Probing the Structure, Cytocompatibility, and Antimicrobial Efficacy of Silver-, Strontium-, and Zinc-Doped Monetite

Calcium phosphate phases are among the most widely accepted compounds for biomaterial applications, of which the resorbable phases have gained particular attention in recent years. Brushite and its anhydrous form monetite are among the most interesting resorbable calcium phosphate phases that can be applied as cements and for in situ fabrication of three-dimensional (3D) implants. Of these two dicalcium phosphate compounds, monetite is more stable and undergoes slower degradation than brushite. The purpose of the current study is to synthesize and dope monetite with the antimicrobial elements silver and zinc and the osteoinductive element strontium and investigate the possible structural variations as well as their biocompatibility and antimicrobial effectiveness. For this, powder X-ray diffraction (PXRD), energy-dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), and cryo-transmission electron microscopy (cryo-TEM) were used to thoroughly study the synthesized structures. Moreover, the ASTM E-2149-01 protocol and a cell proliferation assay were used to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) and the cytocompatibility of the different phases with the Soas-2 cell line, respectively. The results confirm the successful synthesis and doping procedures, such that zinc was the most incorporated element into the monetite phase and strontium was the least incorporated element. The microbiological studies revealed that silver is a very effective antimicrobial agent at low concentrations but unsuitable at high concentrations because its cytotoxicity would prevail. On the other hand, doping the compounds with zinc led to a reasonable antimicrobial activity without compromising the biocompatibility to obviously high concentrations. The study also highlights that strontium, widely known for its osteoinductivity, bears an antimicrobial effect at high concentrations. The generated doped compounds could be beneficial for prospective studies as bone cements or for scaffold biomaterial applications.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

Analyses of the modulatory effects of antibacterial silver doped calcium phosphate-based ceramic nano-powder on proliferation, survival, and angiogenic capacity of different mammalian cells in vitro

In this study, the antibacterial, cytotoxic, and angiogenic activities of silver doped calcium phosphate-based inorganic powder (ABT or PAG) were systematically investigated. ABT powders containing varying silver content were fabricated using a wet chemical manufacturing method. Antibacterial efficiencies of the ABT powders were investigated using a standard test with indicator bacteria and yeast. The cytotoxic effects of ABT on three different fibroblast cells and human umbilical vein endothelial cells (HUVECs) were assessed using MTT assay. ABT powder exhibits concentration-related cytotoxicity characteristics. Apoptotic activity, attachment capability, and wound healing effects were examined on fibroblasts. The angiogenic activity of ABT was investigated by tube formation assay in HUVECs; 10 μg ml(-1) and 100 μg ml(-1) concentrations of the highest metal ion content of ABT did not disrupt the tube formation of HUVECs. All these tests showed that ABT does not compromise the survival of the cells and might impose regeneration ability to various cell types. These results indicate that silver doped calcium phosphate-based inorganic powder with an optimal silver content has good potential for developing new biomaterials for implant applications.

Bioactive polymeric composites for tooth mineral regeneration: physicochemical and cellular aspects

Our studies of amorphous calcium phosphate (ACP)-based dental materials are focused on the design of bioactive, non-degradable, biocompatible, polymeric composites derived from acrylic monomer systems and ACP by photochemical or chemically activated polymerization. Their intended uses include remineralizing bases/liners, orthodontic adhesives and/or endodontic sealers. The bioactivity of these materials originates from the propensity of ACP, once exposed to oral fluids, to release Ca and PO₄ ions (building blocks of tooth and bone mineral) in a sustained manner while spontaneously converting to thermodynamically stable apatite. As a result of ACP's bioactivity, local Ca- and PO₄-enriched environments are created with supersaturation conditions favorable for the regeneration of tooth mineral lost to decay or wear. Besides its applicative purpose, our research also seeks to expand the fundamental knowledge base of structure-composition-property relationships existing in these complex systems and identify the mechanisms that govern filler/polymer and composite/tooth interfacial phenomena. In addition to an extensive physicochemical evaluation, we also assess the leachability of the unreacted monomers and in vitro cellular responses to these types of dental materials. The systematic physicochemical and cellular assessments presented in this study typically provide model materials suitable for further animal and/or clinical testing. In addition to their potential dental clinical value, these studies suggest the future development of calcium phosphate-based biomaterials based on composite materials derived from biodegradable polymers and ACP, and designed primarily for general bone tissue regeneration.

The Effect of Zirconia in Hydroxyapatite on Staphylococcus epidermidis Growth

Synthetic hydroxyapatite (HA) has been widely used and developed as the material for bone substitute in medical applications. The addition of zirconia is needed to improve the strength of hydroxyapatite as the bone substitute. One of the drawbacks in the use of biomedical materials is the occurrence of biomaterial-centred infections. The recent method of limiting the presence of microorganism on biomaterials is by providing biomaterial-bound metal-containing compositions. In this case, S. epidermidis is the most common infectious organism in biomedical-centred infection. Objective. This study was designed to evaluate the effect of zirconia concentrations in hydroxyapatite on the growth of S. epidermidis. Methods and Materials. The subjects of this study were twenty hydroxyapatite discs, divided into four groups in which one was the control and the other three were the treatment groups. Zirconia powder with the concentrations of 20%, 30%, and 40% was added into the three different treatment groups. Scanning electron microscope analysis was performed according to the hydroxyapatite and hydroxyapatite-zirconia specimens. All discs were immersed into S. epidermidis culture for 24 hours and later on they were soaked into a medium of PBS. The cultured medium was spread on mannitol salt agar. After incubation for 24 hours at 37°C , the number of colonies was measured with colony counter. Data obtained were analyzed using the ANOVA followed by the pairwise comparison. Result. The statistical analysis showed that different concentrations of zirconia powder significantly influenced the number of S. epidermidis colony (P < 0.05) . Conclusion. The addition of zirconia into hydroxyapatite affected the growth of S. epidermidis. Hydroxyapatite with 20% zirconia proved to be an effective concentration to inhibit the growth of S. epidermidis colony.

Fine-Tuning of Polymeric Resins and Their Interfaces with Amorphous Calcium Phosphate. A Strategy for Designing Effective Remineralizing Dental Composites

For over a decade our group has been designing, preparing and evaluating bioactive, remineralizing composites based on amorphous calcium phosphate (ACP) fillers embedded in polymerized methacrylate resin matrices. In these studies a major focus has been on exploring structure-property relationships of the matrix phase of these composites on their anti-cariogenic potential. The main challenges were to gain a better understanding of polymer matrix/filler interfacial properties through controlling the surface properties of the fillers or through fine-tuning of the resin matrix. In this work, we describe the effect of chemical structure and composition of the resin matrices on some of the critical physicochemical properties of the copolymers and their ACP composites. Such structure-property studies are essential in formulating clinically effective products, and this knowledge base is likely to have strong impact on the future design of therapeutic materials, appropriate for mineral restoration in defective tooth structures.

Development of remineralizing, antibacterial dental materials

Light curable methacrylate dental monomers containing reactive calcium phosphate filler (monocalcium phosphate monohydrate (MCPM) with particle diameter of 29 or 90microm) and beta-tricalcium phosphate (beta-TCP) at 1:1 weight ratio in a powder:liquid ratio (PLR) of 1:1 or 3:1 and chlorhexidine diacetate (0 or 5 wt.%), were investigated. Upon light exposure, approximately 90% monomer conversion was gained irrespective of the formulation. Increasing the PLR promoted water sorption by the set material, induced expansion and enhanced calcium, phosphate and chlorhexidine release. Concomitantly, a decline in compressive and biaxial flexural strengths occurred. With a reduction in MCPM particle diameter, however, calcium and phosphate release was reduced and less deterioration in strength observed. After 24h, the remaining MCPM had reacted with water and beta-TCP, forming, within the set materials, brushite of lower solubility. This provided a novel means to control water sorption, component release and strength properties. Measurable chlorhexidine release was observed for 6weeks. Both diffusion rate and total percentage of chlorhexidine release decreased with lowering PLR or by adding buffer to the storage solutions. Higher chlorhexidine release was associated with reduced bacterial growth on agar plates and in a biofilm fermenter. In cell growth media, brushite and hydroxyapatite crystals precipitated on the composite material surfaces. Cells spread on both these crystals and the exposed polymer composite surfaces, indicating their cell compatibility. These formulations could be suitable antibacterial, biocompatible and remineralizing dental adhesives/liners.

Effect of Chemical Structure and Composition of the Resin Phase on Vinyl Conversion of Amorphous Calcium Phosphate-filled Composites

The objective of this study was to elucidate the effect of chemical structure and composition of the polymer matrix on the degree of vinyl conversion (DC) of copolymers (unfilled resins) and their amorphous calcium phosphate (ACP) composites attained upon photo-polymerization. The DC can also be an indicator of the relative potential of these polymeric materials to leach out into the oral environment un-reacted monomers that could adversely affect their biocompatibility. The following resins were examined: 1) 2,2-bis[p-(2'-hydroxy-3'-methacryloxypropoxy)phenyl]propane (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) (1:1 mass ratio; BT resin) combined with hydroxyethyl methacrylate (HEMA; BTH resin) and with HEMA and zirconyl dimethacrylate (BTHZ resin), 2) urethane dimethacrylate (UDMA)/HEMA resins, and 3) pyromellitic glycerol dimethacrylate (PMGDMA)/TEGDMA (PT resin). To make composite specimens, resins were mixed with a mass fraction of 40 % zirconia-hybridized ACP. Copolymers and their composites were evaluated by near infra-red spectroscopy for DC after 1 d and 28 d post-cure at 23 °C. Inclusion of HEMA into the BT and UDMA resins yielded copolymers and composites with the highest DCs. The significantly lower DCs of PT copolymers and their composites are attributed to the rigid aromatic core structure, tetra-vinyl functionality and limited methacrylate side-chain flexibility of the surface-active PMGDMA monomer. There was, however, an increase in the 28 d DC for the PT materials as there was for the BTHZ system. Surprisingly, the usual decrease observed in DC in going from unfilled polymer to composite was reversed for the PT system.