Protein adsorption to a bioactive glass with special reference to precorrosion

Bioactivity in SBF versus trace element effects: The isolated role of Mg2+ and Zn2+ in osteoblast behavior

The bioactivity assay originally proposed by Kokubo is one of the most commonly used tests to indirectly evaluate the biocompatibility of bioactive glasses. However, extensive evidence has shown that trace elements present in biomaterials may stimulate cellular behavior in different ways even when no apatite formation is observed, i.e., in biomaterials with low or no bioactivity. To further elucidate this topic, we designed three different SiO₂-rich bioglass compositions in which CaO was partially replaced by ZnO and MgO, two oxides known to affect bioactivity as well as osteoblastic behavior. The physicochemical changes induced by the presence of oxides and their effects on biological behavior, as well as the adhesion, proliferation and differentiation of human osteoblast-like osteosarcoma cells (MG-63), were followed by a bioactivity assay in simulated body fluid (SBF). The insertion of ZnO or MgO decreased the glass transition (T_g) and crystallization (T_c) temperatures as a function of the increase in nonbonding oxygens, which was directly reflected in the higher solubility. The release of Mg²⁺ ions from the MgO-containing samples inhibited the bioactivity in SBF, inducing high cell adhesion and proliferation and moderate ALP activity. The release of Zn²⁺ also inhibited the bioactivity in SBF but, in contrast to the release of Mg²⁺, induced low cell adhesion and proliferation and high ALP activity compared to the control.

TiO2 Coating and UV Photofunctionalization Enhance Blood Coagulation on Zirconia Surfaces

This in vitro study was designed to evaluate the effect of sol-gel derived TiO₂ coating on blood coagulation, blood protein adsorption, and platelet response on zirconia surfaces. Square-shaped zirconia (n=96) (10x10x2 mm) was cut, ground, sintered, and finally cleansed ultrasonically in each of acetone and ethanol for 5 minutes. Three experimental groups (n=32) were fabricated: (a) zirconia coated with sol-gel derived TiO₂, (b) zirconia coated with sol-gel derived TiO₂ and treated with ultraviolet (UV) irradiation for 1 hour, and (c) non-coated zirconia as control. The coatings were prepared from tetraisopropyl orthotitanate solution by dip-coating. The thrombogenicity of the specimens was evaluated using a whole blood kinetic clotting time method where the extent of blood clotting was evaluated at 10, 20, 30, 40, 50, and 60 minutes (n=4/time point, total n=24/group). Scanning electron microscope images were taken to observe platelet morphologies after 1-hour incubation with platelet-rich plasma (PRP) (n=5/group). Surface characteristics were visualized using atomic force microscopy (n=1/group). Adsorption of plasma proteins and fibronectin on each surface was studied by gel electrophoresis (n=2/group). Significant differences were observed in blood coagulation between the test groups at 20-, 30-, 40-, and 50-minute time points (p<0.005). UV treated TiO₂ coated specimens showed fastest blood coagulation followed by TiO₂ coated and non-coated specimens. Furthermore, platelets appeared at a higher activation state on coated specimens. Gel electrophoresis revealed no difference in protein adsorption among the experimental groups. In summary, TiO₂ coatings promoted blood coagulation, and it was further enhanced by UV treatment, which has the potential to hasten the wound healing process in vivo.

Silicon: the evolution of its use in biomaterials

In the 1970s, several studies revealed the requirement for silicon in bone development, while bioactive silicate glasses simultaneously pioneered the current era of bioactive materials. Considerable research has subsequently focused on the chemistry and biological function of silicon in bone, demonstrating that the element has at least two separate effects in the extracellular matrix: (i) interacting with glycosaminoglycans and proteoglycans during their synthesis, and (ii) forming ionic substitutions in the crystal lattice structure of hydroxyapatite. In addition, the dissolution products of bioactive glass (predominantly silicic acids) have significant effects on the molecular biology of osteoblasts in vitro, regulating the expression of several genes including key osteoblastic markers, cell cycle regulators and extracellular matrix proteins. Researchers have sought to capitalize on these effects and have generated a diverse array of biomaterials, which include bioactive glasses, silicon-substituted hydroxyapatites and pure, porosified silicon, but all these materials share similarities in the mechanisms that result in their bioactivity. This review discusses the current data obtained from original research in biochemistry and biomaterials science supporting the role of silicon in bone, comparing both the biological function of the element and analysing the evolution of silicon-containing biomaterials.

Evaluation of biocompatibility using in vitro methods: interpretation and limitations

The in vitro biocompatibility of novel materials has to be proven before a material can be used as component of a medical device. This must be done in cell culture tests according to internationally recognized standard protocols. Subsequently, preclinical and clinical tests must be performed to verify the safety of the new material and device. The present chapter focuses on the first step, the in vitro testing according to ISO 10993-5, and critically discusses its limited significance. Alternative strategies and a brief overview of activities to improve the current in vitro tests are presented in the concluding section.

Development of multinuclear giant cells during the degradation of Bioglass® particles in rabbits

Bioglass particles of the compositions 45s5, 52s, and 55s were implanted in the distal femoral epiphysis of rabbits. Animals were sacrificed at 7, 28, and 84 days postoperatively and specimens investigated using electron microscopy and electron dispersive X-ray analysis. The intention was to correlate the finding of different types of multinuclear giant cells (MNGC) in the center of the implantation bed with earlier hypothesized accumulated particle eluates and changed particle compositions. The distribution of Si, Na, Ca, P, O, S, and Cl throughout the implantation bed was analyzed. Bioglass particles degraded either in Si-rich remnants or in CaP-shells. MNGC of foreign body giant cell type in high numbers as well as of osteoclast-like type at later time intervals in small numbers were found on the surface of Si-rich as well as on Ca- and P-rich particle remnants. Osteoclast-like cells were detected on the particles after transformation in CaP-shells. It is concluded that the formation of different types of MNGC is determined by the composition of the substrate, that is, osteoclast-like cells develop exclusively on resorbable substrates. The absolute number of MNGC depended on the time after implantation and the solubility of the implant. Bone bonding, however, only occurred on Ca- and P-rich surfaces.

Protein adsorption onto two bioactive glass-ceramics

Recent research suggests that the biocompatibility of an implant is to a large extent determined by selective adsorption of proteins from surrounding body fluids. Protein adsorption from human plasma onto two bioactive glass-ceramics (RKKP and AP40) which differ in La and Ta content, was studied by means of chromatography and two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). The quantitative analysis showed that the glass-ceramics have good protein binding capacities indicating multilayer formation. A correlation between chemical composition and the amount of adsorbed proteins was observed. The presence of La and Ta decreased the protein adsorption, so AP40 bound significantly more protein per surface unit then did RKKP. Preferential adsorption of apolipoprotein J, fibrinogen and fibronectin was observed.

Bioactive glass S53P4 in repair of septal perforations and its interactions with the respiratory infection-associated microorganisms Haemophilus influenzae and Streptococcus pneumoniae

Interpositional grafts between mucoperiosteal flaps are commonly used in the repair of septal perforations. We studied the use of bioactive glass (BAG) S53P4 as an interpositional graft in 11 patients suffering from septal perforations. In aqueous environments, ions are released from the BAG and the pH rises in its vicinity, both of which may influence the growth and adhesion of microorganisms. Thus, we also studied the effects of the BAG S53P4 as granules or discs on the respiratory infection-associated microorganisms Haemophilus influenzae and Streptococcus pneumoniae. Growth inhibition was studied using an agar plate test and adhesion was analyzed both with and without serum precoating of the BAG S53P4. The perforations were successfully closed in 10 of 11 patients. One patient had a near total septum perforation, which could not be closed. No BAG-associated infections were seen during the follow-up. The BAG S53P4 did not show any clear growth inhibition of the microorganisms, which showed low adhesion to the material. Serum precoating increased the adsorption. Thus, uncoated BAG S53P4 seems to be a good graft in the repair of septal perforations.

In vivo comparison of bioactive glass particles in rabbits

Bioglass particles of the compositions 45s5, 52s and 55s were implanted in the distal femoral epiphysis of rabbits. Animals were sacrificed at 7, 28, and 84 d postoperatively and specimens investigated using light microscopy and histomorphometry. Bone bonding occurred in a zentripetal fashion and fastest for 45s5. Bone formation was hampered at the core of the implantation bed where bone bonding showed a peak at 28d and diminished at 84d (except for 55s). This went along with a significant increase in numerous multinuclear giant cells (MNGC). Implantation model, particle size and surface-area-to-volume ratio are discussed as possible parameters determining bone regeneration.

Interactions between the bioactive glass S53P4 and the atrophic rhinitis-associated microorganism klebsiella ozaenae

In an aqueous environment, ions are released from a bioactive glass (BAG) and the pH rises in its vicinity. This may influence both growth and colonization of microorganisms. We studied the effects of the BAG S53P4 on the atrophic rhinitis-associated microorganism Klebsiella ozaenae. The glass was used in the form of granules or discs. Growth inhibition was studied using an agar plate test. Adhesion was studied by incubating bacterial suspension with the glass. The effect of the presence of the bacteria on the formation of the Si-rich layer on the bioactive glass was also analyzed. Furthermore, a follow up study of 19-74 months with ozena patients surgically treated with the BAG S53P4 was performed. The bioactive glass showed no clear growth inhibition of K. ozaenae in the agar plate test. K. ozaenae showed low adherence to the BAG S53P4. No growth of the microbe was seen on the glass during the 8 h incubations and the Si-rich layer was formed normally. The clinical follow-up study showed no infections of the implants and the symptoms of the patients were markedly reduced. Thus, the BAG S53P4 did not favor adhesion and colonization of K. ozaenae, in vitro, which is supported by the in vivo findings showing no BAG-associated infections or reinfections.

Adherence of Streptococcus mutans to an E-glass fiber-reinforced composite and conventional restorative materials used in prosthetic dentistry

The adherence of Streptococcus mutans to E-glass used in fiber-reinforced composites, denture base polymer, and four other restoratives was investigated. The materials were studied with and without a parotid saliva and serum pellicle. Specimens of the studied materials (E-glass, denture base polymer, titanium, cobalt-chromium alloy, gold alloy, and grained feldspar ceramic) were incubated in a suspension of S. mutans, allowing initial adhesion to occur. The degree of bacterial adhesion was studied using scanning electron microscopy (SEM). The studied uncoated materials showed rather similar adhesion of S. mutans. Saliva coating resulted in a decrease of adherence to all materials except glass. With a saliva pellicle E-glass showed the strongest ability to bind S. mutans, and it differed significantly from the other studied materials. Serum coating markedly decreased adhesion to all materials, and only minor differences among the studied materials were observed. The results of this study suggest that the studied restoratives are rather similar with respect to S. mutans adhesion and that a saliva pellicle may promote adhesion of S. mutans to glass fibers.

Dental materials: 1996 literature review. Part 2

This critical review of the published literature on dental materials for the year 1996 has been compiled by the Dental Materials Panel of the UK. It continues the series of annual reviews started in 1973 and published in the Journal of Dentistry. Emphasis has been placed upon publications which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, dentine bonding, dental amalgam, endodontic materials, casting alloys, resin-bonded bridges and ceramo-metallic restorations, ceramics, denture base resins and soft lining materials, impression materials, implants materials, orthodontic materials, biomechanics and image processing, resin composites and casting investment materials and waxes). Three hundred and thirteen articles have been reviewed.