can be reversely and repeatedly switched between the non-fouling status and the bacterial killing status, thereby allowing several bacteria-killing/surface regeneration cycles to be performed without significant loss of the initial bactericidal activity. Eventually, smart antibiofilm coatings that release their antimicrobial payload on demand, being activated by various triggers such as changes in local pH, temperature, or enzymatic triggers, are presented. Special emphasis is given to the most recent trend in the field of anti-infective surfaces, specifically smart self-defensive surfaces for which activation and switch to the bactericidal status are triggered by the pathogens themselves.

Graphene–Chitosan Hybrid Dental Implants with Enhanced Antibacterial and Cell-Proliferation Properties

Dental implants are widely used tooth replacement tools owing to their good oral rehabilitation and reconstruction capacities. Since dental implants are designed as a replacement for natural teeth, multi-functional abilities are desired to achieve successful implant treatment with improved osseointegration through promotion of mammalian cell activity and prevention of bacterial cell activity. In this study, we developed a graphene–chitosan hybrid dental implant (GC hybrid implant) using various concentrations of graphene, which demonstrated the different surface properties including increased wettability and roughness. Importantly, the GC hybrid implant under the optimal condition (i.e., 1% GC hybrid implant) could significantly promote osteoblast proliferation while reducing biofilm formation and bacterial activity. Our study demonstrates the potential of using this GC hybrid implant as a new type of dental implant, which can offer an effective design for the fabrication of advanced dental implants.

Two-dimensional nanocoating-enabled orthopedic implants for bimodal therapeutic applications

As one of the promising orthopedic materials, polyetheretherketone (PEEK) has high chemical durability and similar mechanical properties to the cortical bone; nevertheless, the inherent bioinert nature of PEEK dramatically impedes its broader clinical applications in the management of bone infection. To address this challenge, herein, we developed a multifunctional two-dimensional (2D) nanocoating to assemble graphene oxide (GO) nanosheets, a polydopamine (pDA) nanofilm, and an oligopeptide onto the surface of porous sulfonated PEEK (SPEEK). The resulting multifunctional PEEK implants exhibited enhanced cytocompatibility, alkaline phosphatase activity, and calcium matrix deposition as well as osteogenesis-associated gene expression. Moreover, the animal experiments based on a rabbit femur defect model confirmed that the 2D nanocoating prominently boosted the in vivo osseointegration and bone remodeling. Besides, the GO/pDA hybrid complex anchoring on the SPEEK surface through π-π stacking can generate robust antibacterial phototherapy resulting from the synergetic photothermal/photodynamic therapeutic effects. Accordingly, this work provides a paradigm to empower inert PEEK implants with bi-/multi-modal therapeutic applications, such as against bone infection treatment.

Subsidence of Additively-Manufactured Cages in Foam Substrates: Effect of Contact Topology

Subsidence of implants into bone is a major source of morbidity. The underlying mechanics of the phenomenon are not clear, but are likely related to interactions between contact stresses and the underlying porous trabecular bone structure. To gain insight into these interactions, we studied the penetration of three-dimensional (3D)-printed indenters with systematically varying geometries into Sawbones® foam substrates and isolated the effects of contact geometry from those of overall contact size and area. When size, contact area, and indented material stiffness and strength are controlled for, we show that resistance to penetration is in fact a function of topology only. Indenters with greater line contact lengths support higher subsidence loads in compression. These results have direct implications for the design of implants to resist subsidence into bone.

Antibacterial Properties of Triethoxysilylpropyl Succinic Anhydride Silane (TESPSA) on Titanium Dental Implants

Infections related to dental implants are a common complication that can ultimately lead to implant failure, and thereby carries significant health and economic costs. In order to ward off these infections, this paper explores the immobilization of triethoxysilylpropyl succinic anhydride (TESPSA, TSP) silane onto dental implants, and the interaction of two distinct monospecies biofilms and an oral plaque with the coated titanium samples. To this end, titanium disks from prior machining were first activated by a NaOH treatment and further functionalized with TESPSA silane. A porous sodium titanate surface was observed by scanning electron microscopy and X-ray photoelectron spectroscopy analyses confirmed the presence of TESPSA on the titanium samples (8.4% for Ti-N-TSP). Furthermore, a lactate dehydrogenase assay concluded that TESPSA did not have a negative effect on the viability of human fibroblasts. Importantly, the in vitro effect of modified surfaces against Streptococcus sanguinis, Lactobacillus salivarius and oral plaque were studied using a viable bacterial adhesion assay. A significant reduction was achieved in all cases but, as expected, with different effectiveness against simple mono-species biofilm (ratio dead/live of 0.4) and complete oral biofilm (ratio dead/live of 0.6). Nevertheless, this approach holds a great potential to provide dental implants with antimicrobial properties.

Enhanced antibacterial activity of titanium by surface modification with polydopamine and silver for dental implant application

BACKGROUND

Biofilm formation and microbial colonization on the surface of implant devices may cause dental caries and peri-implantitis. Therefore, various surface treatments have been developed to improve the antibacterial activity of titanium implant.

METHODS

Silver-loaded polydopamine coating was formed by immersing pure titanium in dopamine hydrochloride/HCl buffer solution for 24 h in 50 mL silver nitrate solutions with different concentrations for 30 min. Microbial growth inhibition and microbial growth curve analyses for bacterial solutions of Streptococcus mutans and Porphyromonas gingivalis incubated with the specimens were respectively conducted by counting the numbers of colonies on agar solid medium and by measuring absorbance using enzyme-linked immunosorbent assay reader.

RESULTS

Silver nanoparticles were uniformly distributed over the whole surface of the polydopamine and silver-coated titanium specimens. The numbers of microbial colonies for both bacteria cultured with surface-modified titanium were significantly lower than those cultured with uncoated titanium. When Streptococcus mutans and Porphyromonas gingivalis were cultured with surface-modified titanium, the lag phase of the growth curves for both bacteria was continually maintained, whereas the lag phase for Streptococcus mutans and Porphyromonas gingivalis changed to exponential phase after 9 and 15 h, respectively, when both bacteria were cultured with uncoated titanium.

CONCLUSION

It was confirmed that the coating of polydopamine and silver on the surface of titanium effectively retards the microbial growth, which can cause the formation of biofilm and pathogenesis of gum disease in the mouth.

An effective dual-factor modified 3D-printed PCL scaffold for bone defect repair

Numerous bioactive molecules produced in cells are involved in the process of bone formation. We consider that appropriate, simultaneous application of two types of bioactive molecules would accelerate the regeneration of tissues and organs. Therefore, we combined aspirin-loaded liposomes (Asp@Lipo) and bone forming peptide-1 (BFP-1) on three dimensional-printed polycaprolactone (PCL) scaffold and determined whether this system improved bone regeneration outcomes. in vitro experiments indicated that Asp@Lipo/BFP-1at a 3:7 ratio was the best option for enhancing the osteogenic efficiency of human mesenchymal stem cells (hMSCs). This was confirmed in an in vivo cranial defect animal model. In addition, RNA-Seq was applied for preliminarily exploration of the mechanism of action of this composite scaffold system, and the results suggested that it mainly improved bone regeneration via the PI3K/AKT signaling pathway. This approach will have potential for application in bone tissue engineering and regenerative medicine.

Elucidating structure–function relationships governing the interfacial response of human mesenchymal stem cells to polydopamine coatings

Deposition of mussel-inspired polydopamine (PDA) has rapidly emerged as a simple yet effective strategy to functionalize the surface of biomaterials.

3-D printed Ti-6Al-4V scaffolds for supporting osteoblast and restricting bacterial functions without using drugs: Predictive equations and experiments

Conditions resulting from musculoskeletal deficiencies (MSDs) are wide-ranging and retain the likelihood for restricting motion or producing pain, especially in the lower back, neck, and upper limbs. Engineered scaffold devices are being produced to replace antiquated modalities that suffer from structural and mechanical deficiencies in the treatment of MSDs. Here, as-fabricated Ti-6Al-4V-based Hive™ interbody fusion scaffolds, commercialized by HD Lifesciences LLC, were assayed for their osteogenicity and antibacterial potential using a series of characterization and in vitro tests, as well as by quantitative analyses. A topographical assessment of the Hive™ meshes indicated that the elementally pure substrates are microscopically porous and rough, in addition to displaying structural heterogeneity. Roughness estimations and static contact angle measurements recommended the use of the as-fabricated Ti-6Al-4V substrates for supporting osteoblast attachment, especially, due to the improved surface roughness and wettability values of these scaffolds relative to the unembellished Ti-6Al-4V surfaces. Quantitative correlations relating the surface properties of roughness and energy were applied to predict cellular behaviors. Cell growth suppositions were experimentally corroborated. Critical in vitro data indicated the competencies of the Hive™ scaffolds for promoting the adhesion and proliferation of human fetal osteoblasts (hFOBs), accumulating substantial calcium deposition from metabolizing hFOBs, and restricting the attachment of bacteria. The model system that investigated the pre-adsorption of casein proteins along the Hive™ test substrates additionally furthered the notion that bacterial attachment may be restricted, with short-scale adhesion dynamics serving as the theoretical basis for this hypothesis. In this manner, this study showed that through predictive models and experiments, these novel 3D printed Ti-based scaffolds can increase bone cell while decreasing bacteria functions without using drugs. STATEMENT OF SIGNIFICANCE: Sintered Ti-6Al-4V spinal fusion devices (Hive™) manufactured and marketed by HD Lifesciences LLC were assessed for their biocompatibility and antibacterial performance. A mixed methods approach was employed, whereby quantitative measures were used to predict the ability for Hive™ substrates to adsorb specialized proteins and to restrict bacterial surface colonization. In vitro tests that evaluated bone cell and bacterial adhesion, calcium deposition, and protein adsorption supported quantitative predictions. The data herein presented demonstrate the following: (1) surface energy is an important predictor of implant-cell interactions, (2) strong correlations exist between surface energy and surface roughness, (3) mathematical models can be used to improve and predict implant device perofrmance, and (4) porous, rough, 3D-printed materials perform well in terms of biocompatibility and antimicrobial efficacy.

Chitosan/hydroxyapatite modified carbon/carbon composites: synthesis, characterization and in vitro biocompatibility evaluation

Carbon/carbon composite (C/C), due to its bio-inert property, is prone to cause bone consolidation defects and bacterial infections in clinical applications. Therefore, there is a great demand in practical applications to prevent implant infections and enhance its bone consolidation capability. In this study, we have developed a facile approach to construct a chitosan/hydroxyapatite composite modified layer on C/C surface by electrochemical deposition and a covalent grafting technique, and the modified layer has both the antibacterial activity of chitosan (CS) and the bioactivity of hydroxyapatite (HAP). The microstructure and chemical composition of the modified layer were analyzed using scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS) and water contact angle measurements. The biological properties of the composites were evaluated using cell culture, antimicrobial test and real-time quantitative PCR in vitro. The results showed that the CS/HAP modified C/C exhibited excellent biocompatibility, bacteriostasis and osteoinductive ability. These properties are beneficial for the potential application of the modified C/C composite as a bone tissue replacement material.

Carbon/carbon composite (C/C), due to its bio-inert property, is prone to cause bone consolidation defects and bacterial infections in clinical applications.

Triple-functional polyetheretherketone surface with enhanced bacteriostasis and anti-inflammatory and osseointegrative properties for implant application

Polyetheretherketone (PEEK) is considered a potential orthopedic/dental material because of its excellent mechanical and chemical properties (e.g., similar elastic modulus to that of human bone). However, the poor bacteriostasis and anti-inflammatory and osseointegrative properties of bioinert PEEK impede its clinical application. We previously developed a facile and versatile surface modification method using dexamethasone plus minocycline-loaded liposomes (Dex/Mino liposomes) bonded by a mussel-inspired polydopamine coating, which effectively modulated cell inflammatory response and discouraged bacterial colonization in vitro. Herein, we report the application of this multifunctional surface modification method to improve bioinert PEEK, aimed at further studying the in vitro osteogenesis and in vivo properties of Dex/Mino liposome-modified PEEK to prevent bacterial contamination, attenuate the inflammatory response, and enhance ossification for physiologic osseointegration. Our study established that the Dex/Mino liposome-modified PEEK surface presented favorable stability and cytocompatibility. Compared with bare PEEK, improved osteogenic differentiation of human mesenchymal stem cells under both osteoinductive and osteoconductive conditions was found on the functionalized surface due to the liposomal Dex releasing. In vivo bacteriostasis assay confirmed that Mino released from the functionalized surface provided an effective antibacterial effect. Moreover, the subcutaneous foreign body reaction and beagle femur implantation models corroborated the enhanced anti-inflammatory and osteointegrative properties of the functionalized PEEK. Our findings indicate that the developed Dex/Mino liposome-modified PEEK with enhanced antibacterial, anti-inflammatory, and osseointegrative capacity has great potential as an orthopedic/dental implant material for clinical application.

Polydopamine-assisted surface modification for orthopaedic implants

Along with the massive use of implants in orthopaedic surgeries in recent few decades, there has been a tremendous demand for the surface modification of the implants to avoid surgery failure and improve their function. Polydopamine (PDA), being able to adhere to almost all kinds of substrates and possessing copious functional groups for covalently immobilizing biomolecules and anchoring metal ions, has been widely used for surface modification of materials since its discovery in the last decade. PDA and its derivatives can be used for the surface modification of orthopaedic implants to modulate cellular responses, including cell spreading, migration, proliferation, and differentiation, and may thereby enhance the function of existing implants. In addition, the osseointegration and antimicrobial properties of orthopaedic implants may also be improved by PDA-based coatings. The aim of this review is to provide a brief overview of current advances of surface modification technologies for orthopaedic implants using PDA and its derivatives as a medium. Given the versatility of PDA-based adhesion, such PDA-assisted surface modification technologies will certainly benefit the development of new orthopaedic implants.

THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE

Surface treatments of orthopaedic implants, which are normally inert materials, are essential for their performance in vivo. This review summarizes recent advances in the surface modification of orthopaedic implants using facile and highly versatile techniques based on the use of polydopamine (PDA) and its derivatives.

Studies on Cell Compatibility, Antibacterial Behavior, and Zeta Potential of Ag-Containing Polydopamine-Coated Bioactive Glass-Ceramic

Dopamine is a small molecule that mimics the adhesive component (L-DOPA) of marine mussels with a catecholamine structure. Dopamine can spontaneously polymerize to form polydopamine (PDA) in a mild basic environment. PDA binds, in principle, to all types of surfaces and offers a platform for post-modification of surfaces. In this work, a novel Ag-containing polydopamine coating has been developed for the functionalization of bioactive glass-ceramics. In order to study the interactions between the surface of uncoated and coated samples and the environment, we have measured the surface zeta potential. Results confirmed that PDA can interact with the substrate through different chemical groups. A strongly negative surface zeta potential was measured, which is desirable for biocompatibility. The dual function of the material, namely the capability to exhibit bioactive behavior while being antibacterial and not harmful to mammalian cells, was assessed. The biocompatibility of the samples with MG-63 (osteoblast-like) cells was determined, as well as the antibacterial behavior against Gram-positive Staphylococcus carnosus and Gram-negative Escherichia coli bacteria. During cell biology tests, uncoated and PDA-coated samples showed biocompatibility, while cell viability on Ag-containing PDA-coated samples was reduced. On the other hand, antibacterial tests confirmed the strong antimicrobial properties of Ag-containing PDA-coated samples, although tailoring of the silver release will be necessary to modulate the dual effect of PDA and silver.