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Duta L, Grumezescu V. The Effect of Doping on the Electrical and Dielectric Properties of Hydroxyapatite for Medical Applications: From Powders to Thin Films. MATERIALS (BASEL, SWITZERLAND) 2024; 17:640. [PMID: 38591446 PMCID: PMC10856152 DOI: 10.3390/ma17030640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 04/10/2024]
Abstract
Recently, the favorable electrical properties of biomaterials have been acknowledged as crucial for various medical applications, including both bone healing and growth processes. This review will specifically concentrate on calcium phosphate (CaP)-based bioceramics, with a notable emphasis on hydroxyapatite (HA), among the diverse range of synthetic biomaterials. HA is currently the subject of extensive research in the medical field, particularly in dentistry and orthopedics. The existing literature encompasses numerous studies exploring the physical-chemical, mechanical, and biological properties of HA-based materials produced in various forms (i.e., powders, pellets, and/or thin films) using various physical and chemical vapor deposition techniques. In comparison, there is a relative scarcity of research on the electrical and dielectric properties of HA, which have been demonstrated to be essential for understanding dipole polarization and surface charge. It is noteworthy that these electrical and dielectric properties also offer valuable insights into the structure and functioning of biological tissues and cells. In this respect, electrical impedance studies on living tissues have been performed to assess the condition of cell membranes and estimate cell shape and size. The need to fill the gap and correlate the physical-chemical, mechanical, and biological characteristics with the electrical and dielectric properties could represent a step forward in providing new avenues for the development of the next-generation of high-performance HA-doped biomaterials for future top medical applications. Therefore, this review focuses on the electrical and dielectric properties of HA-based biomaterials, covering a range from powders and pellets to thin films, with a particular emphasis on the impact of the various dopants used. Therefore, it will be revealed that each dopant possesses unique properties capable of enhancing the overall characteristics of the produced structures. Considering that the electrical and dielectric properties of HA-based biomaterials have not been extensively explored thus far, the aim of this review is to compile and thoroughly discuss the latest research findings in the field, with special attention given to biomedical applications.
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Affiliation(s)
- Liviu Duta
- National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor St., 077125 Magurele, Romania
| | - Valentina Grumezescu
- National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor St., 077125 Magurele, Romania
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Assimilation of manganese metal ion doped hydroxyapatite by Co-Precipitation technique. J INDIAN CHEM SOC 2022. [DOI: 10.1016/j.jics.2022.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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El-Bassyouni GT, Turky GM, Kenawy SH, Abd El-Aty AA, Hamzawy EM. Effect of Yttrium Oxide in Hydroxyapatite Biocomposite Materials: Electrical and Antimicrobial Evaluation. ECS JOURNAL OF SOLID STATE SCIENCE AND TECHNOLOGY 2021; 10:123014. [DOI: 10.1149/2162-8777/ac44f6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Synthesis and characterization of biocomposite materials of hydroxyapatite (HA) and yttrium oxide (Y2O3) were investigated. HA nanoparticles powder was obtained from mussel shells via a wet chemical precipitation routine. HA powder was doped with 1 and 2 wt% of Y2O3. For microstructural examination, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), and scanning electron microscopy (SEM) coupled with energy dispersive X-rays (EDX) were used. In addition, the dielectric and electrical properties and antimicrobial activities were investigated. XRD patterns reveal the crystallization of the oxyapatite. The peak intensities of pristine HA are inferior compared to the yttrium containing HA composites, thus suggesting that the addition of yttrium promotes the crystallization of HA due to the variance in their ionic radii. FT-IR shows a variation in the phosphate wavenumber, indicating the integration of yttrium into the HA matrix. SEM reveals nanorod- or worm-like crystals arose in clusters. With increasing Y2O3, from 1 to 2 wt%, the DC conductivity reduces from 16 to 9.3 nS/cm, which confirms that high amounts of Y3+ substitute Ca2+ in the HA matrix. In the high-frequency range, the AC conductivity linearly increases with increasing frequency following the universal power law. Further, antimicrobial activity results showed that the addition of yttrium in HA improves the antimicrobial effects against pathogenic bacteria and fungi. Additional research is needed to investigate the doping concentration of yttrium ions, and an anticipated property could be comprehended for several forthcoming biomedical applications.
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Albulym O, Kaygili O, Hussien MSA, Zahran HY, Kilany M, Darwish R, Bulut N, Alshahrie A, Yahia IS. Synthesis and Characterization of Yttrium-Doped Hydroxyapatite Nanoparticles and Their Potential Antimicrobial Activity. J BIOMATER TISS ENG 2021. [DOI: 10.1166/jbt.2021.2758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study reports a detailed analysis of the yttrium doping effects into hydroxyapatite (HAp) nano-structures at different amounts (e.g., 0, 1, 2.5, 5, 7.5, 10, and 15%) on the structural, spectroscopic, dielectric, and antimicrobial properties. For this purpose, seven HAp samples
having the Y-contents mentioned above were prepared using the microwave-assisted sol-gel precipitation technique. The structure of synthesized samples was fully described via X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier transforms infrared (FTIR). Raman spectroscopy
and dielectric measurements were used to characterize the spectroscopic properties. Furthermore, the samples’ antimicrobial features have been assisted through the agar disk diffusion technique. This study showed that the crystallinity decreased with the adding of Y-ions inside the HAp
matrix. The Y-contents have influenced the crystallite size, lattice parameters, dislocation density, lattice strain, and unit cell volume. The surface morphology is composed of the agglomerated smaller particles. Remarkable changes in the dielectric properties were observed with the adding
of Y-ions. The alternating current conductivity obeys the Jonscher’s relation. Y-doped hydroxyapatite nanoparticles have a considerable inhibitory effect against bacteria and fungi (Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans).
The Y-doped hydroxyapatite nanoparticles are a promising material for bone cement engineering with a potential bio-activity
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Affiliation(s)
- Obaid Albulym
- Department of Biology, Faculty of Science, King Khalid University, Abha, 61421, Saudi Arabia
| | - Omer Kaygili
- Department of Physics, Faculty of Science, Firat University, 23119, Elazig, Turkey
| | - Mai S. A. Hussien
- Department of Chemistry, Faculty of Education, Ain Shams University, Roxy, 11757, Cairo, Egypt
| | - H. Y. Zahran
- Nanoscience Laboratory for Environmental and Bio-Medical Applications (NLEBA), Semiconductor Lab., Metallurgical Lab. 1, Department of Physics, Faculty of Education, Ain Shams University, Roxy, 11757, Cairo, Egypt
| | - Mona Kilany
- Department of Biology, Faculty of Science, King Khalid University, Abha, 61421, Saudi Arabia
| | - R. Darwish
- Physics Department, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Niyazi Bulut
- Department of Physics, Faculty of Science, Firat University, 23119, Elazig, Turkey
| | - Ahmed Alshahrie
- Physics Department, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - I. S. Yahia
- Nanoscience Laboratory for Environmental and Bio-Medical Applications (NLEBA), Semiconductor Lab., Metallurgical Lab. 1, Department of Physics, Faculty of Education, Ain Shams University, Roxy, 11757, Cairo, Egypt
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Pharmaceutical electrospinning and 3D printing scaffold design for bone regeneration. Adv Drug Deliv Rev 2021; 174:504-534. [PMID: 33991588 DOI: 10.1016/j.addr.2021.05.007] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/26/2021] [Accepted: 05/11/2021] [Indexed: 12/13/2022]
Abstract
Bone regenerative engineering provides a great platform for bone tissue regeneration covering cells, growth factors and other dynamic forces for fabricating scaffolds. Diversified biomaterials and their fabrication methods have emerged for fabricating patient specific bioactive scaffolds with controlled microstructures for bridging complex bone defects. The goal of this review is to summarize the points of scaffold design as well as applications for bone regeneration based on both electrospinning and 3D bioprinting. It first briefly introduces biological characteristics of bone regeneration and summarizes the applications of different types of material and the considerations for bone regeneration including polymers, ceramics, metals and composites. We then discuss electrospinning nanofibrous scaffold applied for the bone regenerative engineering with various properties, components and structures. Meanwhile, diverse design in the 3D bioprinting scaffolds for osteogenesis especially in the role of drug and bioactive factors delivery are assembled. Finally, we discuss challenges and future prospects in the development of electrospinning and 3D bioprinting for osteogenesis and prominent strategies and directions in future.
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Shkir M. Noticeable impact of Er doping on structural, vibrational, optical, dielectric and electrical parameters of flash combustion synthesized NiO NPs for optoelectronic applications. INORG CHEM COMMUN 2020. [DOI: 10.1016/j.inoche.2020.108229] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Shkir M, Khan ZR, Chandekar KV, Alshahrani T, Kumar A, AlFaify S. A facile microwave synthesis of Cr-doped CdS QDs and investigation of their physical properties for optoelectronic applications. APPLIED NANOSCIENCE 2020. [DOI: 10.1007/s13204-020-01505-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Gurgenc T, Biryan F. Production, thermal and dielectrical properties of Ag-doped nano-strontium apatite and nano h-BN filled poly(4-(3-(2,3,4-trimethoxyphenyl) acryloyl) phenyl acrylate) composites. JOURNAL OF POLYMER RESEARCH 2020. [DOI: 10.1007/s10965-020-02166-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Sundarabharathi L, Ponnamma D, Parangusan H, Chinnaswamy M, Al-Maadeed MAA. Effect of anions on the structural,
morphological and dielectric properties of hydrothermally synthesized hydroxyapatite
nanoparticles. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-019-1807-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Abstract
Synthetic nano hydroxyapatites (HA) have been considered as
potential biomaterials for bone tissue engineering applications because of its
excellent biological properties. The present work deals with the synthesis of HA
nanoparticles from different anion source materials via autoclave assisted
hydrothermal method. All the prepared HA nanoparticles were characterized by
X-ray diffraction (XRD), Fourier transformation infrared spectra, field emission
scanning electron microscopy, energy dispersive spectra and high resolution
transmission electron microscopy. The XRD patterns reveal the pure and hexagonal
phase structure with smaller crystallite size for HA obtained from various
calcium salt precursors. HA particles prepared from nitrate precursors show
spherical morphology with 32 nm grain size whereas those derived from the
acetate, chloride and egg shell precursors respectively show needle-like,
irregular and oval morphology. The effect of different anions on the dielectric
properties and alternating conductivity of HA is investigated, as a polarized
surface can trigger biological reactions. For the particles obtained from
nitrate, acetate, chloride and egg shell precursors respectively give dielectric
constant (εʹ) values of 9.96, 13.22, 9.92 and 10.86 at 5 MHz. The εʹ and
dielectric loss (εʹʹ) values for the HA nanoparticles decrease with increase in
the applied frequency as well. The alternating current conductivity values
confirm that the as-synthesized HA samples exhibit insulating behavior. In short
this article provides the various applicability of HA particles in
optoelectronics and drug delivery.
Graphic abstract
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Shkir M, Ganesh V, AlFaify S, Yahia I, Maurya K. Remarkable effect of l-Ascorbic acid on crystal morphology, structural, crystalline perfection, optical, photoluminescence and dielectric properties of Zinc(tris) thiourea sulphate (ZTS) single crystals. ARAB J CHEM 2020. [DOI: 10.1016/j.arabjc.2017.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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El Khouri A, Zegzouti A, Elaatmani M, Capitelli F. Bismuth-substituted hydroxyapatite ceramics synthesis: Morphological, structural, vibrational and dielectric properties. INORG CHEM COMMUN 2019. [DOI: 10.1016/j.inoche.2019.107568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Basu S, Basu B. Unravelling Doped Biphasic Calcium Phosphate: Synthesis to Application. ACS APPLIED BIO MATERIALS 2019; 2:5263-5297. [DOI: 10.1021/acsabm.9b00488] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Subhadip Basu
- Materials Research Centre, Indian Institute of Science, Bangalore 560012, India
| | - Bikramjit Basu
- Materials Research Centre, Indian Institute of Science, Bangalore 560012, India
- Center for BioSystems Science and Engineering, Indian Institute of Science, Bangalore 560012, India
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Shkir M, Ganesh V, AlFaify S, Maurya KK, Vijayan N. Effect of phenol red dye on monocrystal growth, crystalline perfection, and optical and dielectric properties of zinc (tris) thiourea sulfate. J Appl Crystallogr 2017. [DOI: 10.1107/s1600576717014339] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In this work, the growth of large size (∼25 × 29 × 5 mm and ∼25 × 24 × 6 mm) colorful single crystals of zinc (tris) thiourea sulfate (ZTS) in the presence of 0.05–2 wt% phenol red (PR) dye was achieved using a simple and low-cost technique. Powder X-ray diffraction patterns confirm the presence of PR dye, which is indicated by an enhancement of the Raman peak intensities, a shift in their position and the appearance of a few extra peaks. The quality of the grown crystals was assessed by high-resolution X-ray diffraction, which shows that the crystalline perfection of 1 wt% PR-dyed ZTS crystals is better than that of 2 wt% PR-dyed crystals. The measured UV–vis absorbance spectra show two additional, strong absorption bands at ∼430 and 558 nm in the dyed crystals, due to the presence of PR dye, along with a band at ∼276 nm which is present for all crystals but is slightly shifted for the dyed crystals. Photoluminescence spectra were recorded at two excitation wavelengths (λexc= 310 and 385 nm). The luminescence intensity is found to be enriched in dyed crystals, with some extra emission bands. An enhancement in the value of the dielectric constant and a.c. electrical conductivity was also observed in the dyed ZTS crystals.
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Sundarabharathi L, Parangusan H, Ponnamma D, Al-Maadeed MAA, Chinnaswamy M. In-vitro biocompatibility, bioactivity and photoluminescence properties of Eu 3+ /Sr 2+ dual-doped nano-hydroxyapatite for biomedical applications. J Biomed Mater Res B Appl Biomater 2017; 106:2191-2201. [PMID: 29052356 DOI: 10.1002/jbm.b.34023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/15/2017] [Accepted: 09/24/2017] [Indexed: 12/12/2022]
Abstract
In the present investigation, we have successfully synthesized luminescent Eu3+ -doped and Eu3+ /Sr2+ codoped hydroxyapatite (HA) nanoparticles through sol-gel assisted precipitation method with the aim of developing novel biomaterials containing osteoblast mineral (Sr2+ ) and luminescence activator (Eu3+ ). The structure, morphology, thermal stability, and luminescence properties of the resultant spherical nanoparticles (50-100 nm diameters) were studied. Moreover, the in-vitro bioactivity of Eu0.1 Sr0.1 HA nanoparticles was investigated by immersing in the simulated body fluid for many weeks. The antimicrobial activity results against gram positive and gram negative bacterial stains, showed better resistivity for the Eu0.1 Sr0.1 HA among the other compositions. The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay of live/dead cells cultured with Eu3+ /Sr2+ -doped HA nanoparticles retained its normal morphology and did not show a significant impact on cell proliferation at various incubation days, which evidence for the material's superior biocompatible nature even at a higher concentration of 375 µg/mL. Thus, the incorporation of dual ions in HA nanoparticles with strong luminescence properties develops potential biomaterial for live cell imaging and in nanomedicine. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2191-2201, 2018.
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Affiliation(s)
| | | | | | | | - Mahendran Chinnaswamy
- Department of Physics, Sri Ramakrishna Mission Vidyalaya College of Arts and Science, Coimbatore, Tamil Nadu, India
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Robinson L, Salma-Ancane K, Stipniece L, Meenan BJ, Boyd AR. The deposition of strontium and zinc Co-substituted hydroxyapatite coatings. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:51. [PMID: 28197823 DOI: 10.1007/s10856-017-5846-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/04/2017] [Indexed: 06/06/2023]
Abstract
The in vitro and in vivo performance of hydroxyapatite (HAp) coatings can be modified by the addition of different trace ions, such as silicon (Si), lithium (Li), magnesium (Mg), zinc (Zn) or strontium (Sr) into the HAp lattice, to more closely mirror the complex chemistry of human bone. To date, most of the work in the literature has considered single ion-substituted materials and coatings, with limited reports on co-substituted calcium phosphate systems. The aim of this study was to investigate the potential of radio frequency magnetron sputtering to deposit Sr and Zn co-substituted HAp coatings using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS). The FTIR and XPS results highlight that all of the Sr, Zn and Sr-Zn co-substituted surfaces produced are all dehydroxylated and are calcium deficient. All of the coatings contained HPO42- groups, however; only the pure HAp coating and the Sr substituted HAp coating contained additional CO32- groups. The XRD results highlight that none of the coatings produced in this study contain any other impurity CaP phases, showing peaks corresponding to that of ICDD file #01-072-1243 for HAp, albeit shifted to lower 2θ values due to the incorporation of Sr into the HAp lattice for Ca (in the Sr and Sr-Zn co-substituted surfaces only). Therefore, the results here clearly show that RF magnetron sputtering offers a simple means to deliver Sr and Zn co-substituted HAp coatings with enhanced surface properties. (a) XRD patterns for RF magnetron sputter deposited hydroxyapatite coatings and (b)-(d) for Sr, Zn and Sr-Zn co-substituted coatings, respectively. The XPS spectra in (b) confirms the presence of a HA sputter deposited coating as opposed to
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Affiliation(s)
- L Robinson
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, Northern Ireland, UK
| | - K Salma-Ancane
- Rudolfs Cimdins Riga Biomaterials Innovations and Development Centre of RTU, Institute of General Chemical Engineering, Faculty of Materials Science and Applied Chemistry, Riga Technical University, Pulka 3, Riga, LV, 1007, Latvia
| | - L Stipniece
- Rudolfs Cimdins Riga Biomaterials Innovations and Development Centre of RTU, Institute of General Chemical Engineering, Faculty of Materials Science and Applied Chemistry, Riga Technical University, Pulka 3, Riga, LV, 1007, Latvia
| | - B J Meenan
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, Northern Ireland, UK
| | - A R Boyd
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, Northern Ireland, UK.
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Facile microwave-assisted synthesis of Te-doped hydroxyapatite nanorods and nanosheets and their characterizations for bone cement applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 72:472-480. [PMID: 28024611 DOI: 10.1016/j.msec.2016.11.074] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/19/2016] [Accepted: 11/21/2016] [Indexed: 02/06/2023]
Abstract
In this work, the authors have fabricated the nanorods and nanosheets of pure and Te-doped HAp with different Te concentrations (0.04, 0.08, 0.16, 0.24wt%) by microwave-assisted technique at low temperature. The crystallite size, degree of crystallinity and lattice parameters are calculated. FE-SEM study confirms that the fabricated nanostructures are nanorods of diameter about 10nm in undoped and at low concentration of Te doping. However, at and higher concentration, it becomes nanosheets of about 5nm thickness. X-ray diffraction, FT-IR and FT-Raman studies shows that the prepared products are of HAp and Te has been successfully incorporated. From EDX the Ca/P molar ratio of the pure HAp is about 1.740, while this ratio for 0.04, 0.08, 0.16, 0.24 wt% Te doped is about 1.53, 1.678, 1.724, 1.792, respectively. Crystallite size was found to be increased with Te doping from 15nm to 62nm. The value of dielectric constant is found to be enhanced at higher concentrations of Te. The values of linear absorption coefficient were also determined and show that the prepared material with Te doping is more absorbable than pure and will be highly applicable in radiation detection applications. Furthermore, the antimicrobial potential of pure and Te doped HAp was examined against some Gram- negative and positive bacteria and fungi by agar disk diffusion method. The results demonstrated that the antimicrobial activity of Te doped HAp is stronger than that of pure HAp where it exhibited the highest activity against Bacillus subtilis>Candida albicans>Shigella dysenteriae.
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