Dissolution, leaching, and Al2O3 enrichment at the surface of bioactive glasses studied by solution analysis

Evaluation of antibacterial properties of hydroxyapatite/bioactive glass and fluorapatite/bioactive glass nanocomposite foams as a cellular scaffold of bone tissue

AIMS AND OBJECTIVES:

Infection is a serious problem for patients after implantation surgery, which is difficult to treat with antibiotic therapy. The present study was developed to evaluate and compare the antibacterial properties of hydroxyapatite/bioactive glass (HA/BG) and fluorapatite/bioactive glass (FA/BG) nanocomposite foams as a cellular scaffold for use in bone defects by two macrodilution and disk diffusion methods.

MATERIALS AND METHODS:

Staphylococcus aureus, Enterococcus faecalis, and Streptococcus mutans were cultured in brain heart infusion broth medium with nanocomposite powder for 5 days, and their bioactivity levels were evaluated by daily culturing on solid agar medium plates. To carry out the disk diffusion test, a disc form of nanocomposite foams was used on agar medium with 48 h incubation.

RESULTS:

None of two nanocomposites even at their highest concentration (200 mg/mL) did not prevent the growth of two Staphylococcus aureus and Enterococcus faecalis microorganisms. However, HA/BG nanocomposite on the 3^rd day at a concentration of 200 mg/mL and on 4^th and 5^th day at a concentration of 100 mg/mL and FA/BG nanocomposite on the 4^th day at a concentration of 100 mg/mL and on the 5^th day at a concentration of 50 mg/mL could be able to kill Streptococcus mutans microorganism. In the disc diffusion test, none of the nanocomposites could create a nongrowth zone. Both tested biomaterials showed increased antibacterial properties over time and concentration increase.

CONCLUSION:

HA/BG and FA/BG nanocomposites, due to their biocompatibility and antimicrobial properties, are good choices for implantation instead of damaged bone tissue in tissue engineering.

Effect of Alumina Incorporation on the Surface Mineralization and Degradation of a Bioactive Glass (CaO-MgO-SiO₂-Na₂O-P₂O₅-CaF₂)-Glycerol Paste

This study investigates the dissolution behavior as well as the surface biomineralization in simulated body fluid (SBF) of a paste composed of glycerol (gly) and a bioactive glass in the system CaO-MgO-SiO₂-Na₂O-P₂O₅-CaF₂ (BG). The synthesis of the bioactive glass in an alumina crucible has been shown to significantly affect its bioactivity due to the incorporation of aluminum (ca. 1.3–1.4 wt %) into the glass network. Thus, the kinetics of the hydroxyapatite (HA) mineralization on the glass prepared in the alumina crucible was found to be slower than that reported for the same glass composition prepared in a Pt crucible. It is considered that the synthesis conditions lead to the incorporation of small amount of aluminum into the BG network and thus delay the HA mineralization. Interestingly, the BG-gly paste was shown to have significantly higher bioactivity than that of the as-prepared BG. Structural analysis of the paste indicate that glycerol chemically interacts with the glass surface and strongly alter the glass network architecture, thus generating a more depolymerized network, as well as an increased amount of silanol groups at the surface of the glass. In particular, BG-gly paste features early intermediate calcite precipitation during immersion in SBF, followed by hydroxyapatite formation after ca. seven days of SBF exposure; whereas the HA mineralization seems to be suppressed in BG, probably a consequence of the incorporation of aluminum into the glass network. The results obtained within the present study reveal the positive effect of using pastes based on bioactive glasses and organic carriers (here alcohols) which may be of interest not only due to their advantageous visco-elastic properties, but also due to the possibility of enhancing the glass bioactivity upon surface interactions with the organic carrier.

Development of fish collagen/bioactive glass/chitosan composite nanofibers as a GTR/GBR membrane for inducing periodontal tissue regeneration

The development of a guided tissue or bone regeneration (GTR/GBR) membrane with excellent performance has been a major challenge in the biomedical field. The present study was designed to prepare a biomimetic electrospun fish collagen/bioactive glass/chitosan (Col/BG/CS) composite nanofiber membrane and determine its structure, mechanical property, antibacterial activity, and biological effects on human periodontal ligament cells (HPDLCs). The effects of this composite membrane on inducing periodontal tissue regeneration were evaluated using a dog class II furcation defect model. It was found that the composite membrane had a biomimetic structure with good hydrophilicity (the contact angle was 12.83 ± 3°) and a tensile strength of 13.1 ± 0.43 Mpa. Compared to the pure fish collagen membrane, the composite membrane showed some degree of antibacterial activity on Streptococcus mutans. The composite membrane not only enhanced the cell viability and osteogenic gene expression of the HPDLCs, but also promoted the expression of RUNX-2 and OPN protein. Further animal experiments confirmed that the composite membrane was able to promote bone regeneration in the furcation defect of dogs. In conclusion, a biomimetic fish Col/BG/CS composite membrane has been developed in the present study, which can induce tissue regeneration with a certain degree antibacterial activity, providing a basis for potential application as a GTR/GBR membrane.

In vitro antibiofilm activity of bioactive glass S53P4

AIM

This work aimed to investigate the ability of different formulations of bioactive glass (BAG)-S53P4 to interfere with bacterial biofilm produced on prosthetic material by methicillin-resistant Staphylococcus aureus and multi-drug-resistant Pseudomonas aeruginosa.

MATERIALS & METHODS

Antibiofilm activity of three formulations of bioglass was assessed at different time points through two different analyses: Crystal Violet and confocal laser scanning microscopy assays.

RESULTS

Significant differences in the whole biofilm were observed between BAG-S53P4-treated and control samples, while no marked changes in antibiofilm activity were observed among the tested formulations. Data from colorimetric assay were confirmed by confocal laser scanning microscopy analysis, which evidenced the significant reduction in biomass and a decrease of total cell volume when both S. aureus and P. aeruginosa biofilms were treated with BAG-S53P4.

CONCLUSION

BAG-S53P4 can be considered as an excellent adjuvant in the treatment of prosthetic infections related to biofilm.

Efficacy of antibacterial bioactive glass S53P4 against S. aureus biofilms grown on titanium discs in vitro

We evaluated the effectiveness of different sizes of bioactive glass S53P4 against Staphylococcus aureus biofilms grown on metal discs in vitro. S. aureus biofilms were cultivated on titanium discs. BAG-S53P4 (0.5-0.8 mm and <45 µm) were placed in contact with the discs containing biofilms. Glass beads (0.5 mm) were used as a control. After each interval, the pH from each sample was measured. Colony forming units were counted for the biofilm recovery verification. In parallel, we tested the activity of bioactive glass against S. aureus planktonic cells. We found that BAG-S53P4 can suppress S. aureus biofilm formation on titanium discs in vitro. The suppression rate of biofilm cells by BAG-S53P4 <45 µm was significantly higher than by BAG-S53P4 0.5-0.8 mm. BAG-S53P4 has a clear growth-inhibitory effect on S. aureus biofilms. BAG-S53P4 <45 µm is more efficient against biofilm growth in vitro comparing with BAG-S53P4 0.5-0.8 mm. Bioactive glass S53P4 has potential to be used as bone substitute for the resolution of infection complications in joint replacement surgeries and treatment of chronic osteomyelitis.

Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitro and prospective clinical study

BACKGROUND

This study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.

METHODS

In vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.

RESULTS

In vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24 hrs against all the tested species. This activity continued in the subsequent 24 hrs and no growth was observed for all strains after 72 hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9%) at the follow-up, while 2 subjects showed infection recurrence at 6 months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.

CONCLUSIONS

The in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.

TRIAL REGISTRATION

Deutschen Register Klinischer Studien (DRKS) unique identifier: DRKS00005332.

Dissolution patterns of biocompatible glasses in 2-amino-2-hydroxymethyl-propane-1,3-diol (Tris) buffer

A continuous flow measurement system with sensitive on-line ion analysis has been applied to study the initial dissolution behaviour of biocompatible glasses in Tris. Altogether 16 glasses with widely varying compositions were studied. The measurement system allowed for quantitative determination of the time-dependent rates of dissolution of sodium, potassium, calcium, magnesium, silicon and phosphorus during the first 10-15 min in contact with Tris solution. The dissolution rates of the different ions showed significant glass to glass variations, but all glasses studied showed one of four distinct dissolution patterns. The ion dissolution rates after an exposure of 1000 s, expressed as the normalized surface-specific mass loss rates, were compared with the in vitro and in vivo reactivity of the glasses as predicted by models in the literature. The results showed a clear correlation between the dissolution rates of the glasses in Tris and their reactivity as measured by other different methods. Consequently, the measured short-term dissolution patterns could be used to determine which glasses are suitable as bioactive, biodegradable, or inert biomaterials for medical devices.

Biomaterials in orthopaedics

At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field.

Antibacterial effect of bioactive glasses on clinically important anaerobic bacteria in vitro

Bioactive glasses (BAGs) of different compositions have been studied for decades for clinical use and they have found many dental and orthopaedic applications. Particulate BAGs have also been shown to have antibacterial properties. This large-scale study shows that two bioactive glass powders (S53P4 and 13-93) and a sol-gel derived material (CaPSiO II) have an antibacterial effect on 17 clinically important anaerobic bacterial species. All the materials tested demonstrated growth inhibition, although the concentration and time needed for the effect varied depending on the BAG. Glass S53P4 had a strong growth-inhibitory effect on all pathogens tested. Glass 13-93 and sol-gel derived material CaPSiO II showed moderate antibacterial properties.

Bactericidal effects of bioactive glasses on clinically important aerobic bacteria

Bioactive glasses (BAGs) have been studied for decades for clinical use, and they have found many dental and orthopedic applications. BAGs have also been shown to have an antibacterial effect e.g., on some oral microorganisms. In this extensive work we show that six powdered BAGs and two sol-gel derived materials have a clear antibacterial effect on 29 clinically important bacterial species. We also incorporated a rapid and accurate flow cytometric (FCM) method to calculate and standardize the numbers of viable bacteria inoculated in the suspensions used in the tests for antibacterial activity. In all materials tested growth inhibition could be demonstrated, although the concentration and time needed for the effect varied depending on the BAG. The most effective glass was S53P4, which had a clear growth-inhibitory effect on all pathogens tested. The sol-gel derived materials CaPSiO and CaPSiO II also showed a strong antibacterial effect. In summary, BAGs were found to clearly inhibit the growth of a wide selection of bacterial species causing e.g., infections on the surfaces of prostheses in the body after implantation.

Bone reconstruction: from bioceramics to tissue engineering

Over the past 30 years, an enormous array of biomaterials proposed as ideal scaffolds for cell growth have emerged, yet few have demonstrated clinical efficacy. Biomaterials, regardless of whether they are permanent or biodegradable, naturally occurring or synthetic, need to be biocompatible, ideally osteoinductive, osteoconductive, integrative, porous and mechanically compatible with native bone to fulfill their desired role in bone tissue engineering. These materials provide cell anchorage sites, mechanical stability and structural guidance and in vivo, provide the interface to respond to physiologic and biologic changes as well as to remodel the extracellular matrix in order to integrate with the surrounding native tissue. Calcium phosphate ceramics and bioactive glasses were introduced more than 30 years ago as bone substitutes. These materials are considered bioactive as they bond to bone and enhance bone tissue formation. The bioactivity property has been attributed to the similarity between the surface composition and structure of bioactive materials, and the mineral phase of bone. The drawback in using bioactive glasses and calcium phosphate ceramics is that close proximity to the host bone is necessary to achieve osteoconduction. Even when this is achieved, new bone growth is often strictly limited because these materials are not osteoinductive in nature. Bone has a vast capacity for regeneration from cells with stem cell characteristics. Moreover, a number of different growth factors including bone morphogenetic proteins, have been demonstrated to stimulate bone growth, collagen synthesis and fracture repair both in vitro and in vivo. Attempts to develop a tissue-engineering scaffold with both osteoconductivity and osteoinductivity have included loading osteoinductive proteins and/or osteogenic cells on the traditional bioactive materials. Yet issues that must be considered for the effective application of bioceramics in the field of tissue engineering are the degree of bioresorption and the poor mechanical strength. The synthesis of a new generation of biomaterials that can specifically serve as tissue engineering scaffolds for drug and cell delivery is needed. Nanotechnology can provide an alternative way of processing porous bioceramics with high mechanical strength and enhanced bioactivity and resorbability.

Osseointegration of alumina with a bioactive coating under load-bearing and unloaded conditions

The aim of the study was to evaluate the osseointegration of Al(2)O(3) coated with a bioactive glass ceramic (BioveritI), in a load-bearing implant model in sheep in comparison to uncoated Al(2)O(3) and to a minimally loaded situation. Both types of implants were inserted into the proximal tibia (load-bearing model) and in a drill hole defect into the tibia diaphysis (minimally loaded model). Under load-bearing conditions, the coating resulted in significantly higher interfacial shear strength and a high amount of mineralized bone in direct contact to the implant surface. In contrast, the uncoated Al(2)O(3) was surrounded by a thick connective tissue layer corresponding to low interfacial shear strength. In the minimally loaded model, however, there was rather a tendency of lower interfacial shear strength in the case of the coated implants. This finding corresponds to the histological results, which showed mineralized bone in the interface of uncoated Al(2)O(3), whereas in the case of the coated implants a thin layer of osteoid was observed. It was suggested that the osseointegration of Al(2)O(3) could be improved by the coating under load-bearing conditions, under which uncoated Al(2)O(3) ceramics cannot directly bind to bone.

Dissolution Kinetics, Selective Leaching, and Interfacial Reactions of a Bioglass Coating Enriched in Alumina

Bioglass coatings are interesting for developing a direct bond between prostheses and bone. But the high solubility of these materials limits their application. The addition of alumina can be used to control their solubility, but may inhibit the bonding mechanisms. In this paper, we study a bioglass in the SiO(2)-Na(2)O-CaO-P(2)O(5)-K(2)O-Al(2)O(3)-MgO system. After delays of implantation from 2 to 12 months, the bioglass/bone interface is characterized by energy-dispersive X-ray spectroscopy coupled with scanning transmission electron microscopy. Bioglass dissolution can be decomposed into three steps with selective leaching. Results show that, at 2 months after implantation, the bioglass is composed of Al, Si, Ca, and P. Alumina addition increases the coating stability without inhibiting the bonding process. Complex physicochemical reactions take place at the bioglass periphery. The coating bonds to bone through a Ca-P layer on top of a pure Si-rich layer. These phenomena are associated with bioactivity properties, which occur for up to 6 months. After 12 months, the bioglass is composed of silicon. Copyright 2001 Academic Press.

Bioactivity of sol-gel bioactive glass coated alumina implants

Alumina on alumina total hip arthroplasty has been in use for more than 25 years with encouraging results. However, an improvement of the alumina/bone interface still is required. The objective of this study was to investigate the in vitro and in vivo osteoconductive properties of sol-gel bioactive glass coated alumina implants. Two sol-gel glass compositions (58S Bioglass(R) and 77S Bioglass(R)) were used as coatings on alumina substrates and implanted in a rabbit model. The 58S sol-gel coating was employed in two configurations, single (A58S1) and double layer (A58S2). SEM analysis after one week in simulated body fluid revealed small crystals assumed to represent the initial phase of hydroxyapatite formation, whereas no clear conclusion could be drawn from Fourier transform infrared spectroscopy data. The percentage of bone in direct contact was greater for coated implants when compared to bulk alumina implants (p <0.001). In the case of A58S1 implants, bone percentage significantly increased from 45.1% after 3 weeks up to 87. 8% after 24 weeks of implantation (p = 0.0004). The presence of osteoid tissue, related to an aluminum release from the alumina substrates, was greatly diminished when compared to melt-derived glass-coated alumina implants.

Morphological evaluation of osteoblasts cultured on different calcium phosphate ceramics

The objective of these investigations was to develop an in vitro test system for evaluating novel rapidly resorbable calcium phosphate ceramics of varying composition. Rat bone marrow cells were cultured on the disc-shaped test substrates for 14 days. Five calcium phosphates were examined: R1 CaNaPO4; R1/M2, composed of CaNaPO4 and MgNaPO4; R1/2, composed of CaNaPO4 and Mg2SiO4; R1 + 9% SiO2 consisting of CaNaPO4 and 9% SiO2 (wt%) and R17, Ca2KNa(PO4)2. Two studies were performed. In study I cultures were re-fed every two to three days. In study II the medium was changed daily, and calcium and phosphate concentrations of the medium were determined daily. Specimens were prepared for light microscopy and morphometric evaluation of the cell-covered substrate area, scanning electron microscopy and energy-dispersive X-ray analysis. With all materials tested except for R1/2, an increase of cellular growth was observed after changing the medium daily. Of the different calcium phosphate ceramics tested, R17 and R1/M2 facilitated osteoblast growth and elaboration of extracellular matrix to the highest degree. The inhibition of cell growth encountered with R1 in study I and R1/2 in both studies seemed to be related to a high phosphate-ion release from these materials.

Protein adsorption to a bioactive glass with special reference to precorrosion

The protein adsorption properties of the bioactive glass S53P4 were studied using albumin, IgG, and fibrinogen solutions (1 mg/mL) as well as diluted plasma, serum, and 1:1:1 mixtures of albumin, IgG, and fibrinogen. The bioactive glass granules (315-500 microns) were used in the experiments without pretreatments or as precorroded with an Si-rich or a Ca,P-rich layer. The protein adsorption properties of S53P4 were compared to a commercial bioactive glass (Bioglass), an inert glass, an experimental glass ceramic, titanium (Ti), and hydroxyapatite (HA). The untreated S53P4 bound in Trisbuffered saline mainly albumin from diluted plasma and serum and the 1:1:1 (1 mg of each) mixture of albumin, IgG, and fibrinogen. No binding of fibrinogen was observed. The omission of NaCl from the buffer used in the experiments increased the number of proteins bound by the S53P4. Most of the albumin bound by the glass could be detached with 0.5-1M NaCl speaking for electrostatic protein bonding. The protein adsorption properties of Bioglass resembled those of S53P4. The Ca,P-rich layer glass, the inert glass, the glass ceramic, HA, and Ti all bound several plasma and serum proteins, including fibrinogen. The Si-rich layer glass showed protein binding properties resembling the untreated glass more than the Ca,P-rich layer glass. The protein adsorption test used in the present study revealed differences in the protein adsorption properties of the studied materials, which may reflect differences in their surface potentials. It also functioned in registration of corrosion-induced changes in the surface properties of the S53P4. As judged by the protein adsorption properties, the untreated S53P4 could have a higher biocompatibility than the two precorroded glasses. Precorrosion, especially the formation of the Ca,P-rich layer, increased the number of proteins bound by the S53P4. Thus, a precorroded glass as compared to the untreated glass could be a better carrier of specific proteins that may be used to improve the biocompatibility of the bioactive glass.

Aluminium release from glass ionomer cements during early water exposure in vitro

Aluminium is a major constituent of glass ionomer cements. During mixing and setting aluminium is released from the glass into the polyalkeonic acid solution. Part of this aluminium may not combine with the polyalkeonic acid, but may be released from the cement. The aluminium release from auto-cured and light-cured glass ionomer cements during early water exposure was studied. The former cements released more aluminium than the latter. Scanning electron microscopy (SEM) showed extensive loss of polymer matrix for the cements with the highest aluminium release. Insufficient curing of light-cured cements also resulted in loss of matrix. It is suggested that the considerable release of aluminium from glass ionomer cements during early water exposure may explain the reported lack of mineralization of predentin in the pulp beneath glass ionomer cements. This would correspond to the inhibiting effect of aluminium on bone mineralization.