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Zhang D, Deng T, Luo Z, Zhu A, Yang B, Zhong H, Li S, Yang X. [Surface modification of titanium implant with hBMP-2/hIGF-1 for promoting biocompatibility and osteogenesis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1277-1282. [PMID: 34549722 DOI: 10.12122/j.issn.1673-4254.2021.08.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To prepare the human bone morphogenetic protein-2(hBMP-2)/human insulin-like growth factor-1(hIGF-1)coating titanium(Ti)and assess its performance as a dental implant material. METHODS hBMP-2 and hIGF-1 were coated to the smooth surface of a Ti plate, and its efficacy for promoting bone formation and bone integration was compared with a pristine Ti plate.The surface characteristics of the metal samples were evaluated using scanning electron microscope (SEM) and by contact angle measurement.MG63 cells were seeded on the surface of the Ti plates, and MTT assay and alizarin red staining was used to examine the cell proliferation and formation of calcified nodules, respectively.Alkaline phosphatase (ALP)secretion of the cells was examined with ELISA, and cellular expressions of osteocalcin and osteopontin were detected with Western blotting for assessing osteogenesis. RESULTS SEM examination showed that the surface of Ti with hBMP-2 and hIGF-1 coating presented with a radial pattern resembling snowflakes.The contact angles of non-coated Ti, hBMP-2-coated Ti, hIGF-1-coated, and hBMP-2/-hIGF-1-coated Ti samples were 83.2°, 54°, 56° and 54°, respectively.Compared with the non-coated Ti plate, the surface-modified Ti samples showed a significantly smaller contact angle (P=0.032, 0.029, and 0.028), indicating a good hydrophilicity of the samples.MTT assay showed that MG63 cells grew well on the surface of the coated Ti plates.The hBMP-2/IGF-1 coating significantly induced cellular secretion of ALP(P=0.021, 0.014)and obviously promoted osteogenesis of MG63 cells (P < 0.05).Western blotting results showed that hBMP-2/IGF-1 coating significantly enhanced the expressions of osteocalcin and osteopontin in the seeded cells (P < 0.05). CONCLUSION hBMP-2 and hIGF-1 coating of Ti material can promote osteogenesis of the cells seeded on its surface to improve the performance of such Ti material as dental implants.
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Affiliation(s)
- D Zhang
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - T Deng
- Department of Stomatology, Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
| | - Z Luo
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - A Zhu
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - B Yang
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - H Zhong
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - S Li
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - X Yang
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
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Jia S, Liu Y, Ma Z, Liu C, Chai J, Li Z, Song W, Hu K. A novel vertical aligned mesoporous silica coated nanohydroxyapatite particle as efficient dexamethasone carrier for potential application in osteogenesis. Biomed Mater 2020; 16. [PMID: 33197902 DOI: 10.1088/1748-605x/abcae1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022]
Abstract
Bone defect is a common problem and inducing osteoblasts differentiation is the key process for the regenerative repair. Recently, the mesoporous silica (MS) coated nanohydroxyapatite particles nHA (nHA-MS) has shown enhanced intrinsic potency for bone regeneration, whereas whether the osteogenesis potency can be further enhanced after drug delivery has not been investigated. In this study, the nHA-MS was fabricated by a novel biphase stratification growth way. The cytotoxicity in MC3T3-E1 was validated by MTT assay, apoptosis analysis and cell cycle examination. The cell uptake was observed by confocal laser scanning microscope and transmission electron microscope respectively. After adsorption with dexamethasone (DEX), the osteogenic differentiation was determined both in vitro and in vivo. The synthesized nHA-MS showed a core-shell structure that the nanorod-like nHA was coated by a porous MS shell (~5 nm pores diameter, ~50 nm thickness). A dose-dependent cytotoxicity was observed and below 10 µg/ml was a safe concentration. The nHA-MS also showed efficient cell uptake efficiency and more efficient in DEX loading and release. After DEX adsorption, the nanoparticles exhibited enhanced osteogenic induction in MC3T3-E1 and rat calvarial bone defect regeneration. In conclusion, the nHA-MS is a favorable platform for drug delivery to obtain more enhanced osteogenesis capabilities.
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Affiliation(s)
- Sen Jia
- Fourth Military Medical University School of Stomatology, Xi'an, CHINA
| | - Yan Liu
- Fourth Military Medical University School of Stomatology, Xi'an, CHINA
| | - Zhiwei Ma
- Fourth Military Medical University School of Stomatology, Xi'an, CHINA
| | | | - Juan Chai
- Xi'an Medical University, Xi'an, Shaanxi, CHINA
| | - Zixia Li
- Xi'an Medical University, Xi'an, Shaanxi, CHINA
| | - Wen Song
- Fourth Military Medical University School of Stomatology, Xi'an, 710000, CHINA
| | - Kaijin Hu
- Fourth Military Medical University School of Stomatology, Xi'an, CHINA
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Abstract
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.
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Wu K, Liu M, Li N, Zhang L, Meng F, Zhao L, Liu M, Zhang Y. Chitosan-miRNA functionalized microporous titanium oxide surfaces via a layer-by-layer approach with a sustained release profile for enhanced osteogenic activity. J Nanobiotechnology 2020; 18:127. [PMID: 32907598 PMCID: PMC7487814 DOI: 10.1186/s12951-020-00674-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The biofunctionalization of titanium implants for high osteogenic ability is a promising approach for the development of advanced implants to promote osseointegration, especially in compromised bone conditions. In this study, polyelectrolyte multilayers (PEMs) were fabricated using the layer-by-layer approach with a chitosan-miRNA (CS-miRNA) complex and sodium hyaluronate (HA) as the positively and negatively charged polyelectrolytes on microarc-oxidized (MAO) Ti surfaces via silane-glutaraldehyde coupling. METHODS Dynamic contact angle and scanning electron microscopy measurements were conducted to monitor the layer accumulation. RiboGreen was used to quantify the miRNA loading and release profile in phosphate-buffered saline. The in vitro transfection efficiency and the cytotoxicity were investigated after seeding mesenchymal stem cells (MSCs) on the CS-antimiR-138/HA PEM-functionalized microporous Ti surface. The in vitro osteogenic differentiation of the MSCs and the in vivo osseointegration were also evaluated. RESULTS The surface wettability alternately changed during the formation of PEMs. The CS-miRNA nanoparticles were distributed evenly across the MAO surface. The miRNA loading increased with increasing bilayer number. More importantly, a sustained miRNA release was obtained over a timeframe of approximately 2 weeks. In vitro transfection revealed that the CS-antimiR-138 nanoparticles were taken up efficiently by the cells and caused significant knockdown of miR-138 without showing significant cytotoxicity. The CS-antimiR-138/HA PEM surface enhanced the osteogenic differentiation of MSCs in terms of enhanced alkaline phosphatase, collagen production and extracellular matrix mineralization. Substantially enhanced in vivo osseointegration was observed in the rat model. CONCLUSIONS The findings demonstrated that the novel CS-antimiR-138/HA PEM-functionalized microporous Ti implant exhibited sustained release of CS-antimiR-138, and notably enhanced the in vitro osteogenic differentiation of MSCs and in vivo osseointegration. This novel miRNA-functionalized Ti implant may be used in the clinical setting to allow for more effective and robust osseointegration.
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Affiliation(s)
- Kaimin Wu
- Department of Stomatology, Navy 971st Hospital, No. 22 Minjiang Road, Qingdao, 266071, China
| | - Mengyuan Liu
- Oral Research Center, Qingdao Municipal Hospital, Qingdao, 266071, China
| | - Nan Li
- Third Department of Cadre's Ward, Navy 971st Hospital, Qingdao, 266071, China
| | - Li Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, No. 145 West Changle Road, Xi'an, 710032, China
| | - Fanhui Meng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, No. 145 West Changle Road, Xi'an, 710032, China
| | - Lingzhou Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology and Oral Medicine, School of Stomatology, The Fourth Military Medical University, No. 145 West Changle Road, Xi'an, 710032, China.
| | - Min Liu
- Department of Stomatology, Navy 971st Hospital, No. 22 Minjiang Road, Qingdao, 266071, China.
| | - Yumei Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, No. 145 West Changle Road, Xi'an, 710032, China.
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Chen L, Bai M, Du R, Wang H, Deng Y, Xiao A, Gan X. The non-viral vectors and main methods of loading siRNA onto the titanium implants and their application. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2020; 31:2152-2168. [PMID: 32646287 DOI: 10.1080/09205063.2020.1793706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Surface modification of titanium implants by siRNA is quite efficient for improving implant osseointegration. Loading siRNA onto their surface is a crucial factor for siRNA-functionalized implants to realize their biological function. Direct binding of siRNA to implants has low siRNA binding and releasing rate, so usually it needs to be mediated by vectors. Polymeric, nonmaterial-mediated and lipid-based vectors are types of non-viral vectors which are commonly used for delivering siRNA. Three major methods of loading process, namely simple physical adsorption, layer-by-layer assembly and electrodeposition, are also summarized. A brief introduction, the basic principle and the general procedure of each method are included. The loading efficiency, which can be measured both qualitatively and quantitatively, together with gene knockdown efficiency, cytotoxicity assay and osteogenesis of the three methods are compared. A good many applications in osteogenesis have also been described in this review.
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Affiliation(s)
- Liangrui Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Mingxuan Bai
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Ruiyu Du
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Hao Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Yi Deng
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan, P.R. China.,State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Anqi Xiao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Xueqi Gan
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China
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Tang J, Chen L, Yan D, Shen Z, Wang B, Weng S, Wu Z, Xie Z, Shao J, Yang L, Shen L. Surface Functionalization with Proanthocyanidins Provides an Anti-Oxidant Defense Mechanism That Improves the Long-Term Stability and Osteogenesis of Titanium Implants. Int J Nanomedicine 2020; 15:1643-1659. [PMID: 32210558 PMCID: PMC7073973 DOI: 10.2147/ijn.s231339] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/17/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Aseptic loosening is a major complication after total joint replacement. Reactive oxygen species generated by local tissue cells and liberated from implant surfaces have been suggested to cause implant failures. Surface modification of titanium (Ti)-based implants with proanthocyanidins (PAC) is a promising approach for the development of anti-oxidant defense mechanism to supplement the mechanical functions of Ti implants. In this study, a controlled PAC release system was fabricated on the surface of Ti substrates using the layer-by-layer (LBL) assembly. MATERIALS AND METHODS Polyethyleneimine (PEI) base layer was fabricated to enable layer-by-layer (LBL) deposition of hyaluronic acid/chitosan (HA/CS) multi-layers without or with the PAC. Surface topography and wettability of the fabricated HA/CS-PAC substrates were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), Fourier-transform infrared spectroscopy (FTIR) and contact angle measurement. PAC release profiles were investigated using drug release assays. MC3T3-E1 pre-osteoblast cells were used to assess the osteo-inductive effects of HA/CS-PAC substrates under conditions H2O2-induced oxidative stress in vitro. A rat model of femoral intramedullary implantation evaluated the osseo-integration and osteo-inductive potential of the HA/CS-PAC coated Ti implants in vivo. RESULTS SEM, AFM, FTIR and contact angle measurements verified the successful fabrication of Ti surfaces with multi-layered HA/CS-PAC coating. Drug release assays revealed controlled and sustained release of PAC over 14 days. In vitro, cell-based assays showed high tolerability and enhanced the osteogenic potential of MC3T3-E1 cells on HA/CS-PAC substrates when under conditions of H2O2-induced oxidative stress. In vivo evaluation of femoral bone 14 days after femoral intramedullary implantation confirmed the enhanced osteo-inductive potential of the HA/CS-PAC coated Ti implants. CONCLUSION Multi-layering of HA/CS-PAC coating onto Ti-based surfaces by the LBL deposition significantly enhances implant osseo-integration and promotes osteogenesis under conditions of oxidative stress. This study provides new insights for future applications in the field of joint arthroplasty.
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Affiliation(s)
- Jiahao Tang
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Liang Chen
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Deyi Yan
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Zijian Shen
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Bingzhang Wang
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Sheji Weng
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Zongyi Wu
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Zhongjie Xie
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Jiancan Shao
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Lei Yang
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
| | - Liyan Shen
- The Second School of Medicine Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
- Key Laboratory of Orthopedics of Zhejiang Province, Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang325000, People’s Republic of China
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Falah G, Giller A, Gutman D, Atzmon G. Breaking the Glass Ceiling. Gerontology 2020; 66:309-314. [PMID: 32101855 DOI: 10.1159/000505995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022] Open
Abstract
Over the past century, the life expectancy in industrialized countries has rapidly risen by over 30 years due to improvements in standards of medical care, sanitation, and lifestyle. Estimation of life expectancy has traditionally been viewed through a lens of epidemiology and public health. However, this data, while considered the "gold standard" of measuring healthy life expectancy, may soon find itself redundant in the face of advancing medical technology. Even as average life expectancy has increased, there has not been an equivalent increase in healthy life expectancy, or "healthspan"; furthermore, there is a current trend of stagnation in life expectancy, as the supposed increases are estimated to be drastically slowing down, in part due to exhaustion of our current ability to extend the human lifespan. In this viewpoint, we will examine the developing fields of medicine and life sciences which will reshape our current approach to life expectancy prediction.
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Affiliation(s)
- Ghadeer Falah
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Abram Giller
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Danielle Gutman
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Gil Atzmon
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel,
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Cao Y, Tan YF, Wong YS, Liew MWJ, Venkatraman S. Recent Advances in Chitosan-Based Carriers for Gene Delivery. Mar Drugs 2019; 17:md17060381. [PMID: 31242678 PMCID: PMC6627531 DOI: 10.3390/md17060381] [Citation(s) in RCA: 173] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/17/2019] [Accepted: 06/22/2019] [Indexed: 02/07/2023] Open
Abstract
Approximately 4000 diseases are associated with malfunctioning genes in a particular cell type. Gene-based therapy provides a platform to modify the disease-causing genes expression at the cellular level to treat pathological conditions. However, gene delivery is challenging as these therapeutic genes need to overcome several physiological and intracellular barriers in order, to reach the target cells. Over the years, efforts have been dedicated to develop efficient gene delivery vectors to overcome these systemic barriers. Chitosan, a versatile polysaccharide, is an attractive non-viral vector material for gene delivery mainly due to its cationic nature, biodegradability and biocompatibility. The present review discusses the design factors that are critical for efficient gene delivery/transfection and highlights the recent progress of gene therapy using chitosan-based carriers.
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Affiliation(s)
- Ye Cao
- School of Materials Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore.
| | - Yang Fei Tan
- School of Materials Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore.
| | - Yee Shan Wong
- School of Materials Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore.
| | - Melvin Wen Jie Liew
- School of Materials Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore.
| | - Subbu Venkatraman
- School of Materials Science & Engineering, Nanyang Technological University, Singapore 639798, Singapore.
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Li W, Yang Y, Zhang H, Xu Z, Zhao L, Wang J, Qiu Y, Liu B. Improvements on biological and antimicrobial properties of titanium modified by AgNPs-loaded chitosan-heparin polyelectrolyte multilayers. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:52. [PMID: 31016469 DOI: 10.1007/s10856-019-6250-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 04/03/2019] [Indexed: 05/11/2023]
Abstract
Microbial infection around dental implants is a major cause for the loss of devices, including soft tissue infection in early period, post-operation peri-implantitis, and osseointegration failure. Silver nanoparticles (AgNPs) with wide antimicrobial spectrum, strong antimicrobial effect and hypotoxicity, as well as low incidence of antibiotic resistance, are widely involved in biomedical applications. Herein, firmly anchoring AgNPs onto the surface of implants through physical-chemical reaction is likely to relieve the above issues. In this study, AgNPs were biosynthesized by a simple and "green" method with chitosan (CS) as stabilizing and reducing agents. Then, AgNPs-loaded CS-heparin polyelectrolyte multilayers (PEMs) were constructed on alkali-heat treated titanium (Ti) substrates via layer-by-layer (LbL) self-assembly technique. The successful surface modification could be confirmed by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS), and the constructed system could provide the continuous release of Ag+ over 28 days till mucosa healing. In short, this work revealed that the construction of multilayer coatings containing AgNPs on Ti substrates promoted adhesion and proliferation of human gingival fibroblasts (HGFs) and also enhanced the antimicrobial properties. This manifests the LbL technique is a viable and promising method for forming continuous antimicrobial coatings, to reduce microbial infection and improve the quality of peri-implant soft tissue seal. The preparation process of AgNPs-loaded CS-heparin PEMs on Ti substrate.
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Affiliation(s)
- Wen Li
- School of Stomatology, Lanzhou University, Lanzhou, 730000, P. R. China
| | - Yanwei Yang
- Department of Stomatology, Lanzhou General Hospital, Lanzhou Military Area Command, PLA, Lanzhou, 730050, P. R. China
- State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, P. R. China
| | - Hongchen Zhang
- School of Stomatology, Lanzhou University, Lanzhou, 730000, P. R. China
- Department of Stomatology, Lanzhou General Hospital, Lanzhou Military Area Command, PLA, Lanzhou, 730050, P. R. China
- State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, P. R. China
- School of Nursing, Lanzhou University, Lanzhou, 730000, P. R. China
| | - Zexian Xu
- School of Stomatology, Lanzhou University, Lanzhou, 730000, P. R. China
| | - Libo Zhao
- School of Stomatology, Lanzhou University, Lanzhou, 730000, P. R. China
| | - Jinqing Wang
- State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou, 730000, P. R. China
| | - Yinong Qiu
- Department of Stomatology, Lanzhou General Hospital, Lanzhou Military Area Command, PLA, Lanzhou, 730050, P. R. China.
| | - Bin Liu
- School of Stomatology, Lanzhou University, Lanzhou, 730000, P. R. China.
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10
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Yang BC, Zhou XD, Yu HY, Wu Y, Bao CY, Man Y, Cheng L, Sun Y. [Advances in titanium dental implant surface modification]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:124-129. [PMID: 31168977 PMCID: PMC7030153 DOI: 10.7518/hxkq.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/02/2019] [Indexed: 02/05/2023]
Abstract
Titanium dental implants have wide clinical application due to their many advantages, including comfort, aesthetics, lack of damage to adjacent teeth, and significant clinical effects. However, the failure of osseointegration, bone resorption, and peri-implantitis limits their application. Physical-chemical and bioactive coatings on the surface of titanium implants could improve the successful rate of dental implants and meet the clinical application requirements. This paper reviews the characteristics of surface modification of titanium implants from the aspects of physics, chemistry, and biology. Results provide information for research and clinical application of dental implant materials.
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Affiliation(s)
- Bang-Cheng Yang
- Engineering Research Center in Biomaterials, Sichuan University & Sichuan Guojia Biomaterials Co., Ltd, Chengdu 610064, China
| | - Xue-Dong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hai-Yang Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yao Wu
- Engineering Research Center in Biomaterials, Sichuan University & Sichuan Guojia Biomaterials Co., Ltd, Chengdu 610064, China
| | - Chong-Yun Bao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Man
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yao Sun
- Dept. of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai 200072, China
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11
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James EN, Van Doren E, Li C, Kaplan DL. Silk Biomaterials-Mediated miRNA Functionalized Orthopedic Devices. Tissue Eng Part A 2018; 25:12-23. [PMID: 29415631 DOI: 10.1089/ten.tea.2017.0455] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Silk-based bioresorbable medical devices, such as screws, plates, and rods, have been under investigation due to their promising properties for orthopedic repairs. Options to functionalize these new devices for enhanced control of bone regeneration would also exploit the compatible processing methods used to generate the devices. MicroRNAs are important regulators of bone maintenance and formation, and miRNA-based therapeutics have the potential to aid bone repair, utilizing a transient therapeutic approach with local bioactivity. We hypothesized that silk-based orthopedic devices could be used for the local delivery of miRNAs, using anti-sense miR-214 (AS-miR-214), to inhibit endogenous expression of osteoinductive antagonist and thereby supporting the upregulation of osteoinductive target molecules activating transcription factor 4 (ATF4) and Osterix (Osx). AS-miR-214 silk devices, prepared using surface coating, demonstrated continuous release of miRNA inhibitors up to 7 days in vitro. Additionally, human mesenchymal stem cells seeded on AS-miR-214 silk films expressed higher levels of osteogenic genes ATF4, Osx, Runx2, and Osteocalcin. Interestingly, these cells exhibited lower cell viability and DNA content over 21 days. Conversely, the cells demonstrated significantly higher levels of alkaline phosphatase expression and calcium deposition compared with cells seeded on silk films with nontargeting miRNA controls. The study demonstrated that the silk-based orthopedic devices, in conjunction with bioactive miRNA-based therapeutics, may serve as a novel system for localized bone tissue engineering, enhancing osteogenesis at the implant interface while avoiding detrimental systematic side effects.
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Affiliation(s)
- Eric N James
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts
| | - Emily Van Doren
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts
| | - Chunmei Li
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts
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12
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Tsuchiya S, Sugimoto K, Kamio H, Okabe K, Kuroda K, Okido M, Hibi H. Kaempferol-immobilized titanium dioxide promotes formation of new bone: effects of loading methods on bone marrow stromal cell differentiation in vivo and in vitro. Int J Nanomedicine 2018; 13:1665-1676. [PMID: 29593412 PMCID: PMC5865554 DOI: 10.2147/ijn.s150786] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Surface modification of titanium dioxide (TiO2) implants promotes bone formation and shortens the osseointegration period. Kaempferol is a flavonoid that has the capacity to promote osteogenic differentiation in bone marrow stromal cells. The aim of this study was to promote bone formation around kaempferol immobilized on TiO2 implants. Methods There were four experimental groups. Alkali-treated TiO2 samples (implants and discs) were used as a control and immersed in Dulbecco's phosphate-buffered saline (DPBS) (Al-Ti). For the coprecipitation sample (Al-cK), the control samples were immersed in DPBS containing 50 µg kaempferol/100% ethanol. For the adsorption sample (Al-aK), 50 µg kaempferol/100% ethanol was dropped onto control samples. The surface topography of the TiO2 implants was observed by scanning electron microscopy with energy-dispersive X-ray spectroscopy, and a release assay was performed. For in vitro experiments, rat bone marrow stromal cells (rBMSCs) were cultured on each of the TiO2 samples to analyze cell proliferation, alkaline phosphatase activity, calcium deposition, and osteogenic differentiation. For in vivo experiments, TiO2 implants placed on rat femur bones were analyzed for bone-implant contact by histological methods. Results Kaempferol was detected on the surface of Al-cK and Al-aK. The results of the in vitro study showed that rBMSCs cultured on Al-cK and Al-aK promoted alkaline phosphatase activity, calcium deposition, and osteogenic differentiation. The in vivo histological analysis revealed that Al-cK and Al-aK stimulated new bone formation around implants. Conclusion TiO2 implant-immobilized kaempferol may be an effective tool for bone regeneration around dental implants.
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Affiliation(s)
- Shuhei Tsuchiya
- Department of Oral and Maxillofacial Surgery, Nagoya University Hospital, Nagoya, Japan
| | - Keisuke Sugimoto
- Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hisanobu Kamio
- Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuto Okabe
- Department of Oral and Maxillofacial Surgery, Nagoya University Hospital, Nagoya, Japan
| | - Kensuke Kuroda
- Institute of Materials and Systems for Sustainability, Nagoya University, Nagoya, Japan
| | - Masazumi Okido
- Institute of Materials and Systems for Sustainability, Nagoya University, Nagoya, Japan
| | - Hideharu Hibi
- Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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13
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Song W, Yang C, Svend Le DQ, Zhang Y, Kjems J. Calcium-MicroRNA Complex-Functionalized Nanotubular Implant Surface for Highly Efficient Transfection and Enhanced Osteogenesis of Mesenchymal Stem Cells. ACS APPLIED MATERIALS & INTERFACES 2018; 10:7756-7764. [PMID: 29420881 DOI: 10.1021/acsami.7b18289] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Controlling mesenchymal stem cell (MSC) differentiation by RNA interference (RNAi) is a promising approach for next-generation regenerative medicine. However, efficient delivery of RNAi therapeutics is still a limiting factor. In this study, we have developed a simple, biocompatible, and highly effective delivery method of small RNA therapeutics into human MSCs (hMSCs) from an implant surface by calcium ions. First, we demonstrated that simple Ca/siRNA targeting green fluorescent protein (GFP) nanocomplexes were able to efficiently silence GFP in GFP-expressing hMSCs with adequate Ca2+ concentration (>5 mM). In addition, a single transfection could obtain a long-lasting silencing effect for more than 2 weeks. All three of the main endocytosis pathways (clathrin- and caveolin-mediated endocytosis and macropinocytosis) were involved in the internalization of the Ca/siRNA complexes by MSCs, and macropinocytosis plays the most dominant role. Furthermore, the Ca/siRNA complexes could be efficiently loaded onto the titanium implant surface when pretreated with anodization to create a nanotube (NT) layer. Because of the hydrophilic property of the NT surface, the Ca/siRNA was quickly loaded (less than 4 h) with high efficiency (nearly 100%), forming an even amorphous coating. The Ca/siRNA-coated NT surface showed an initial burst release of 80% of the siRNA complexes over 2 h, which is adequate to achieve robust gene silencing of attached hMSCs. To demonstrate the therapeutic potential of our Ca/siRNA coating technology, Ca/antimiR-138 complexes were loaded on to the NT surface, which strongly enhanced the osteogenic differentiation of hMSCs. In conclusion, our findings suggest that Ca2+ is an effective and biocompatible carrier to deliver small RNA therapeutics into hMSCs, both in solution and from functionalized surfaces, which provides a novel approach to control the MSC differentiation and tissue regeneration.
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Affiliation(s)
- Wen Song
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology , The Fourth Military Medical University , Xi'an 710032 , China
| | | | | | - Yumei Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology , The Fourth Military Medical University , Xi'an 710032 , China
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14
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Shi Q, Qian Z, Liu D, Liu H. Surface Modification of Dental Titanium Implant by Layer-by-Layer Electrostatic Self-Assembly. Front Physiol 2017; 8:574. [PMID: 28824462 PMCID: PMC5545601 DOI: 10.3389/fphys.2017.00574] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/24/2017] [Indexed: 12/27/2022] Open
Abstract
In vivo implants that are composed of titanium and titanium alloys as raw materials are widely used in the fields of biology and medicine. In the field of dental medicine, titanium is considered to be an ideal dental implant material. Good osseointegration and soft tissue closure are the foundation for the success of dental implants. Therefore, the enhancement of the osseointegration and antibacterial abilities of titanium and its alloys has been the focus of much research. With its many advantages, layer-by-layer (LbL) assembly is a self-assembly technique that is used to develop multilayer films based on complementary interactions between differently charged polyelectrolytes. The LbL approach provides new methods and applications for the surface modification of dental titanium implant. In this review, the application of the LbL technique to surface modification of titanium including promoting osteogenesis and osseointegration, promoting the formation and healing of soft tissues, improving the antibacterial properties of titanium implant, achieving local drug delivery and sustained release is summarized.
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Affiliation(s)
- Quan Shi
- Department of Stomatology, Chinese PLA General HospitalBeijing, China
| | - Zhiyong Qian
- School of Biological Science and Medical Engineering, Beihang UniversityBeijing, China
| | - Donghua Liu
- Department of Advanced Interdisciplinary Studies, Institute of Basic Medical Sciences and Tissue Engineering Research Center, Academy of Military Medical Sciences (AMMS)Beijing, China
| | - Hongchen Liu
- Department of Stomatology, Chinese PLA General HospitalBeijing, China
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15
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Establishing Antibacterial Multilayer Films on the Surface of Direct Metal Laser Sintered Titanium Primed with Phase-Transited Lysozyme. Sci Rep 2016; 6:36408. [PMID: 27821857 PMCID: PMC5099579 DOI: 10.1038/srep36408] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 10/14/2016] [Indexed: 12/13/2022] Open
Abstract
Direct metal laser sintering is a technology that allows the fabrication of titanium (Ti) implants with a functional gradation of porosity and surface roughness according to three-dimensional (3D) computer data. The surface roughness of direct metal laser sintered titanium (DMLS-Ti) implants may provide abundant binding sites for bacteria. Bacterial colonization and subsequent biofilm formation can cause unsatisfactory cell adhesion and implant-related infections. To prevent such infections, a novel phase-transited lysozyme (PTL) was utilized as an initial functional layer to simply and effectively prime DMLS-Ti surfaces for subsequent coating with antibacterial multilayers. The purpose of the present study was to establish a surface with dual biological functionality. The minocycline-loaded polyelectrolyte multilayers of hyaluronic acid (HA) and chitosan (CS) formed via a layer-by-layer (LbL) self-assembly technique on PTL-functionalized DMLS-Ti were designed to inhibit pathogenic microbial infections while allowing the DMLS-Ti itself and the modified coatings to retain acceptable biocompatibility. The experimental results indicate that the DMLS-Ti and the hydrogel treated surfaces can inhibit early bacterial adhesion while completely preserving osteoblast functions. This design is expected to gain considerable interest in the medical field and to have good potential for applications in multifunctional DMLS-Ti implants.
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16
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Wang Z, Hu Z, Zhang D, Zhuo M, Cheng J, Xu X, Xing Y, Fan J. Silencing tumor necrosis factor-alpha in vitro from small interfering RNA-decorated titanium nanotube array can facilitate osteogenic differentiation of mesenchymal stem cells. Int J Nanomedicine 2016; 11:3205-14. [PMID: 27478375 PMCID: PMC4951061 DOI: 10.2147/ijn.s104090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Titanium implants are known for their bone bonding ability. However, the osseointegration may be severely disturbed in the inflammation environment. In order to enhance osseointegration of the implant in an inflamed environment, the small interfering RNA (siRNA) targeting tumor necrosis factor alpha (TNF-α) was used to functionalize titanium surface for gene silencing. The chitosan–tripolyphosphate–hyaluronate complexes were used to formulate nanoparticles (NPs) with siRNA, which were adsorbed directly by the anodized titanium surface. The surface characterization was analyzed by scanning electron microscope, atomic force microscopy, as well as contact angle measurement. The fluorescence microscope was used to monitor the degradation of the layer. The coculture system was established with mesenchymal stem cells (MSCs) grown directly on functionalized titanium surface and RAW264.7 cells (preactivated by lipopolysaccharide) grown upside in a transwell chamber. The transfection and knockdown efficiency of TNF-α in RAW264.7 cells were determined by fluorescence microscope, quantitative polymerase chain reaction, and enzyme-linked immunosorbent assay. The cytoskeleton and osteogenic differentiation of MSCs were also analyzed. Regular vertical aligned nanotubes (~100 nm diameter and ~300 nm length) were generated after anodization of polished titanium. After loading with NPs, the nanotubes were filled and covered by a layer of amorphous particles. The surface topography changed and wettability decreased after covering with NPs. As expected, a burst degradation of the film was observed, which could provide sufficient NPs in the released supernatant and result in transfection and knockdown effects in RAW264.7 cells. The cytoskeleton arrangement of MSCs was elongated and the osteogenic differentiation was also significantly improved on NPs loading surface. In conclusion, the siRNA decorated titanium implant could simultaneously suppress inflammation and improve osteogenesis, which may be suitable for peri-implant bone formation under inflammatory conditions.
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Affiliation(s)
| | - Zhiqiang Hu
- Department of Otorhinolaryngology, No 113 Hospital of PLA, Ningbo
| | - Dawei Zhang
- Department of Orthopaedics, Xijing Hospital of PLA, Xi'an, People's Republic of China
| | | | | | | | | | - Jie Fan
- Department of Otorhinolaryngology, No 113 Hospital of PLA, Ningbo
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17
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Zhong X, Song Y, Yang P, Wang Y, Jiang S, Zhang X, Li C. Titanium Surface Priming with Phase-Transited Lysozyme to Establish a Silver Nanoparticle-Loaded Chitosan/Hyaluronic Acid Antibacterial Multilayer via Layer-by-Layer Self-Assembly. PLoS One 2016; 11:e0146957. [PMID: 26783746 PMCID: PMC4718720 DOI: 10.1371/journal.pone.0146957] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 12/22/2015] [Indexed: 12/11/2022] Open
Abstract
Objectives The formation of biofilm around implants, which is induced by immediate bacterial colonization after installation, is the primary cause of post-operation infection. Initial surface modification is usually required to incorporate antibacterial agents on titanium (Ti) surfaces to inhibit biofilm formation. However, simple and effective priming methods are still lacking for the development of an initial functional layer as a base for subsequent coatings on titanium surfaces. The purpose of our work was to establish a novel initial layer on Ti surfaces using phase-transited lysozyme (PTL), on which multilayer coatings can incorporate silver nanoparticles (AgNP) using chitosan (CS) and hyaluronic acid (HA) via a layer-by-layer (LbL) self-assembly technique. Methods In this study, the surfaces of Ti substrates were primed by dipping into a mixture of lysozyme and tris(2-carboxyethyl)phosphine (TCEP) to obtain PTL-functionalized Ti substrates. The subsequent alternating coatings of HA and chitosan loaded with AgNP onto the precursor layer of PTL were carried out via LbL self-assembly to construct multilayer coatings on Ti substrates. Results The results of SEM and XPS indicated that the necklace-like PTL and self-assembled multilayer were successfully immobilized on the Ti substrates. The multilayer coatings loaded with AgNP can kill planktonic and adherent bacteria to 100% during the first 4 days. The antibacterial efficacy of the samples against planktonic and adherent bacteria achieved 65%-90% after 14 days. The sustained release of Ag over 14 days can prevent bacterial invasion until mucosa healing. Although the AgNP-containing structure showed some cytotoxicity, the toxicity can be reduced by controlling the Ag release rate and concentration. Conclusions The PTL priming method provides a promising strategy for fabricating long-term antibacterial multilayer coatings on titanium surfaces via the LbL self-assembly technique, which is effective in preventing implant-associated infections in the early stage.
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Affiliation(s)
- Xue Zhong
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Yunjia Song
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Peng Yang
- Key Laboratory of Applied Surface and Colloid Chemistry, Ministry of Education, College of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi’an, PR China
| | - Yao Wang
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Shaoyun Jiang
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Xu Zhang
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
- * E-mail: (X. Zhang); (CL)
| | - Changyi Li
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
- * E-mail: (X. Zhang); (CL)
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