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Maddy KS, Tigre JY, Lu VM, Costello MC, Errante EL, Levi AD, Burks SS. Influence of instrumentation type on outcomes after surgical management of spondylodiscitis: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:3175-3190. [PMID: 38148366 DOI: 10.1007/s00586-023-08065-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE Spondylodiscitis refers to infection of the intervertebral disk and neighboring structures. Outcomes based on instrumentation type are not well reported in the literature, but are important in establishing guidelines for surgical management of spondylodiscitis. This study aims to clarify the effect of instrumentation material selection on clinical and radiographic outcomes in patients with spondylodiscitis. METHODS Studies that evaluated the use of polyetheretherketone (PEEK), titanium, allograft, and/or autologous bone grafts for spondylodiscitis were identified in the literature. Radiographic and clinical data were analyzed using a meta-analysis of proportions, with estimated risk and confidence intervals reported for our primary study outcomes. RESULTS Thirty-two retrospective studies totaling 1088 patients undergoing surgical management of spondylodiscitis with PEEK, TTN, allograft, and autologous bone graft instrumentation were included. There were no differences in fusion rates (p-interaction = 0.55) with rates of fusion of 93.4% with TTN, 98.6% with allograft, 84.2% with autologous bone graft, and 93.9% with PEEK. There were no differences in screw loosening (p-interaction = 0.52) with rates of 0.33% with TTN, 0% with allograft, 1.3% with autologous bone graft, and 8.2% with PEEK. There were no differences in reoperation (p-interaction = 0.59) with rates of 2.64% with TTN, 0% with allograft, 1.69% with autologous bone graft, and 3.3% with PEEK. CONCLUSIONS This meta-analysis demonstrates that the choice of instrumentation type in the surgical management of spondylodiscitis resulted in no significant differences in rate of radiographic fusion, screw loosening, or reoperation. Future comparative studies to optimize guidelines for the management of spondylodiscitis are needed.
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Affiliation(s)
- Krisna S Maddy
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave Miami, Miami, FL, 33136, USA.
| | - Joseph Yunga Tigre
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave Miami, Miami, FL, 33136, USA
| | - Victor M Lu
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave Miami, Miami, FL, 33136, USA
| | - Meredith C Costello
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave Miami, Miami, FL, 33136, USA
| | - Emily L Errante
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave Miami, Miami, FL, 33136, USA
| | - Allan D Levi
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave Miami, Miami, FL, 33136, USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S Shelby Burks
- Department of Neurological Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Ave Miami, Miami, FL, 33136, USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
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Uysal I, Tezcaner A, Evis Z. Methods to improve antibacterial properties of PEEK: A review. Biomed Mater 2024; 19:022004. [PMID: 38364280 DOI: 10.1088/1748-605x/ad2a3d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/16/2024] [Indexed: 02/18/2024]
Abstract
As a thermoplastic and bioinert polymer, polyether ether ketone (PEEK) serves as spine implants, femoral stems, cranial implants, and joint arthroplasty implants due to its mechanical properties resembling the cortical bone, chemical stability, and radiolucency. Although there are standards and antibiotic treatments for infection control during and after surgery, the infection risk is lowered but can not be eliminated. The antibacterial properties of PEEK implants should be improved to provide better infection control. This review includes the strategies for enhancing the antibacterial properties of PEEK in four categories: immobilization of functional materials and functional groups, forming nanocomposites, changing surface topography, and coating with antibacterial material. The measuring methods of antibacterial properties of the current studies of PEEK are explained in detail under quantitative, qualitative, andin vivomethods. The mechanisms of bacterial inhibition by reactive oxygen species generation, contact killing, trap killing, and limited bacterial adhesion on hydrophobic surfaces are explained with corresponding antibacterial compounds or techniques. The prospective analysis of the current studies is done, and dual systems combining osteogenic and antibacterial agents immobilized on the surface of PEEK are found the promising solution for a better implant design.
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Affiliation(s)
- Idil Uysal
- Department of Biomedical Engineering, Middle East Technical University, 06800 Ankara, Turkey
| | - Ayşen Tezcaner
- Department of Biomedical Engineering, Middle East Technical University, 06800 Ankara, Turkey
- Department of Engineering Sciences, Middle East Technical University, 06800 Ankara, Turkey
| | - Zafer Evis
- Department of Biomedical Engineering, Middle East Technical University, 06800 Ankara, Turkey
- Department of Engineering Sciences, Middle East Technical University, 06800 Ankara, Turkey
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Liu C, Huang Z, Zhu J, Liu X, Zhu B, Zheng D, Yang B, Tao R, Cai C, Chen X, Liu J, Deng Z. Near-ultraviolet irradiation to stimulate unmodified polyether ether ketone to achieve stable and sustainable antibacterial activity. Colloids Surf B Biointerfaces 2023; 229:113441. [PMID: 37422990 DOI: 10.1016/j.colsurfb.2023.113441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVES This study aims to investigate the cytotoxicity and sustainable antibacterial activity of unmodified PEEK under specific wavelength light treatment (365 nm), and its antibacterial mechanism was also preliminarily discussed. METHODS A near-ultraviolet source with a wavelength of 365 nm and a power of 5 W were selected. The irradiation time was 30 min, and the distance was 100 mm. A water contact angle tester was used to characterize the surface of the PEEK after 1-15 light treatments. MC3TC-E1 cells were used to evaluate the cytotoxicity of the materials under light treatment. Five kinds of common oral bacteria were detected in vitro, and antibacterial efficiency was determined by colony-forming unit (CFU) and scanning electron microscope (SEM). The antibacterial mechanism of PEEK under light was preliminarily discussed by spectrophotometry. The membrane rupture of Staphylococcus aureus and Escherichia coli was detected by lactate dehydrogenase. Staphylococcus aureus and Staphylococcus mutans were selected for the cyclic antibacterial test. Statistical analysis was performed by one-way analysis of variance and Tukey multiple range test. A significance level of 0.05 was considered (α = 0.05). RESULTS The results of the cell experiment showed that PEEK had no cytotoxicity (P > 0.05). CFU results showed that PEEK had an obvious antibacterial effect on Staphylococcus aureus, Staphylococcus mutans, Staphylococcus gordonii and Staphylococcus sanguis, but had no antibacterial effect on Escherichia coli (P < 0.05). The SEM results also verified the above antibacterial effect. The existence of singlet oxygen was confirmed by spectrophotometry. Meanwhile, the rupture of Staphylococcus aureus membrane was verified by lactate dehydrogenase assay. The water contact angle of the PEEK surface did not change significantly after 15 cycles of light treatment. Cyclic antibacterial experiments showed that the antibacterial effect was sustainable. CONCLUSIONS This study showed that PEEK has good cytocompatibility with stable and sustainable antibacterial properties under near-ultraviolet. It provides a new idea to solve the non-antibacterial property of PEEK, and also provides a theoretical basis for its further application in dentistry.
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Affiliation(s)
- Chongxing Liu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Zhuo Huang
- Department of Stomatology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing TCM Hospital Affiliated to Zhejiang Chinese Medical University, Shaoxing 312000, China
| | - Jinlei Zhu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Xiangzhi Liu
- Clinical medical college of Tianjin medical university, Tianjin 300010, China
| | - Bingbing Zhu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Dongyang Zheng
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Bingqian Yang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Ran Tao
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Chenxi Cai
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Xiao Chen
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Jinsong Liu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China.
| | - Zhennan Deng
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325000, China.
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Liu X, Zhang H, Yan B, Yeung KWK, Liao Y, Ouyang L, Liu X. On-Off Phagocytosis and Switchable Macrophage Activation Stimulated with NIR for Infected Percutaneous Tissue Repair of Polypyrrole-Coated Sulfonated PEEK. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2205048. [PMID: 36515274 PMCID: PMC9929275 DOI: 10.1002/advs.202205048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Intelligent control of the immune response is essential for obtaining percutaneous implants with good sterilization and tissue repair abilities. In this study, polypyrrole (Ppy) nanoparticles enveloping a 3D frame of sulfonated polyether ether ketone (SP) surface are constructed, which enhance the surface modulus and hardness of the sulfonated layer by forming a cooperative structure of simulated reinforced concrete and exhibit a superior photothermal effect. Ppy-coated SP could quickly accumulate heat on the surface by responding to 808 nm near-infrared (NIR) light, thereby killing bacteria, and destroying biofilms. Under NIR stimulation, the phagocytosis and M1 activation of macrophages cultured on Ppy-coated SP are enhanced by activating complement 3 and its receptor, CD11b. Phagocytosis and M1 activation are impaired along with abolishment of NIR stimulation in the Ppy-coated SP group, which is favorable for tissue repair. Ppy-coated SP promotes Collagen-I, vascular endothelial growth factor, connective tissue growth factor, and α-actin (Acta2) expression by inducing M2 polarization owing to its higher surface modulus. Overall, Ppy-coated SP with enhanced mechanical properties could be a good candidate for clinical percutaneous implants through on-off phagocytosis and switchable macrophage activation stimulated with NIR.
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Affiliation(s)
- Xingdan Liu
- State Key Laboratory of High Performance Ceramics and Superfine MicrostructureShanghai Institute of CeramicsChinese Academy of SciencesShanghai200050China
- Center of Materials Science and Optoelectronics EngineeringUniversity of Chinese Academy of SciencesBeijing100049China
| | - Haifeng Zhang
- State Key Laboratory of High Performance Ceramics and Superfine MicrostructureShanghai Institute of CeramicsChinese Academy of SciencesShanghai200050China
- Center of Materials Science and Optoelectronics EngineeringUniversity of Chinese Academy of SciencesBeijing100049China
- School of Chemistry and Materials ScienceHangzhou Institute for Advanced StudyUniversity of Chinese Academy of Sciences1 Sub‐lane XiangshanHangzhou310024China
| | - Bangcheng Yan
- State Key Laboratory of High Performance Ceramics and Superfine MicrostructureShanghai Institute of CeramicsChinese Academy of SciencesShanghai200050China
- Center of Materials Science and Optoelectronics EngineeringUniversity of Chinese Academy of SciencesBeijing100049China
| | - Kelvin W. K. Yeung
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic TraumaGuangdong Engineering Technology Research Center for Orthopaedic Trauma RepairDepartment of Orthopaedics and TraumatologyThe University of Hong Kong Shenzhen HospitalShenzhen518053China
| | - Yun Liao
- Department of PharmacyTongren HospitalShanghai Jiao Tong University School of MedicineShanghai200336China
| | - Liping Ouyang
- Department of PharmacyTongren HospitalShanghai Jiao Tong University School of MedicineShanghai200336China
- Hongqiao International Institute of MedicineShanghai Jiao Tong University School of MedicineShanghai200336China
| | - Xuanyong Liu
- State Key Laboratory of High Performance Ceramics and Superfine MicrostructureShanghai Institute of CeramicsChinese Academy of SciencesShanghai200050China
- Center of Materials Science and Optoelectronics EngineeringUniversity of Chinese Academy of SciencesBeijing100049China
- School of Chemistry and Materials ScienceHangzhou Institute for Advanced StudyUniversity of Chinese Academy of Sciences1 Sub‐lane XiangshanHangzhou310024China
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Wiessner A, Wassmann T, Wiessner JM, Schubert A, Wiechens B, Hampe T, Bürgers R. In Vivo Biofilm Formation on Novel PEEK, Titanium, and Zirconia Implant Abutment Materials. Int J Mol Sci 2023; 24:ijms24021779. [PMID: 36675292 PMCID: PMC9865206 DOI: 10.3390/ijms24021779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/16/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
The formation of biofilms on the surface of dental implants and abutment materials may lead to peri-implantitis and subsequent implant failure. Recently, innovative materials such as polyether-ether-ketone (PEEK) and its modifications have been used as abutment materials. However, there is limited knowledge on microbial adhesion to PEEK materials. The aim of this in vivo study was to investigate biofilm formation on the surface of conventional (titanium and zirconia) and PEEK implant abutment materials. Split specimens of titanium, zirconia, PEEK, and modified PEEK (PEEK-BioHPP) were manufactured, mounted in individual removable acrylic upper jaw splints, and worn by 20 healthy volunteers for 24 h. The surface roughness was determined using widefield confocal microscopy. Biofilm accumulation was investigated by fluorescence microscopy and quantified by imaging software. The surface roughness of the investigated materials was <0.2 µm and showed no significant differences between the materials. Zirconia showed the lowest biofilm formation, followed by titanium, PEEK, and PEEK-BioHPP. Differences were significant (p < 0.001) between the investigated materials, except for the polyether-ether-ketones. Generally, biofilm formation was significantly higher (p < 0.05) in the posterior region of the oral cavity than in the anterior region. The results of the present study show a material-dependent susceptibility to biofilm formation. The risk of developing peri-implantitis may be reduced by a specific choice of abutment material.
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Affiliation(s)
- Andreas Wiessner
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Torsten Wassmann
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany
- Correspondence:
| | - Johanna Maria Wiessner
- Department of Orthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Andrea Schubert
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Bernhard Wiechens
- Department of Orthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Tristan Hampe
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Ralf Bürgers
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany
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Liu Y, Fang M, Zhao R, Liu H, Li K, Tian M, Niu L, Xie R, Bai S. Clinical Applications of Polyetheretherketone in Removable Dental Prostheses: Accuracy, Characteristics, and Performance. Polymers (Basel) 2022; 14:polym14214615. [PMID: 36365609 PMCID: PMC9654455 DOI: 10.3390/polym14214615] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
The high-performance thermoplastic polyetheretherketone (PEEK) has excellent mechanical properties, biocompatibility, chemical stability, and radiolucency. The present article comprehensively reviews various applications of PEEK in removable dental prostheses, including in removable partial dentures (RPDs) (frameworks and clasps), double-crown RPDs, and obturators. The clinical performance of PEEK in removable dental prostheses is shown to be satisfactory and promising based on the short-term clinical evidence and technical complications are scarce. Moreover, the accuracy of RPDs is a vital factor for their long-term success rate. PEEK in removable dental prostheses is fabricated using the conventional lost-wax technique and CAD/CAM milling, which produces a good fit. Furthermore, fused deposition modeling is considered to be one of the most practical additive techniques. PEEK in removable prostheses produced by this technique exhibits good results in terms of the framework fit. However, in light of the paucity of evidence regarding other additive techniques, these manufacturers cannot yet be endorsed. Surface roughness, bacterial retention, color stability, and wear resistance should also be considered when attempting to increase the survival rates of PEEK removable prostheses. In addition, pastes represent an effective method for PEEK polishing to obtain a reduced surface roughness, which facilitates lower bacterial retention. As compared to other composite materials, PEEK is less likely to become discolored or deteriorate due to wear abrasion.
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Affiliation(s)
- Yuchen Liu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Ming Fang
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Correspondence: (M.F.); (S.B.)
| | - Ruifeng Zhao
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Hengyan Liu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Kangjie Li
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Min Tian
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Lina Niu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Rui Xie
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Shizhu Bai
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Correspondence: (M.F.); (S.B.)
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Zhang S, Long J, Chen L, Zhang J, Fan Y, Shi J, Huang Y. Treatment methods toward improving the anti-infection ability of poly(etheretherketone) implants for medical applications. Colloids Surf B Biointerfaces 2022; 218:112769. [PMID: 35994991 DOI: 10.1016/j.colsurfb.2022.112769] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 10/15/2022]
Abstract
Due to its favorable chemical stability, biocompatibility, and mechanical properties, Poly(etheretherketone) (PEEK) is a promising material for repairing bone and dental hard tissue defects. However, there are critical disadvantages: PEEK is biologically and chemically inert, which influences osseointegration of implants and bonding strength of prostheses, and its mechanical properties still cannot meet the requirements for some medical applications. Furthermore, bacterial infections and inflammatory reactions often accompany bone defects caused by trauma or inflammation or teeth loss caused by periodontitis. Previous studies mainly focused on enhancing PEEK's bioactivity and mechanical performance, but PEEK also lacks effective anti-infection ability. Thus, it is necessary to improve its anti-infection ability, and this is considered in this paper from two aspects. The first is to inhibit the attachment and growth of bacteria on the material, and the second is to endow the material with immunoregulatory ability, which means mobilizing the host immune system to protect tissue from inflammation. In this review, we analyze and discuss the existing treatment methods to improve the antibacterial and immunomodulatory abilities of PEEK addressing their limitations, relevant future challenges, and required research efforts.
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Affiliation(s)
- Shuqi Zhang
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Jiazhen Long
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Lin Chen
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Jie Zhang
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Yunjian Fan
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Jiayu Shi
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
| | - Yuanjin Huang
- Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulvard, Guangzhou 510280, China.
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8
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Gao W, Han X, Li Y, Zhou Z, Wang J, Shi R, Jiao J, Qi Y, Zhou Y, Zhao J. Modification strategies for improving antibacterial properties of polyetheretherketone. J Appl Polym Sci 2022. [DOI: 10.1002/app.52847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Weijia Gao
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Xiao Han
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Yongli Li
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Zhe Zhou
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Junyan Wang
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Ruining Shi
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Junjie Jiao
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Yuanzheng Qi
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Yanmin Zhou
- Hospital of Stomatology Jilin University Changchun Jilin Province China
| | - Jinghui Zhao
- Hospital of Stomatology Jilin University Changchun Jilin Province China
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9
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Lesmana R, Zulhendri F, Fearnley J, Irsyam IA, Rasyid RPHN, Abidin T, Abdulah R, Suwantika A, Paradkar A, Budiman AS, Pasang T. The Suitability of Propolis as a Bioactive Component of Biomaterials. Front Pharmacol 2022; 13:930515. [PMID: 35754488 PMCID: PMC9213800 DOI: 10.3389/fphar.2022.930515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/17/2022] [Indexed: 12/22/2022] Open
Abstract
Propolis is a resinous product collected by bees from plant exudates to protect and maintain hive homeostasis. Propolis has been used therapeutically for centuries as folk medicine. Modern research investigating the diversity of the chemical composition and plant sources, biological activity, extraction processes, analytical methods, and therapeutic properties in clinical settings have been carried out extensively since the 1980s. Due to its antimicrobial, anti-inflammatory, and immuno-modulator properties, propolis appears to be a suitable bioactive component to be incorporated into biomaterials. This review article attempts to analyze the potential application of propolis as a biomaterial component from the available experimental evidence. The efficacy and compabitility of propolis depend upon factors, such as types of extracts and types of biomaterials. Generally, propolis appears to be compatible with hydroxyapatite/calcium phosphate-based biomaterials. Propolis enhances the antimicrobial properties of the resulting composite materials while improving the physicochemical properties. Furthermore, propolis is also compatible with wound/skin dressing biomaterials. Propolis improves the wound healing properties of the biomaterials with no negative effects on the physicochemical properties of the composite biomaterials. However, the effect of propolis on the glass-based biomaterials cannot be generalized. Depending on the concentration, types of extract, and geographical sources of the propolis, the effect on the glass biomaterials can either be an improvement or detrimental in terms of mechanical properties such as compressive strength and shear bond strength. In conclusion, two of the more consistent impacts of propolis across these different types of biomaterials are the enhancement of the antimicrobial and the immune-modulator/anti-inflammatory properties resulting from the combination of propolis and the biomaterials.
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Affiliation(s)
- Ronny Lesmana
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.,Biological Activity Division, Central Laboratory, Universitas Padjadjaran, Bandung, Indonesia
| | - Felix Zulhendri
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.,Kebun Efi, Kabanjahe, Indonesia
| | | | - Ilham A Irsyam
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Renaldi P H N Rasyid
- Department of Orthopaedics, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Trimurni Abidin
- Department of Conservative Dentistry, Universitas Sumatera Utara, Medan, Indonesia
| | - Rizky Abdulah
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.,Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Auliya Suwantika
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.,Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Anant Paradkar
- Centre for Pharmaceutical Engineering Science, School of Pharmacy, University of Bradford, Bradford, United Kingdom
| | - Arief S Budiman
- Department of Manufacturing and Mechanical Engineering and Technology, Oregon Institute of Technology, Klamath Falls, OR, United States.,Industrial Engineering Department, BINUS Graduate Program, Bina Nusantara University, Jakarta, Indonesia
| | - Timotius Pasang
- Department of Manufacturing and Mechanical Engineering and Technology, Oregon Institute of Technology, Klamath Falls, OR, United States
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10
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Taymour N, Fahmy AE, Gepreel MAH, Kandil S, El-Fattah AA. Improved Mechanical Properties and Bioactivity of Silicate Based Bioceramics Reinforced Poly(ether-ether-ketone) Nanocomposites for Prosthetic Dental Implantology. Polymers (Basel) 2022; 14:polym14081632. [PMID: 35458382 PMCID: PMC9026494 DOI: 10.3390/polym14081632] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/11/2022] Open
Abstract
Polyether-ether-ketone (PEEK) biomaterial has been increasingly employed for orthopedic, trauma, spinal, and dental implants due to its biocompatibility and in vivo stability. However, a lack of bioactivity and binding ability to natural bone tissue has significantly limited PEEK for many challenging dental implant applications. In this work, nanocomposites based on PEEK reinforced with bioactive silicate-based bioceramics (forsterite or bioglass) as nanofillers were prepared using high energy ball milling followed by melt blending and compression molding. The influence of nanofillers type and content (10, 20 and 30 wt.%) on the crystalline structure, morphology, surface roughness, hydrophilicity, microhardness, elastic compression modulus, and flexural strength of the nanocomposites was investigated. The scanning electron microscopy images of the nanocomposites with low nanofillers content showed a homogenous surface with uniform dispersion within the PEEK matrix with no agglomerates. All nanocomposites showed an increased surface roughness compared to pristine PEEK. It was found that the incorporation of 20 wt.% forsterite was the most effective in the nanocomposite formulation compared with bioglass-based nanocomposites; it has significantly improved the elastic modulus, flexural strength, and microhardness. In vitro bioactivity evaluation, which used biomimetic simulated body fluid indicated the ability of PEEK nanocomposites loaded with forsterite or bioglass nanofillers to precipitate calcium and phosphate bone minerals on its surface. These nanocomposites are expected to be used in long-term load-bearing implant applications and could be recommended as a promising alternative to titanium and zirconia when used as a dental implant material.
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Affiliation(s)
- Noha Taymour
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia;
| | - Amal E. Fahmy
- Department of Dental Materials, Faculty of Dentistry, Alexandria University, Azarita, Alexandria 21526, Egypt;
| | - Mohamed Abdel Hady Gepreel
- Department of Materials Science and Engineering, Egypt-Japan University of Science and Technology (E-JUST), New Borg El-Arab City 21934, Egypt;
| | - Sherif Kandil
- Department of Materials Science, Institute of Graduate Studies and Research, Alexandria University, El-Shatby, Alexandria 21526, Egypt;
| | - Ahmed Abd El-Fattah
- Department of Materials Science, Institute of Graduate Studies and Research, Alexandria University, El-Shatby, Alexandria 21526, Egypt;
- Department of Chemistry, College of Science, University of Bahrain, Sakhir P.O. Box 32038, Bahrain
- Correspondence: or
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11
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Suphangul S, Rokaya D, Kanchanasobhana C, Rungsiyakull P, Chaijareenont P. PEEK Biomaterial in Long-Term Provisional Implant Restorations: A Review. J Funct Biomater 2022; 13:jfb13020033. [PMID: 35466215 PMCID: PMC9036277 DOI: 10.3390/jfb13020033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 02/06/2023] Open
Abstract
Polyetheretherketone (PEEK) has become a useful polymeric biomaterial due to its superior properties and has been increasingly used in dentistry, especially in prosthetic dentistry and dental implantology. Promising applications of PEEK in dentistry are dental implants, temporary abutment, implant-supported provisional crowns, fixed prosthesis, removable denture framework, and finger prosthesis. PEEK as a long-term provisional implant restoration has not been studied much. Hence, this review article aims to review PEEK as a long-term provisional implant restoration for applications focusing on implant dentistry. Articles published in English on PEEK biomaterial for long-term provisional implant restoration were searched in Google Scholar, ScienceDirect, PubMed/MEDLINE, and Scopus. Then, relevant articles were selected and included in this literature review. PEEK presents suitable properties for various implant components in implant dentistry, including temporary and long-term provisional restorations. The modifications of PEEK result in wider applications in clinical dentistry. The PEEK reinforced by 30-50% carbon fibers can be a suitable material for the various implant components in dentistry.
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Affiliation(s)
- Suphachai Suphangul
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (S.S.); (C.K.); (P.R.)
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Walailak University, Bangkok 10400, Thailand;
| | - Chatruethai Kanchanasobhana
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (S.S.); (C.K.); (P.R.)
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (S.S.); (C.K.); (P.R.)
| | - Pisaisit Chaijareenont
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (S.S.); (C.K.); (P.R.)
- Correspondence: ; Tel.: +66-(0)53-944-438
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12
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Li W, Deng X, Wu Z, Zhang L, Jiao J. An Electrochemical Sensor for Quantitation of the Oral Health Care Agent Chlorogenic Acid Based on Bimetallic Nanowires with Functionalized Reduced Graphene Oxide Nanohybrids. ACS OMEGA 2022; 7:4614-4623. [PMID: 35155952 PMCID: PMC8829851 DOI: 10.1021/acsomega.1c06612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
Chlorogenic acid (CGA), a phenolic acid from coffee, has been regarded as a powerful ingredient against oxidative stress and inflammation. Meanwhile, its healing feature to interfere with periodontal disease (PD) makes it a promising drug candidate. However, the existing methods for chlorogenic acid detection limit its practical application in purification and further pharmacological study in stomatology due to their lack of accuracy and productivity. Therefore, it is crucial to find a forceful approach to precisely evaluate CGA for an in-depth anti-PD study. In this work, we reported a facile and controllable synthesis of Pt@Pd nanowires (NWs) in a non-compacted core-shell structure with high electrocatalytic activity. In addition, polyethylenimine (PEI)-capped reduced graphene oxide (rGO) nanoflakes provided large binding sites for a network structure composed of interweaved Pt@Pd nanowires and protected hemin from self-destruction, which empowered Pt@Pd NWs-Hemin-PEI-rGO nanohybrids to own a large electroactive surface area and great electrochemical property for CGA detection. The enzyme-free electrochemical sensor based on Pt@Pd NWs-Hemin-PEI-rGO displayed a favorable capacity for trace CGA detection with a detection limit of 7.8 nM and a wide linear range of 0.5 μM to 4 mM. The exceptional sensitivity and selectivity of the sensor made it accomplish the measurements of chlorogenic acid in soft drinks and coffee with high consistency of HPLC results. The satisfactory performance of the obtained sensor enables it to be used for quality control and study of drug metabolism in PD treatments.
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Affiliation(s)
- Wei Li
- Department
of Stomatology, Tianjin Medical University
General Hospital, Tianjin 300052, China
| | - Xiuli Deng
- Department
of Stomatology, Tianjin Medical University
General Hospital, Tianjin 300052, China
- Tianjin
Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
| | - Ziyu Wu
- Tianjin
Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
| | - Louqiang Zhang
- Department
of Stomatology, Tianjin Medical University
General Hospital, Tianjin 300052, China
| | - Jian Jiao
- Department
of Stomatology, Tianjin Medical University
General Hospital, Tianjin 300052, China
- School
of Dentistry, Stomatological Hospital, Tianjin
Medical University, Tianjin 300070, China
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13
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Hu CC, Kumar SR, Vi TTT, Huang YT, Chen DW, Lue SJ. Facilitating GL13K Peptide Grafting on Polyetheretherketone via 1-Ethyl-3-(3-dimethylaminopropyl)carbodiimide: Surface Properties and Antibacterial Activity. Int J Mol Sci 2021; 23:ijms23010359. [PMID: 35008782 PMCID: PMC8745129 DOI: 10.3390/ijms23010359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023] Open
Abstract
In the present work, the antimicrobial peptide (AMP) of GL13K was successfully coated onto a polyetheretherketone (PEEK) substrate to investigate its antibacterial activities against Staphylococcus aureus (S. aureus) bacteria. To improve the coating efficiency, 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC) was mixed with a GL13K solution and coated on the PEEK surface for comparison. Both energy-dispersive X-ray spectroscopy (EDX) and X-ray photoelectron spectroscopy (XPS) data confirmed 30% greater peptide coating on PEEK/GL13K-EDC than PEEK without EDC treatment. The GL13K graft levels are depicted in the micrograms per square centimeter range. The PEEK/GL13K-EDC sample showed a smoother and lower roughness (Rq of 0.530 µm) than the PEEK/GL13K (0.634 µm) and PEEK (0.697 µm) samples. The surface of the PEEK/GL13K-EDC was more hydrophilic (with a water contact angle of 24°) than the PEEK/GL13K (40°) and pure PEEK (89°) samples. The pure PEEK disc did not exhibit any inhibition zone against S. aureus. After peptide coating, the samples demonstrated significant zones of inhibition: 28 mm and 25 mm for the PEEK/GL13K-EDC and PEEK/GL13K samples, respectively. The bacteria-challenged PEEK sample showed numerous bacteria clusters, whereas PEEK/GL13K contained a little bacteria and PEEK/GL13K-EDC had no bacterial attachment. The results confirm that the GL13K peptide coating was able to induce antibacterial and biofilm-inhibitory effects. To the best of our knowledge, this is the first report of successful GL13K peptide grafting on a PEEK substrate via EDC coupling. The present work illustrates a facile and promising coating technique for a polymeric surface to provide bactericidal activity and biofilm resistance to medical implantable devices.
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Affiliation(s)
- Chih-Chien Hu
- Division of Join Reconstruction, Department of Orthopedics, Chang Gung Medical Center at Linkou, Guishan District, Taoyuan City 333, Taiwan;
| | - Selvaraj Rajesh Kumar
- Department of Chemical and Materials Engineering, Chang Gung University, Guishan District, Taoyuan City 333, Taiwan;
| | - Truong Thi Tuong Vi
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Chang Gung Memorial Hospital, Guishan District, Taoyuan City 333, Taiwan;
| | - Yu-Tzu Huang
- Department of Chemical Engineering, Chung Yuan Christian University, Zhongli, Taoyuan City 320, Taiwan;
- R&D Center for Membrane Technology and Research Center for Circular Economy, Chung Yuan Christian University, Zhongli, Taoyuan City 320, Taiwan
| | - Dave W. Chen
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung City 204, Taiwan;
| | - Shingjiang Jessie Lue
- Division of Join Reconstruction, Department of Orthopedics, Chang Gung Medical Center at Linkou, Guishan District, Taoyuan City 333, Taiwan;
- Department of Chemical and Materials Engineering, Chang Gung University, Guishan District, Taoyuan City 333, Taiwan;
- Department of Safety, Health and Environment Engineering, Ming Chi University of Technology, Taishan District, New Taipei City 243, Taiwan
- Correspondence: ; Tel.: +88-63-2118800 (ext. 5489); Fax: +88-63-2118700
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14
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New Insights on Biofilm Antimicrobial Strategies. Antibiotics (Basel) 2021; 10:antibiotics10040407. [PMID: 33918561 PMCID: PMC8069210 DOI: 10.3390/antibiotics10040407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 12/14/2022] Open
Abstract
Over the last few decades, the study of microbial biofilms has been gaining interest among the scientific community [...].
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15
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Review on Development and Dental Applications of Polyetheretherketone-Based Biomaterials and Restorations. MATERIALS 2021; 14:ma14020408. [PMID: 33467576 PMCID: PMC7830426 DOI: 10.3390/ma14020408] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Polyetheretherketone (PEEK) is an important high-performance thermoplastic. Its excellent strength, stiffness, toughness, fatigue resistance, biocompatibility, chemical stability and radiolucency have made PEEK attractive in dental and orthopedic applications. However, PEEK has an inherently hydrophobic and chemically inert surface, which has restricted its widespread use in clinical applications, especially in bonding with dental resin composites. Cutting edge research on novel methods to improve PEEK applications in dentistry, including oral implant, prosthodontics and orthodontics, is reviewed in this article. In addition, this article also discusses innovative surface modifications of PEEK, which are a focus area of active investigations. Furthermore, this article also discusses the necessary future studies and clinical trials for the use of PEEK in the human oral environment to investigate its feasibility and long-term performance.
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