Synthesis and characterization of silica-chitosan hybrid materials as antibacterial coatings for titanium implants

Chitosan-based materials for dental implantology: A comprehensive review

Chitosan, a versatile biopolymer, has gained recognition in the discipline of dental implantology due to possessing salient properties. This comprehensive review explores the potential of chitosan in dental implants, focusing on its biocompatibility, bioactivity, and the various chitosan-based materials that have been utilized for dental implant therapy. The review also highlights the importance of surface treatment in dental implants to enhance osseointegration and inhibit bacterial biofilm formation. Additionally, the chemical structure, properties, and sources of chitosan are described, along with its different structural forms. The characteristics of chitosan particularly color, molecular weight, viscosity, and degree of deacetylation are discussed about their influence on its applications. This review provides valuable insights into the promising utilization of polymeric chitosan in enhancing the success and functionality of dental implants. This study highlights the potential applications of chitosan in oral implantology. Chitosan possesses various advantageous properties, including muco-adhesiveness, hemostatic action, biocompatibility, biodegradability, bioactivity, and antibacterial and antifungal activities, which enhance its uses in dental implantology. However, it has limited aqueous solubility at the physiological pH, which sometimes restricts its biological application, but this problem can be overcome by using modified chitosan or chitosan derivatives, which have also shown encouraging results. Recent research suggests that chitosan may act as a promising material for coating titanium-based implants, improving osteointegration together with antibacterial properties.

Biomimetic Coatings in Implant Dentistry: A Quick Update

Biomimetic dental implants are regarded as one of the recent clinical advancements in implant surface modification. Coatings with varying thicknesses and roughness may affect the dental implant surface's chemical inertness, cell adhesion, and antibacterial characteristics. Different surface coatings and mechanical surface changes have been studied to improve osseointegration and decrease peri-implantitis. The surface medication increases surface energy, leading to enhanced cell proliferation and growth factors, and, consequently, to a rise in the osseointegration process. This review provides a comprehensive update on the numerous biomimetic coatings used to improve the surface characteristics of dental implants and their applications in two main categories: coating to improve osseointegration, including the hydroxyapatite layer and nanocomposites, growth factors (BMPs, PDGF, FGF), and extracellular matrix (collagen, elastin, fibronectin, chondroitin sulfate, hyaluronan, and other proteoglycans), and coatings for anti-bacterial performance, covering drug-coated dental implants (antibiotic, statin, and bisphosphonate), antimicrobial peptide coating (GL13K and human beta defensins), polysaccharide antibacterial coatings (natural chitosan and its coupling agents) and metal elements (silver, zinc, and copper).

Osteoblast and bacterial cell response on RGD peptide-functionalized chitosan coatings electrophoretically deposited from different suspensions on Ti13Nb13Zr alloy

Metallic materials for long-term load-bearing implants still do not provide high antimicrobial activity while maintaining strong compatibility with bone cells. This study aimed to modify the surface of Ti13Nb13Zr alloy by electrophoretic deposition of a chitosan coating with a covalently attached Arg-Gly-Asp (RGD) peptide. The suspensions for coating deposition were prepared in two different ways either using hydroxyacetic acid or a carbon dioxide saturation process. The coatings were deposited using a voltage of 10 V for 1 min. The prepared coatings were examined using SEM, EDS, FTIR, and XPS techniques. In addition, the wettability of these surfaces, corrosion resistance, adhesion of the coatings to the metallic substrate, and their antimicrobial activity (E. coli, S. aureus) and cytocompatibility properties using the MTT and LDH assays were studied. The coatings produced tightly covered the metallic substrate. Spectroscopic studies confirmed that the peptide did not detach from the chitosan chain during electrophoretic deposition. All tested samples showed high corrosion resistance (corrosion current density measured in nA/cm2 ). The deposited coatings contributed to a significant increase in the antimicrobial activity of the samples against Gram-positive and Gram-negative bacteria (reduction in bacterial counts from 99% to, for CS-RGD-Acid and the S. aureus strain, total killing capacity). MTT and LDH results showed high compatibility with bone cells of the modified surfaces compared to the bare substrate (survival rates above 75% under indirect contact conditions and above 100% under direct contact conditions). However, the adhesion of the coatings was considered weak.

Overview of strategies to improve the antibacterial property of dental implants

The increasing number of peri-implant diseases and the unsatisfactory results of conventional treatment are causing great concern to patients and medical staff. The effective removal of plaque which is one of the key causes of peri-implant disease from the surface of implants has become one of the main problems to be solved urgently in the field of peri-implant disease prevention and treatment. In recent years, with the advancement of materials science and pharmacology, a lot of research has been conducted to enhance the implant antimicrobial properties, including the addition of antimicrobial coatings on the implant surface, the adjustment of implant surface topography, and the development of new implant materials, and significant progress has been made in various aspects. Antimicrobial materials have shown promising applications in the prevention of peri-implant diseases, but meanwhile, there are some shortcomings, which leads to the lack of clinical widespread use of antimicrobial materials. This paper summarizes the research on antimicrobial materials applied to implants in recent years and presents an outlook on the future development.

Chitosan-Silica Hybrid Biomaterials for Bone Tissue Engineering: A Comparative Study of Xerogels and Aerogels

Chitosan (CS) is a natural biopolymer that shows promise as a biomaterial for bone-tissue regeneration. However, because of their limited ability to induce cell differentiation and high degradation rate, among other drawbacks associated with its use, the creation of CS-based biomaterials remains a problem in bone tissue engineering research. Here we aimed to reduce these disadvantages while retaining the benefits of potential CS biomaterial by combining it with silica to provide sufficient additional structural support for bone regeneration. In this work, CS-silica xerogel and aerogel hybrids with 8 wt.% CS content, designated SCS8X and SCS8A, respectively, were prepared by sol-gel method, either by direct solvent evaporation at the atmospheric pressure or by supercritical drying in CO₂, respectively. As reported in previous studies, it was confirmed that both types of mesoporous materials exhibited large surface areas (821 m²g^-1-858 m²g^-1) and outstanding bioactivity, as well as osteoconductive properties. In addition to silica and chitosan, the inclusion of 10 wt.% of tricalcium phosphate (TCP), designated SCS8T10X, was also considered, which stimulates a fast bioactive response of the xerogel surface. The results here obtained also demonstrate that xerogels induced earlier cell differentiation than the aerogels with identical composition. In conclusion, our study shows that the sol-gel synthesis of CS-silica xerogels and aerogels enhances not only their bioactive response, but also osteoconduction and cell differentiation properties. Therefore, these new biomaterials should provide adequate secretion of the osteoid for a fast bone regeneration.

Review of Antimicrobial Nanocoatings in Medicine and Dentistry: Mechanisms of Action, Biocompatibility Performance, Safety, and Benefits Compared to Antibiotics

This review discusses topics relevant to the development of antimicrobial nanocoatings and nanoscale surface modifications for medical and dental applications. Nanomaterials have unique properties compared to their micro- and macro-scale counterparts and can be used to reduce or inhibit bacterial growth, surface colonization and biofilm development. Generally, nanocoatings exert their antimicrobial effects through biochemical reactions, production of reactive oxygen species or ionic release, while modified nanotopographies create a physically hostile surface for bacteria, killing cells via biomechanical damage. Nanocoatings may consist of metal nanoparticles including silver, copper, gold, zinc, titanium, and aluminum, while nonmetallic compounds used in nanocoatings may be carbon-based in the form of graphene or carbon nanotubes, or composed of silica or chitosan. Surface nanotopography can be modified by the inclusion of nanoprotrusions or black silicon. Two or more nanomaterials can be combined to form nanocomposites with distinct chemical or physical characteristics, allowing combination of different properties such as antimicrobial activity, biocompatibility, strength, and durability. Despite their wide range of applications in medical engineering, questions have been raised regarding potential toxicity and hazards. Current legal frameworks do not effectively regulate antimicrobial nanocoatings in matters of safety, with open questions remaining about risk analysis and occupational exposure limits not considering coating-based approaches. Bacterial resistance to nanomaterials is also a concern, especially where it may affect wider antimicrobial resistance. Nanocoatings have excellent potential for future use, but safe development of antimicrobials requires careful consideration of the "One Health" agenda, appropriate legislation, and risk assessment.

Chitosan hydrogel modified with lanthanum as a drug delivery system for epigallocatechin gallate: Investigation of hydrogel - drug interaction by FT-IR and Raman spectroscopy

In the presented work, chitosan hydrogel modified with lanthanum was obtained for the first time. The hydrogel was used as a carrier in the controlled release of epigallocatechin gallate. The work proved the effectiveness of drug sorption by hydrogel and controlled release in simulated body fluids. The drug was released slowly and in a controlled manner from the carrier. The research techniques used in this work (FT-IR spectroscopy and imaging, Raman spectroscopy, SEM/EDS) allowed to confirm the successful retention of EGCG on the hydrogel surface. On the basis of the EDS mapping, it was possible to confirm the even distribution of the lanthanum ions. Using FT-IR imaging, we verified that the drug was evenly distributed on the entire surface of the prepared material. The antifungal effectiveness of the material has been proven on several types of fungi. The research proved that the prepared material is capable of long-term release of the active substance and has antifungal properties. As a result, the prepared material can be successfully used as an implantable hydrogel or a coating in, e.g. titanium implants.

Effects of Nitrurized Titanium on Microhardness and Human Dental Pulp Stem Cell Adhesion and Differentiation

To compare the Vickers microhardness, surface roughness, initial adhesion, and osteogenic differentiation on titanium (Ti) and nitrurized titanium (NTi) plates were treated by UV irradiation and chitosan. Each plate was subjected to Vickers hardness with a pressure of 2.9 N for 10 seconds and roughness evaluation by atomic force microscope (AFM) analysis. Three groups of each type of plates were tested: control (C), ultraviolet irradiation (UV), and chitosan (Q). The UV group was exposed to UV-irradiation for 20 min at 253.7 nm (52 μW/cm2). The Q group was coated with 1% chitosan, and the C group had no treatment. The osteoblasts (2 × 106 cells/mL) were inoculated in each group for 60 min and their viability was determined by the MTT bioassay. Osteogenic differentiation was performed over 4 weeks and determined by alizarin red staining. The mean was analyzed with the Shapiro-Wilks, Kruskall-Wallis, and Mann-Whitney U tests of normality (n = 9/gp). The NTi plates hardness (125.1 ± 4.01 HV) was higher (P = 0.026) than the Ti plates (121.3 ± 2.23 HV). The surface topography was: NTi (Ra = 0.098 μm) and Ti (Ra = 0.212 μm). The quantification of cell adhesion was: Ti + Q = 123 ± 4.9% (P < 0.05) < NTi + Q = 107 ± 3.3% < Ti = 100 ± 10.7% < NTi = 72 ± 6.8% < NTi + UV = 71 ± 4.4% < Ti + UV = 69 ± 3.5%, regardless the plates, the presence of chitosan induce a faster osteogenic differentiation. The Ti + Q plates tested the highest cell attachment and osteogenic adhesion suggesting their potential use of chitosan for cell-implant interaction.

Dual-Functional Polyetheretherketone Surface with an Enhanced Osteogenic Capability and an Antibacterial Adhesion Property In Vitro by Chitosan Modification

A chitosan layer was covalently bonded to a polyetheretherketone (PEEK) surface using a simple facile self-assembly method to address inadequate biological activity and infection around the implant. The surface characterization, layer degradation, biological activity, and antibacterial adhesion properties of chitosan-modified PEEK (PEEK-CS) were studied. Through chitosan grafting, the surface morphology changed, the surface roughness increased, and the contact angle decreased significantly. PEEK-CS boosted cell adhesion, proliferation, increased alkaline phosphate activity, extracellular matrix mineralization, and expression of osteogenic genes. PEEK-CS demonstrated less adhesion to Porphyromonas gingivalis as well as less bacterial adhesion to P. gingivalis and Streptococcus mutans. According to our findings, chitosan modification significantly improved the osteogenic ability and antibacterial adhesion of PEEK in vitro.

Improvement in osteogenesis, vascularization, and corrosion resistance of titanium with silicon-nitride doped micro-arc oxidation coatings

Titanium (Ti) implants have been widely used for the treatment of tooth loss due to their excellent biocompatibility and mechanical properties. However, modifying the biological properties of these implants to increase osteointegration remains a research challenge. Additionally, the continuous release of various metal ions in the oral microenvironment due to fluid corrosion can also lead to implant failure. Therefore, simultaneously improving the bioactivity and corrosion resistance of Ti-based materials is an urgent need. In recent decades, micro-arc oxidation (MAO) has been proposed as a surface modification technology to form a surface protective oxide layer and improve the comprehensive properties of Ti. The present study doped nano silicon nitride (Si₃N₄) particles into the Ti surface by MAO treatment to improve its corrosion resistance and provide excellent osteoinduction by enhancing alkaline phosphatase activity and osteogenic-related gene expression. In addition, due to the presence of silicon, the Si₃N₄-doped materials showed excellent angiogenesis properties, including the promotion of cell migration and tubule formation, which play essential roles in early recovery after implantation.

Role of chitosan in titanium coatings. trends and new generations of coatings

Survival studies of dental implants currently reach high figures. However, considering that the recipients are middle-aged individuals with associated pathologies, research is focused on achieving bioactive surfaces that ensure osseointegration. Chitosan is a biocompatible, degradable polysaccharide with antimicrobial and anti-inflammatory properties, capable of inducing increased growth and fixation of osteoblasts around chitosan-coated titanium. Certain chemical modifications to its structure have been shown to enhance its antibacterial activity and osteoinductive properties and it is generally believed that chitosan-coated dental implants may have enhanced osseointegration capabilities and are likely to become a commercial option in the future. Our review provided an overview of the current concepts and theories of osseointegration and current titanium dental implant surfaces and coatings, with a special focus on the in vivo investigation of chitosan-coated implants and a current perspective on the future of titanium dental implant coatings.

Photocatalytic Remediation of Harmful Alexandrium minutum Bloom Using Hybrid Chitosan-Modified TiO2 Films in Seawater: A Lab-Based Study

The uncontrolled growth of harmful algal blooms (HABs) can negatively impact the environment and pose threats to human health and aquatic ecosystems. Titanium dioxide (TiO2) is known to be effective in killing harmful algae through flocculation and sedimentation. However, TiO2 in a dispersed form can harm other non-target marine organisms, which has raised concerns by environmentalists and scientists. This research seeks to explore the utility of immobilized titanium oxide as a photocatalyst for mitigation of HABs, where the Alexandrium minutum bloom was used as a model system herein. Chitosan was modified with 0.2 wt.% TiO2 (Chi/TiO2 (x mL; x = 1, 3 and 5 mL) and the corresponding films were prepared via solvent casting method. Scanning electron microscope (SEM) images of the films reveal a highly uneven surface. X-ray diffraction (XRD) analysis indicates the reduction in chitosan crystallinity, where the presence of TiO2 was negligible, in accordance with its dispersion within the chitosan matrix. The photocatalytic mitigation of A.minutum was carried out via a physical approach in a laboratory-scale setting. The negative surface charge of the films was observed to repel the negatively charged A.minutum causing fluctuation in the removal efficiency (RE). The highest RE (76.1 ± 13.8%) was obtained when Chi/TiO2 (1 mL) was used at 72 h, where the hydroxyl radicals generated were inferred to contribute to the deactivation of the algae cells by causing oxidative stress. An outcome of this study indicates that such hybrid films have the potential to replace the non-immobilized (dispersed) TiO2 for HAB mitigation. However, further investigation is required to deploy these films for field applications at a larger scale.

Bone Quantification Around Chitosan-Coated Titanium Dental Implants: A Preliminary Study by Micro-CT Analysis in Jaw of a Canine Model

Surface treatments of Ti in the dental implant industry are performed with the aim of in-creasing its bioactivity and osseointegration capacity. Chitosan (Cht) is a polysaccharide that has been proposed as a promising biomaterial in tissue engineering and bone regeneration, due to its ability to stimulate the recruitment and adhesion of osteogenic progenitor cells. The aim of our preliminary study was to evaluate, by micro-computed tomography (micro-CT), the osseointegration and bone formation around Cht-coated implants and to compare them with conventional surface-etched implants (SLA type). Four im-plants (8.5 mm length × 3.5 mm Ø) per hemiarch, were inserted into the jaws of five dogs, divided into two groups: chitosan-coated implant group (ChtG) and control group (CG). Twelve weeks after surgery, euthanasia was performed, and sectioned bone blocks were obtained and scanned by micro-CT and two bone parameters were measured: bone in contact with the implant surface (BCIS) and peri-implant bone area (PIBA). For BCIS and PIBA statistically significant values were obtained for the ChtG group with respect to CG (p = 0.005; p = 0.014 and p < 0.001 and p = 0.002, respectively). The results, despite the limitations, demonstrated the usefulness of chitosan coatings. However, studies with larger sample sizes and adequate experimental models would be necessary to confirm the results.

Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications

An increase in the world population and its life expectancy, as well as the ongoing concern about our physical appearance, have elevated the relevance of dental implantology in recent decades. Engineering strategies to improve the survival rate of dental implants have been widely investigated, focusing on implant material composition, geometry (usually guided to reduce stiffness), and interface surrounding tissues. Although efforts to develop different implant surface modifications are being applied in commercial dental prostheses today, the inclusion of surface coatings has gained special interest, as they can be tailored to efficiently enhance osseointegration, as well as to reduce bacterial-related infection, minimizing peri-implantitis appearance and its associated risks. The use of biomaterials to replace teeth has highlighted the need for the development of reliable analytical methods to assess the therapeutic benefits of implants. This literature review considers the state-of-the-art strategies for surface modification or coating and analytical methodologies for increasing the survival rate for teeth restoration.

Thermoresponsive and Self-Healing Hydrogel Based on Chitosan Derivatives and Polyoxometalate as an Antibacterial Coating

Hospital-acquired infections are a serious threat to the recovery of patients. To prevent such infections, an antibacterial coating is an effective method to eliminate bacterial colonization on healthcare-related surfaces. Herein, we report an antibacterial hydrogel composed of silver-containing polyoxometalate (AgP₅W₃₀ POM) and carboxymethyl chitosan (CMC). The silver ion is encapsulated inside the POM cage and demonstrates long-lasting bacteriostasis after repeated exposure to both Gram-positive and Gram-negative bacteria. The chemical structure of chitosan derivatives, as well as the concentration and pH, is studied to tune the mechanical properties of the hydrogel. The hydrogel undergoes a gel-sol transition above the critical temperature and possesses self-healing ability. This hydrogel can be readily coated on the surface of versatile bulk materials, which is especially convenient for porous objects and resists the growth of Staphylococcus aureus, Escherichia coli, and methicillin-resistant S. aureus (MRSA). In summary, we envision that the AgP₅W₃₀-CMC hydrogel has great potential to serve as an antibacterial coating to decrease the prevalence of hospital-acquired infections.

Multifunctional polyethylene imine hybrids decorated by silica bioactive glass with enhanced mechanical properties, antibacterial, and osteogenesis for bone repair

Inorganic/organic hybrids and bioactive glasses demonstrate promising potential as bone substitute biomaterials. A sol-gel hybrid consisting of silica bioactive glass and biodegradable polymer can combine the high bioactivity of a glass with the toughness of a polymer. In this study, multifunctional hybrids with a combination of organic-inorganic hybrid structure class II consisting of polyethyleneimine (PEI) generation 4 (G4) and bioactive glass with enhanced mechanical properties, mineralization, antibacterial, and osteogenesis activities were synthesized by the sol-gel method. Glycidoxypropyl) trimethoxysilane (GPTMS) with different concentrations was used as a covalent bonding agent between PEI polymer and bioactive glass. The effect of GPTMS content was assessed in the presence and absence of calcium in the hybrid structures in terms of morphology, wettability, mechanical properties, antibacterial activity, cell viability, and in vitro osteogenic differentiation properties. By increasing the amount of GPTMS, the compressive strength increased from 1.95 MPa to 2.34 MPa, which was comparable to human trabecular bone. All the hybrids presented antibacterial activity against Staphylococcus aureus, forming an inhibition zone of 13-16 mm. An increase in cell viability of 82.22% in PSCaG90 was obtained after 1 day of MG-63 cell culture. Alkaline phosphatase expression and mineralization of MG-63 cells increased in the PSCaG90 hybrid in the absence of an osteogenic medium compared to PSG60 and PSG90. The PSCaG90 hybrid indicated considerable in vitro osteogenic capacity in the absence of a differentiation medium, expressing high levels of bone-specific proteins including collagen I (COL1A1), Runt-related transcription factor 2 (RUNX2), osteopontin (OPN), and osteocalcin (OCN), compared to calcium-free hybrids. Overall, our results suggest that the presence of calcium in the PSCaG90 leads to a significant increase in osteogenic differentiation of MG-63 cells even in the absence of differentiation medium, which suggests these hybrid structures with multifunctional properties as promising candidates for bone repair.

Dental Implant Nano-Engineering: Advances, Limitations and Future Directions

Titanium (Ti) and its alloys offer favorable biocompatibility, mechanical properties and corrosion resistance, which makes them an ideal material choice for dental implants. However, the long-term success of Ti-based dental implants may be challenged due to implant-related infections and inadequate osseointegration. With the development of nanotechnology, nanoscale modifications and the application of nanomaterials have become key areas of focus for research on dental implants. Surface modifications and the use of various coatings, as well as the development of the controlled release of antibiotics or proteins, have improved the osseointegration and soft-tissue integration of dental implants, as well as their antibacterial and immunomodulatory functions. This review introduces recent nano-engineering technologies and materials used in topographical modifications and surface coatings of Ti-based dental implants. These advances are discussed and detailed, including an evaluation of the evidence of their biocompatibility, toxicity, antimicrobial activities and in-vivo performances. The comparison between these attempts at nano-engineering reveals that there are still research gaps that must be addressed towards their clinical translation. For instance, customized three-dimensional printing technology and stimuli-responsive, multi-functional and time-programmable implant surfaces holds great promise to advance this field. Furthermore, long-term in vivo studies under physiological conditions are required to ensure the clinical application of nanomaterial-modified dental implants.

Effect of Washing Treatment on the Textural Properties and Bioactivity of Silica/Chitosan/TCP Xerogels for Bone Regeneration

Silica/biopolymer hydrogel-based materials constitute very attractive platforms for various emerging biomedical applications, particularly for bone repair. The incorporation of calcium phosphates in the hybrid network allows for designing implants with interesting biological properties. Here, we introduce a synthesis procedure for obtaining silica–chitosan (CS)–tricalcium phosphate (TCP) xerogels, with CS nominal content varying from 4 to 40 wt.% and 10 to 20 wt.% TCP. Samples were obtained using the sol-gel process assisted with ultrasound probe, and the influence of ethanol or water as washing solvents on surface area, micro- and mesopore volume, and average pore size were examined in order to optimize their textural properties. Three washing solutions with different soaking conditions were tested: 1 or 7 days in absolute ethanol and 30 days in distilled water, resulting in E1, E7, and W30 washing series, respectively. Soaked samples were eventually dried by evaporative drying at air ambient pressure, and the formation of interpenetrated hybrid structures was suggested by Fourier transformed infrared (FTIR) spectroscopy. In addition the impact that both washing solvent and TCP content have on the biodegradation, in vitro bioactivity and osteoconduction of xerogels were explored. It was found that calcium and phosphate-containing ethanol-washed xerogels presented in vitro release of calcium (2–12 mg/L) and silicon ions (~60–75 mg/L) after one week of soaking in phosphate-buffered saline (PBS), as revealed by inductive coupled plasma (ICP) spectroscopy analysis. However, only the release of silicon was detected for water-washed samples. Besides, all the samples exhibited in vitro bioactivity in simulated body fluid (SBF), as well as enhanced in vitro cell growth and also significant focal adhesion development and maturation.

Nanoparticles in Dentistry: A Comprehensive Review

In recent years, nanoparticles (NPs) have been receiving more attention in dentistry. Their advantageous physicochemical and biological properties can improve the diagnosis, prevention, and treatment of numerous oral diseases, including dental caries, periodontal diseases, pulp and periapical lesions, oral candidiasis, denture stomatitis, hyposalivation, and head, neck, and oral cancer. NPs can also enhance the mechanical and microbiological properties of dental prostheses and implants and can be used to improve drug delivery through the oral mucosa. This paper reviewed studies from 2015 to 2020 and summarized the potential applications of different types of NPs in the many fields of dentistry.

Layer-by-Layer Deposited Hybrid Polymer Coatings Based on Polysaccharides and Zwitterionic Silanes with Marine Antifouling Properties

Polyelectrolyte multilayer (PEM) assembly is a versatile tool to construct low-fouling coatings. For application in the marine environment, their structure needs to be stabilized by covalent linkage. Here, we introduce an approach for spin coating of silane-based sol-gel chemistries using layer-by-layer assembly of polysaccharide-based hybrid polymer coatings (LBLHPs). The silane sol-gel chemistry allows the films to be cross-linked under water-based and mild reaction conditions. Two different silanes were used for this purpose, a conventional triethoxymethyl silane and a de novo synthesized zwitterionic silane. The polysaccharide-silane hybrid polymer coatings were thoroughly characterized with spectroscopic ellipsometry, water contact angle (WCA) goniometry, attenuated total reflection-Fourier transform infrared spectroscopy, and atomic force microscopy. The coatings showed good stability in seawater, smooth surfaces, a high degree of hydration, and WCAs below or close to the Berg limit. LBLHPs showed low-fouling properties in biological assays against nonspecific protein adsorption, attachment of the diatom Navicula perminuta, and settlement of zoospores of the macroalga Ulva linza.

Antibacterial Bio-Based Polymers for Cranio-Maxillofacial Regeneration Applications

Cranio-maxillofacial structure is a region of particular interest in the field of regenerative medicine due to both its anatomical complexity and the numerous abnormalities affecting this area. However, this anatomical complexity is what makes possible the coexistence of different microbial ecosystems in the oral cavity and the maxillofacial region, contributing to the increased risk of bacterial infections. In this regard, different materials have been used for their application in this field. These materials can be obtained from natural and renewable feedstocks, or by synthetic routes with desired mechanical properties, biocompatibility and antimicrobial activity. Hence, in this review, we have focused on bio-based polymers which, by their own nature, by chemical modifications of their structure, or by their combination with other elements, provide a useful antibacterial activity as well as the suitable conditions for cranio-maxillofacial tissue regeneration. This approach has not been reviewed previously, and we have specifically arranged the content of this article according to the resulting material and its corresponding application; we review guided bone regeneration membranes, bone cements and devices and scaffolds for both soft and hard maxillofacial tissue regeneration, including hybrid scaffolds, dental implants, hydrogels and composites.

Surface Modification Techniques of Titanium and its Alloys to Functionally Optimize Their Biomedical Properties: Thematic Review

Depending on the requirements of specific applications, implanted materials including metals, ceramics, and polymers have been used in various disciplines of medicine. Titanium and its alloys as implant materials play a critical role in the orthopedic and dental procedures. However, they still require the utilization of surface modification technologies to not only achieve the robust osteointegration but also to increase the antibacterial properties, which can avoid the implant-related infections. This article aims to provide a summary of the latest advances in surface modification techniques, of titanium and its alloys, specifically in biomedical applications. These surface techniques include plasma spray, physical vapor deposition, sol-gel, micro-arc oxidation, etc. Moreover, the microstructure evolution is comprehensively discussed, which is followed by enhanced mechanical properties, osseointegration, antibacterial properties, and clinical outcomes. Future researches should focus on the combination of multiple methods or improving the structure and composition of the composite coating to further enhance the coating performance.

Surface Modified Techniques and Emerging Functional Coating of Dental Implants

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.

Osseointegration of Antimicrobial Acrylic Bone Cements Modified with Graphene Oxide and Chitosan

Acrylic bone cement (ABC) is one of the most used materials in orthopedic surgery, mainly for the fixation of orthopedic implants to the bone. However, ABCs usually present lack of biological activity and osseointegration capacity that leads to loosening of the prosthesis. This work reports the effect of introducing graphene oxide (GO) and chitosan (CS), separately or together, in the ABC formulation on setting performance, mechanical behavior, and biological properties. Introduction of both CS and GO to the ABC decreased the maximum temperature by 21% and increased the antibacterial activity against Escherichia coli by 87%, while introduction of only CS decreased bending strength by 32%. The results of cell viability and cell adhesion tests showed in vitro biocompatibility. The in vivo response was investigated using both subdermal and bone parietal implantations in Wistar rats. Modified ABCs showed absence of immune response, as confirmed by a normal inflammatory response in Wistar rat subdermal implantation. The results of the parietal bone implantation showed that the addition of CS and GO together allowed a near total healing bone–cement interface, as observed in the micrographic analysis. The overall results support the great potential of the modified ABCs for application in orthopedic surgery mainly in those cases where osseointegration is required.

Biofunctional Elements Incorporated Nano/Microstructured Coatings on Titanium Implants with Enhanced Osteogenic and Antibacterial Performance

Bone fracture is prevalent among athletes and senior citizens and may require surgical insertion of bone implants. Titanium (Ti) and its alloys are widely used in orthopedics due to its high corrosion resistance, good biocompatibility, and modulus compatible with natural bone tissues. However, bone repair and regrowth are impeded by the insufficient intrinsic osteogenetic capability of Ti and Ti alloys and potential bacterial infection. The physicochemical properties of the materials and nano/microstructures on the implant surface are crucial for clinical success and loading with biofunctional elements such as Sr, Zn, Cu, Si, and Ag into nano/microstructured TiO2 coating has been demonstrated to enhance bone repair/regeneration and bacterial resistance of Ti implants. In this review, recent advances in biofunctional element-incorporated nano/microstructured coatings on Ti and Ti alloy implants are described and the prospects and limitations are discussed.

Influence of the chitosan morphology on the properties of acrylic cements and their biocompatibility

Acrylic bone cements (ABC) are materials widely used in orthopedics and biomedical applications. Several active compounds have been introduced to ABC formulations to improve their mechanical properties and bifunctionality. In this research, we studied the effect of the addition of chitosan (CS) microspheres and chitosan sheets on ABC formulations. For mechanical performance optimization, the compression strength was taken as a response variable using an extreme vertices mixing design with fraction by weight of CS and poly(methyl methacrylate) (PMMA) as the variable factors. According to the statistical analysis, the control samples (without CS), samples with 7% (wt.) of CS sheets, and samples with 17% (wt.) of CS spheres presented the best compression properties: 90.6 MPa and 95.6 MPa, respectively. The study of these formulations confirmed that CS spheres allow a higher amount of loading on the formulation, maintaining comparable compression strength. By ¹H-NMR, it was observed that the residual monomer was similar in all wording. The hydrolytic degradation assay in simulated body fluid (SBF) determined that the sphere incorporation increased by 50% and 35% for the water uptake and weight loss values, respectively, when compared with the reported values with CS sheets. By morphological analysis via SEM, it was observed that the porosity increased considerably in the presence of CS spheres throughout the immersion time in SBF. The subdermal implant results demonstrated excellent compatibility between the cement studied and the biological environment.

Acrylic bone cements (ABC) are materials widely used in orthopedics and biomedical applications.

Preparation and Performance of Silica-di-Block Polymer Hybrids for BSA-Resistance Coatings

A series of tem-responsive and protein-resistance property silica-di-block polymers SiO₂-g-PMMA-b-P(PEGMA) hybrids are synthesized with methyl methacrylate (MMA) and poly (ethylene glycol) methyl ether methacrylate (PEGMA) by the surface-initiated atom transfer radical polymerization (SI-ATRP). The morphology in tetrahydrofuran (THF) solution, lower critical solution temperature (LCST), surface morphology, bovine serum albumin (BSA)-resistance property, and thermal stability of nanoparticles were analyzed. The results of ¹H-NMR, GPC, and TEM prove that the silica-di-block hybrids have been obtained. The silica-di-block hybrids shows the LCST (52–64 °C) in aqueous solution. The hybrid films casted by THF present distributed uniform granular bulges and the film surface is relatively smooth (Ra = 15.4 nm ~ 10.5 nm). The results of QCM-D showed that only a small amount of BSA protein(△f = 18.6 ~ 11.8 Hz) was adsorbed on the surface of the films. The result of XPS also demonstrated that only a small amount of BSA protein was absorbed onto the surface of the film (N% = 1.86). The TGA analyses indicate that the thermal decomposition temperature of hybrids is 288 °C. Thus, it is suggested that the hybrids are served as a suitable coating with BSA resistance property and thermal stability.

Surface Modifications for Implants Lifetime extension: An Overview of Sol-Gel Coatings

The limited lifetime of implants entails having patients undergo replacement surgeries, several times throughout life in young patients, with significant risks for them and extensive cost for healthcare service. The overcoming of such inconvenience is still today a hard challenge for the scholars of the biomedical and biomaterial fields. The improvement of the currently employed implants through surface modification by coatings application is the main strategy proposed to avoid implants failure, and the sol-gel coating is an ideal technology to achieve this goal. Therefore, the present review aims to provide an overview of the most important problems leading to implant failure, the sol-gel coating technology, and its use as a strategy to overcome such issues.

Development of Robust Chitosan–Silica Class II Hybrid Coatings with Antimicrobial Properties for Titanium Implants

The purpose of this study was to develop robust class II organic–inorganic films as antibacterial coatings on titanium alloy (Ti6Al4V) implants. Coating materials were prepared from organic chitosan (20–80 wt.%) coupled by 3-glycydoxytrimethoxysilane (GPTMS) with inorganic tetraethoxysilane (TEOS). These hybrid networks were imbedded with antimicrobial silver nanoparticles (AgNPs) and coated onto polished and acid-etched Ti6Al4V substrates. Magic-angle spinning nuclear magnetic resonance (13CMAS-NMR), attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) and the ninhydrin assay, confirmed the presence and degree of covalent crosslinking (91%) between chitosan and GPTMS. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) identified surface roughness and microtopography on thin films and confirmed homogeneous distribution of elements throughout the coating. Cross-hatch and tensile adhesion testing demonstrated the robustness and adherence (15–20 MPa) of hybrid coatings to acid-etched titanium substrates. Staphylococcus aureus and Escherichia coli cultures and their biofilm formation were inhibited by all hybrid coatings. Antibacterial effects increased markedly for coatings loaded with AgNPs and appeared to increase with chitosan content in biofilm assays. These results are promising in the development of class II hybrid materials as robust and highly adherent antibacterial films on Ti6Al4V implants.

Antibacterial effect of chitosan and its derivative on Enterococcus faecalis associated with endodontic infection

Chitosan and its derivatives have been increasingly used for bacteriostasis. To date, the effect of chitosan and N-(2-hydroxyl) propyl-3-trimethyl ammonium chitosan chloride (HTCC) on Enterococcus faecalis (E. faecalis) associated with endodontic infection has remained to be determined. Chitosan and HTCC were serially diluted with double-distilled water (DDW) or PBS at concentrations of 20-2,500 µg/ml. Various strains of E. faecalis (American Type Tissue Collection no. 29212, as well as isolated strains P25RC and P52Sa) in plankton were adjusted to an optical density at 600 nm of 0.10 and treated with chitosan or HTCC. A colony-forming unit assay was used to determine the concentration of residual bacteria after treatment. Furthermore, E. faecalis biofilms were cultured on coverslips and treated with chitosan or HTCC. The coverslips were rinsed, stained using Live/dead^® BacLight™ bacterial viability kit and observed under an inverted fluorescence microscope. In addition, biofilms on dentine blocks were prepared and observed under a scanning electron microscope. MC3T3-E1 pre-osteoblasts were seeded on 96-well plates and treated with chitosan or HTCC at various concentrations. The cytotoxicity of chitosan and HTCC on MC3T3-E1 pre-osteoblasts was detected using a Cell Counting Kit-8 assay after 24, 48 and 72 h of treatment. The results revealed that the final minimum bactericidal concentrations (MBC) of chitosan and HTCC dissolved in DDW were 70 and 140 µg/ml, respectively. Chitosan and HTCC in DDW exerted a significantly greater antibacterial effect as compared with that in PBS (P<0.05). At the MBC, chitosan and HTCC in DDW, but particularly chitosan, had a significant antibacterial effect on E. faecalis biofilm. Chitosan exhibited no cytotoxicity to MC3T3-E1 pre-osteoblasts at a concentration of <625 µg/ml, while HTCC inhibited the proliferation of the cells in the concentration range of 39-10,000 µg/ml. In conclusion, chitosan and HTCC exhibited prominent antibacterial properties on E. faecalis in the planktonic state and as a biofilm via charge interaction, indicating their potential for application in root canal disinfection and fillings.

Advances in biomolecule inspired polymeric material decorated interfaces for biological applications

With the development of surface modification technology, interface properties have great effects on the interaction between biomedical materials and cells and biomolecules, which significantly affects the biocompatibility and functionality of materials. As an orderly and perfect system, biological organisms in nature effectively integrate all kinds of bio-interfaces with physiological functions, which shed light on the importance of biomolecules in organisms. It gives birth to a bio-inspiration strategy to design and fabricate smart materials with specific functionalities, e.g. osteogenic and chondrocytic induced materials inspired by bone sialoprotein and chondroitin sulfate. Through this mimicking approach, various functional materials were utilized to decorate the interfaces and further optimize the performance of biomedical materials, which would widely expand their applications. In this review, followed by a summary and brief introduction of surface modification methods, we highlight recent advances in the fabrication of functional polymeric materials inspired by a range of biomolecules for decorating interfaces. Then, the other applications of biomolecule inspired materials including tissue engineering, diagnosis and treatment of diseases and physiological function regulation are presented and the future outlook is discussed as well.

Bioactivity Behavior Evaluation of PCL-Chitosan-Nanobaghdadite Coating on AZ91 Magnesium Alloy in Simulated Body Fluid

Polymer–ceramic composite coatings on magnesium-based alloys have attracted lots of attention in recent years, to control the speed of degradability and to enhance bioactivity and biocompatibility. In this study, to decrease the corrosion rate in a simulated body fluid (SBF) solution for long periods, to control degradability, and to enhance bioactivity, polycaprolactone–chitosan composite coatings with different percentages of baghdadite (0 wt.%, 3 wt.%, and 5 wt.%) were applied to an anodized AZ91 alloy. According to the results of the immersion test of the composite coating containing 3 wt.% baghdadite in a phosphate buffer solution (PBS), the corrosion rate decreased from 0.45 (for the AZ91 sample) to 0.11 mg/cm2·h after seven days of immersion. To evaluate the apatite formation capability of specimens, samples were immersed in an SBF solution. The results showed that the samples were bioactive as apatite layers formed on the surface of specimens. The composite coating containing 3 wt.% baghdadite showed the highest apatite-formation capability, with a controlled release of ions, and the lowest corrosion rate in the SBF.

Cytotoxicity and hemostatic activity of chitosan/carrageenan composite wound healing dressing for traumatic hemorrhage

Hemorrhage remains a big threat to trauma patients, especially in combat fields. Therefore, we formulated a biocompatible and biopolymer based chitosan/carrageenan composite dressing. This dressing was fabricated using freeze-drying that will serve as a promising material to promote hemostasis and tissue growth required during hemorrhage. The efficacy of dressing was evaluated for its physiochemical analysis, surface morphology, and biodegradability. Further, human dermal fibroblast cells were seeded on dressing and demonstrated non-toxic effects on the cells by showing enhanced cell attachment and proliferation. In vitro hemostatic properties of the dressing were analyzed by human Thrombin-Antithrombin assay. The dressing formed showed steady blood coagulation implying red blood cells and platelet adhesion that helped in thrombin formation, which is responsible for enhancing wound healing. Thus, it is concluded that the composite dressing can be a potent combination to accelerate hemostatic activity against hemorrhage and promote tissue growth for effective wound healing.

Surface Characterization of Electro-Assisted Titanium Implants: A Multi-Technique Approach

The understanding of chemical-physical, morphological, and mechanical properties of polymer coatings is a crucial preliminary step for further biological evaluation of the processes occurring on the coatings' surface. Several studies have demonstrated how surface properties play a key role in the interactions between biomolecules (e.g., proteins, cells, extracellular matrix, and biological fluids) and titanium, such as chemical composition (investigated by means of XPS, TOF-SIMS, and ATR-FTIR), morphology (SEM-EDX), roughness (AFM), thickness (Ellipsometry), wettability (CA), solution-surface interactions (QCM-D), and mechanical features (hardness, elastic modulus, adhesion, and fatigue strength). In this review, we report an overview of the main analytical and mechanical methods commonly used to characterize polymer-based coatings deposited on titanium implants by electro-assisted techniques. A description of the relevance and shortcomings of each technique is described, in order to provide suitable information for the design and characterization of advanced coatings or for the optimization of the existing ones.

Silver Nanoparticles on Chitosan/Silica Nanofibers: Characterization and Antibacterial Activity

A simple, low-cost, and reproducible method for creating materials with even silver nanoparticles (AgNP) dispersion was established. Chitosan nanofibers with silica phase (CS/silica) were synthesized by an electrospinning technique to obtain highly porous 3D nanofiber scaffolds. Silver nanoparticles in the form of a well-dispersed metallic phase were synthesized in an external preparation step and embedded in the CS/silica nanofibers by deposition for obtaining chitosan nanofibers with silica phase decorated by silver nanoparticles (Ag/CS/silica). The antibacterial activity of investigated materials was tested using Gram-positive and Gram-negative bacteria. The results were compared with the properties of the nanocomposite without silver nanoparticles and a colloidal solution of AgNP. The minimum inhibitory concentration (MIC) of obtained AgNP against Staphylococcus aureus (S. aureus) ATCC25923 and Escherichia coli (E. coli) ATCC25922 was determined. The physicochemical characterization of Ag/CS/silica nanofibers using various analytical techniques, as well as the applicability of these techniques in the characterization of this type of nanocomposite, is presented. The resulting Ag/CS/silica nanocomposites (Ag/CS/silica nanofibers) were characterized by small angle X-ray scattering (SAXS), X-ray diffraction (XRD), and atomic force microscopy (AFM). The morphology of the AgNP in solution, both initial and extracted from composite, the properties of composites, the size, and crystallinity of the nanoparticles, and the characteristics of the chitosan fibers were determined by electron microscopy (SEM and TEM).

Optimization of ZnAl/Chitosan Supra-Nano Hybrid Preparation as Efficient Antibacterial Material

The menace of antimicrobial resistance continues to increase and hence the need to discover new antibiotics, especially alternative and effective sources such as hybrid organic-inorganic, organic-organic materials, and other combinations. In this study, an antimicrobial hybrid supra-nano material was prepared by the bi-titration synthesis method of chitosan (CS) and ZnAl layered double hydroxide. Fourier-transform infrared spectrometer (FTIR), thermogravimetric and differential thermal gravimetric (TGA/DTG), ultraviolet-visible (UV-Vis), X-ray diffraction (XRD), and scanning electron microscopy (SEM) analyses indicated that the ZnAl/CS hybrid exhibited low crystallinity with high thermal stability. The results of ZnAl/CS characterization showed the characteristic properties of the individual components ZnAl and CS, indicating a successful preparation of the ZnAl/CS hybrid. The antibacterial tests revealed that the ZnAl/CS hybrid possessed an enhanced antimicrobial effect against both Escherichia coli (E. coli, MTCC 739) and Penicilliumcyclopium (P. cyclopium, AS 3.4513). Under the central composite design (CCD) of the response surface methodology (RSM) tool, the parameters of the hybrid synthesis reaction were optimized and the result obtained was as follows: reaction pH was 11.3, reagent Zn/Al ratio was 3.27, and chitosan concentration was 1.07 g/L. After optimization, it was found that the antibacterial activity of ZnAl/CS was strengthened against E. coli as evidenced by a widening of the inhibition zone of about 41.6%. The antibacterial activity of ZnAl/CS was mainly due to the reactivation of the antibacterial activity of CS associated with the release of Zn²⁺ and Al³⁺ metal ions in addition to ZnO, Al₂O₃, and ZnAl₂O₄ compounds resulting from the method of preparation.

Achievements in the Topographic Design of Commercial Titanium Dental Implants: Towards Anti-Peri-Implantitis Surfaces

Titanium and its alloys constitute the gold standard materials for oral implantology in which their performance is mainly conditioned by their osseointegration capacity in the host's bone. We aim to provide an overview of the advances in surface modification of commercial dental implants analyzing and comparing the osseointegration capacity and the clinical outcome exhibited by different surfaces. Besides, the development of peri-implantitis constitutes one of the most common causes of implant loss due to bacteria colonization. Thus, a synergic response from industry and materials scientists is needed to provide reliable technical and commercial solutions to this issue. The second part of the review focuses on an update of the recent findings toward the development of new materials with osteogenic and antibacterial capacity that are most likely to be marketed, and their correlation with implant geometry, biomechanical behavior, biomaterials features, and clinical outcomes.

Cytocompatible and Antibacterial Properties of Chitosan-Siloxane Hybrid Spheres

Microporous spheres in a hybrid system consisting of chitosan and γ-glycidoxypropyltrimethoxysilane (GPTMS) have advantages in a range of applications, e.g., as vehicles for cell transplantation and soft tissue defect filling materials, because of their excellent cytocompatibility with various cells. In this study, microporous chitosan-GPTMS spheres were prepared by dropping chitosan-GPTMS precursor sols, with or without a cerium chloride, into liquid nitrogen using a syringe pump. The droplets were then freeze dried to give the pores of size 10 to 50 μm. The cell culture tests showed that L929 fibroblast-like cells migrated into the micropores larger than 50 μm in diameter, whereas MG63 osteoblast-like cells proliferated well and covered the granule surfaces. The spheres with cerium chloride showed antibacterial properties against both gram-negative and gram-positive bacteria.

Novel Bioactive and Antibacterial Acrylic Bone Cement Nanocomposites Modified with Graphene Oxide and Chitosan

Acrylic bone cements (ABCs) have played a key role in orthopedic surgery mainly in arthroplasties, but their use is increasingly extending to other applications, such as remodeling of cancerous bones, cranioplasties, and vertebroplasties. However, these materials present some limitations related to their inert behavior and the risk of infection after implantation, which leads to a lack of attachment and makes necessary new surgical interventions. In this research, the physicochemical, thermal, mechanical, and biological properties of ABCs modified with chitosan (CS) and graphene oxide (GO) were studied. Fourier transform infrared (FTIR) spectroscopy, proton nuclear magnetic resonance (¹H-NMR) scanning electron microscopy (SEM), Raman mapping, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), compression resistance, mechanical dynamic analysis (DMA), hydrolytic degradation, cell viability, alkaline phosphatase (ALP) activity with human osteoblasts (HOb), and antibacterial activity against Gram-negative bacteria Escherichia coli were used to characterize the ABCs. The results revealed good dispersion of GO nanosheets in the ABCs. GO provided an increase in antibacterial activity, roughness, and flexural behavior, while CS generated porosity, increased the rate of degradation, and decreased compression properties. All ABCs were not cytotoxic and support good cell viability of HOb. The novel formulation of ABCs containing GO and CS simultaneously, increased the thermal stability, flexural modulus, antibacterial behavior, and osteogenic activity, which gives it a high potential for its uses in orthopedic applications.

Bibliographic review on the state of the art of strontium and zinc based regenerative therapies. Recent developments and clinical applications

This review brings up to date the state of the art of strontium and zinc based regenerative therapies, both having a promoting effect on tissue formation and a role inhibiting resorption in musculoskeletal disorders.