Biofilm behavior on sulfonated poly(ether-ether-ketone) (sPEEK)

The Formation Process and Mechanism of the 3D Porous Network on the Sulfonated PEEK Surface

A three-dimensional (3D) porous network can be prepared on the PEEK surface by sulfonation with enhanced osseointegration and antibacterial properties. However, few studies have been conducted on the formation mechanism of a 3D porous network. In this work, the surface and cross-sectional morphologies, chemical compositions, functional groups, surface wettability, and crystalline states of sulfonated PEEK were investigated at different sulfonation times and coagulant concentrations. The results show that the number of nodular structures and broken fibers on the sulfonated PEEK surface as well as the size of macrovoids in the cross sections increase with increasing sulfonation times when water is used as a coagulant. In contrast, dilute sulfuric acid as a coagulant can inhibit the formation of surface porous structures and macrovoids in the cross sections. Moreover, all of the sulfonated PEEK samples have the same chemical compositions but exhibit better hydrophilicity as the number of microsized pores decreases. It is proposed that non-solvent-induced phase separation (NIPS) occurs during the sulfonation process, and the formation mechanism of surface and cross-sectional morphologies is discussed. Furthermore, it is assumed that the air is trapped in the microsized pores, leaving the surface of the 3D porous network in the Cassie-wetting state. All of these preliminary results throw light on the nature of the sulfonation process and may guide further modification of the structures of sulfonated PEEK.

Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction

The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.

Antifouling Coatings from Glassy Polyelectrolyte Complex Films

Coatings that prevent or decrease fouling are sought for many applications, including those that inhibit the attachment of organisms in aquatic environments. To date, antifouling coatings have mostly followed design criteria assembled over decades: surfaces should be well/strongly hydrated, possess low net charge, and maintain a hydrophilic character when exposed to the location of use. Thus, polymers based on ethylene glycol or zwitterionic repeat units have been shown to be highly effective. Unfortunately, hydrated materials can be quite soft, limiting their use in some environments. In a major paradigm shift, this work describes glassy antifouling films made from certain complexes of positive and negative polyelectrolytes. The dense network of electrostatic interactions yields tough materials below the glass transition temperature, Tg, in normal use, while the highly ionic character of these polyelectrolyte complexes ensures strong hydration. The proximity of equal numbers of opposite charges within these complexes mimics zwitterionic structures. Films, assembled layer-by-layer from aqueous solutions, contained sulfonated poly(ether ether ketone), SPEEK, a rigid polyelectrolyte that binds strongly to a selection of quaternary ammonium polycations. Layer-by-layer buildup of SPEEK and polycations was linear, indicating strong complexes between polyelectrolytes. Calorimetry also showed that complex formation was exothermic. Surfaces coated with these films in the 100 nm thickness range completely resisted adhesion of the common flagellate green algae, Chlamydomonas reinhardtii, which were removed from surfaces at a minimum applied flow rate of 0.8 cm s-1. The total surface charge density of adsorbed cations, determined with a sensitive radioisotopic label, was very low, around 10% of a monolayer, which minimized adsorption driven by counterion release from the surface. The viscoelastic properties of the complexes, which were stable even in concentrated salt solutions, were explored using rheology of bulk samples. When fully hydrated, their Tg values were observed to be above 75 °C.

Liver-Inspired Polyetherketoneketone Scaffolds Simulate Regenerative Signals and Mobilize Anti-Inflammatory Reserves to Reprogram Macrophage Metabolism for Boosted Osteoporotic Osseointegration

Tissue regeneration is regulated by morphological clues of implants in bone defect repair. Engineered morphology can boost regenerative biocascades that conquer challenges such as material bioinertness and pathological microenvironments. Herein, a correlation between the liver extracellular skeleton morphology and the regenerative signaling, namely hepatocyte growth factor receptor (MET), is found to explain the mystery of rapid liver regeneration. Inspired by this unique structure, a biomimetic morphology is prepared on polyetherketoneketone (PEKK) via femtosecond laser etching and sulfonation. The morphology reproduces MET signaling in macrophages, causing positive immunoregulation and optimized osteogenesis. Moreover, the morphological clue activates an anti-inflammatory reserve (arginase-2) to translocate retrogradely from mitochondria to the cytoplasm due to the difference in spatial binding of heat shock protein 70. This translocation enhances oxidative respiration and complex II activity, reprogramming the metabolism of energy and arginine. The importance of MET signaling and arginase-2 in the anti-inflammatory repair of biomimetic scaffolds is also verified via chemical inhibition and gene knockout. Altogether, this study not only provides a novel biomimetic scaffold for osteoporotic bone defect repair that can simulate regenerative signals, but also reveals the significance and feasibility of strategies to mobilize anti-inflammatory reserves in bone regeneration.

Near-ultraviolet irradiation to stimulate unmodified polyether ether ketone to achieve stable and sustainable antibacterial activity

OBJECTIVES

This study aims to investigate the cytotoxicity and sustainable antibacterial activity of unmodified PEEK under specific wavelength light treatment (365 nm), and its antibacterial mechanism was also preliminarily discussed.

METHODS

A near-ultraviolet source with a wavelength of 365 nm and a power of 5 W were selected. The irradiation time was 30 min, and the distance was 100 mm. A water contact angle tester was used to characterize the surface of the PEEK after 1-15 light treatments. MC3TC-E1 cells were used to evaluate the cytotoxicity of the materials under light treatment. Five kinds of common oral bacteria were detected in vitro, and antibacterial efficiency was determined by colony-forming unit (CFU) and scanning electron microscope (SEM). The antibacterial mechanism of PEEK under light was preliminarily discussed by spectrophotometry. The membrane rupture of Staphylococcus aureus and Escherichia coli was detected by lactate dehydrogenase. Staphylococcus aureus and Staphylococcus mutans were selected for the cyclic antibacterial test. Statistical analysis was performed by one-way analysis of variance and Tukey multiple range test. A significance level of 0.05 was considered (α = 0.05).

RESULTS

The results of the cell experiment showed that PEEK had no cytotoxicity (P > 0.05). CFU results showed that PEEK had an obvious antibacterial effect on Staphylococcus aureus, Staphylococcus mutans, Staphylococcus gordonii and Staphylococcus sanguis, but had no antibacterial effect on Escherichia coli (P < 0.05). The SEM results also verified the above antibacterial effect. The existence of singlet oxygen was confirmed by spectrophotometry. Meanwhile, the rupture of Staphylococcus aureus membrane was verified by lactate dehydrogenase assay. The water contact angle of the PEEK surface did not change significantly after 15 cycles of light treatment. Cyclic antibacterial experiments showed that the antibacterial effect was sustainable.

CONCLUSIONS

This study showed that PEEK has good cytocompatibility with stable and sustainable antibacterial properties under near-ultraviolet. It provides a new idea to solve the non-antibacterial property of PEEK, and also provides a theoretical basis for its further application in dentistry.

Antibacterial properties of antimicrobial peptide HHC36 modified polyetheretherketone

Introduction

Polyetheretherketone (PEEK) is considered to be a new type of orthopedic implant material due to its mechanical properties and biocompatibility. It is becoming a replacement for titanium (Ti) due to its near-human-cortical transmission and modulus of elasticity. However, its clinical application is limited because of its biological inertia and susceptibility to bacterial infection during implantation. To solve this problem, there is an urgent need to improve the antibacterial properties of PEEK implants.

Methods

In this work, we fixed antimicrobial peptide HHC36 on the 3D porous structure of sulfonated PEEK (SPEEK) by a simple solvent evaporation method (HSPEEK), and carried out characterization tests. We evaluated the antibacterial properties and cytocompatibility of the samples in vitro. In addition, we evaluated the anti-infection property and biocompatibility of the samples in vivo by establishing a rat subcutaneous infection model.

Results

The characterization test results showed that HHC36 was successfully fixed on the surface of SPEEK and released slowly for 10 days. The results of antibacterial experiments in vitro showed that HSPEEK could reduce the survival rate of free bacteria, inhibit the growth of bacteria around the sample, and inhibit the formation of biofilm on the sample surface. The cytocompatibility test in vitro showed that the sample had no significant effect on the proliferation and viability of L929 cells and had no hemolytic activity on rabbit erythrocytes. In vivo experiments, HSPEEK can significantly reduce the bacterial survival rate on the sample surface and the inflammatory reaction in the soft tissue around the sample.

Discussion

We successfully loaded HHC36 onto the surface of SPEEK through a simple solvent evaporation method. The sample has excellent antibacterial properties and good cell compatibility, which can significantly reduce the bacterial survival rate and inflammatory reaction in vivo. The above results indicated that we successfully improved the antibacterial property of PEEK by a simple modification strategy, making it a promising material for anti-infection orthopedic implants.

On-Off Phagocytosis and Switchable Macrophage Activation Stimulated with NIR for Infected Percutaneous Tissue Repair of Polypyrrole-Coated Sulfonated PEEK

Intelligent control of the immune response is essential for obtaining percutaneous implants with good sterilization and tissue repair abilities. In this study, polypyrrole (Ppy) nanoparticles enveloping a 3D frame of sulfonated polyether ether ketone (SP) surface are constructed, which enhance the surface modulus and hardness of the sulfonated layer by forming a cooperative structure of simulated reinforced concrete and exhibit a superior photothermal effect. Ppy-coated SP could quickly accumulate heat on the surface by responding to 808 nm near-infrared (NIR) light, thereby killing bacteria, and destroying biofilms. Under NIR stimulation, the phagocytosis and M1 activation of macrophages cultured on Ppy-coated SP are enhanced by activating complement 3 and its receptor, CD11b. Phagocytosis and M1 activation are impaired along with abolishment of NIR stimulation in the Ppy-coated SP group, which is favorable for tissue repair. Ppy-coated SP promotes Collagen-I, vascular endothelial growth factor, connective tissue growth factor, and α-actin (Acta2) expression by inducing M2 polarization owing to its higher surface modulus. Overall, Ppy-coated SP with enhanced mechanical properties could be a good candidate for clinical percutaneous implants through on-off phagocytosis and switchable macrophage activation stimulated with NIR.

Use of Piranha Solution as An Alternative Route to Promote Bioactivation of PEEK Surface with Low Functionalization Times

This study aimed to achieve bioactivity on the PEEK surface using piranha solution through a lower functionalization time. For this purpose, the functionalization occurred with piranha solution and 98% sulfuric acid in the proportions of 1:2, 1:1, and 2:1 at periods of 30, 60, and 90 s. The samples treated for longer times at higher concentrations registered the characteristic spectroscopy band associated with sulfonation. Additionally, both chemical treatments allowed the opening of the aromatic ring, increasing the number of functional groups available and making the surface more hydrophilic. The piranha solution treatments with higher concentrations and longer times promoted greater heterogeneity in the surface pores, which affected the roughness of untreated PEEK. Furthermore, the treatments induced calcium deposition on the surface during immersion in SBF fluid. In conclusion, the proposed chemical modifications using sulfuric acid SPEEK 90 and, especially, the piranha solution PEEK-PS 2:1-90, were demonstrated to be promising in promoting the rapid bioactivation of PEEK-based implants.

Strategies to improve bioactive and antibacterial properties of polyetheretherketone (PEEK) for use as orthopedic implants

Polyetheretherketone (PEEK) has gradually become the mainstream material for preparing orthopedic implants due to its similar elastic modulus to human bone, high strength, excellent wear resistance, radiolucency, and biocompatibility. Since the 1990s, PEEK has increasingly been used in orthopedics. Yet, the widespread application of PEEK is limited by its bio-inertness, hydrophobicity, and susceptibility to microbial infections. Further enhancing the osteogenic properties of PEEK-based implants remains a difficult task. This article reviews some modification methods of PEEK in the last five years, including surface modification of PEEK or incorporating materials into the PEEK matrix. For surface modification, PEEK can be modified by chemical treatment, physical treatment, or surface coating with bioactive substances. For PEEK composite material, adding bioactive filler into PEEK through the melting blending method or 3D printing technology can increase the biological activity of PEEK. In addition, some modification methods such as sulfonation treatment of PEEK or grafting antibacterial substances on PEEK can enhance the antibacterial performance of PEEK. These strategies aim to improve the bioactive and antibacterial properties of the modified PEEK. The researchers believe that these modifications could provide valuable guidance on the future design of PEEK orthopedic implants.

Microstructure and Selected Properties of Advanced Biomedical n-HA/ZnS/Sulfonated PEEK Coatings Fabricated on Zirconium Alloy by Duplex Treatment

In this work, sulfonated polyetheretherketone (S-PEEK)-based coatings, nanocrystalline ZnS and hydroxyapatite (n-HA) particles were developed on Zr-2.5Nb zirconium alloy substrates by electrophoretic deposition (EPD) combined with subsequent heat treatment. The properties of suspensions and deposition kinetics were studied. Cationic chitosan polyelectrolyte ensured the stabilization of the suspension and allowed for the co-deposition of all coating components on the cathode. The heating of the coated samples at a temperature of 450 °C and slow cooling resulted in sulfonation of the PEEK and the formation of dense coatings. The coatings were characterized by high roughness, hardness, modulus of elasticity and adhesion strength. The coatings revealed mild hydrophilicity, improved the electrochemical corrosion resistance of the alloy and induced the formation of hydroxyapatite with a cauliflower-like morphology on its surface during the Kokubo test. This work explored the great development potential of advanced sulfonated PEEK-based coatings, incorporating antibacterial and bioactive components by EPD combined with heat treatment to stimulate the surface properties of zirconium alloy for prospective dental and orthopedic applications. The antibacterial and osteoconductive properties of the obtained coatings should be further investigated.

Effect of PEEK Particles on Physiomechanical Behavior of Carbon/Epoxy Composite

The inherently brittle nature and the susceptibility to impact damage hinder the use of carbon/epoxy composite in some areas. In this study, poly ether ether ketone (PEEK) microparticles were incorporated to increase the resistance to delamination and interlaminar fracture toughness. A hand lay-up technique followed by compression molding was used to fabricate composite. The influence of PEEK particles was evaluated by tensile, flexural, short beam shear (SBS), compression, and Charpy impact test. The Barcol hardness, density, fiber volume fraction, and void content were also determined. According to the result, a maximum improvement in the tensile and flexural strength was observed for 2% incorporation of PEEK particles. However, there is downturn found in the flexural modulus. Moreover, a notable increment in the matrix-dominated properties (short beam shear, compression, and Charpy impact strength) was found with the addition of the PEEK particles.

Effect of Acid-Etching Duration on the Adhesive Performance of Printed Polyetheretherketone to Veneering Resin

Three-dimensional printing polyetheretherketone (PEEK) provides a new choice for dental prostheses, while its appropriate bonding procedure and adhesive performance are still unclear. This study aimed to investigate the adhesive performance of printed polyetheretherketone (PEEK) after acid etching to veneering resin. In total, 182 PEEK specimens (including 91 printed and 91 milled specimens) were distributed to 14 subgroups (n = 13/subgroup), according to the manufacturing process and surface treatment. The specimens were polished and etched with sulfuric acid for 0, 5, 30, 60, 90, 120, and 300 s, respectively. Two specimens in each subgroup were observed under a scanning electron microscope (SEM) for surface and cross-section morphology separately. Then, the specimens were treated with a bonding primer, and one specimen in each subgroup was prepared for cross-sectional observation under SEM. The residual 10 specimens of each subgroup bonded with veneering resin were tested with the shear bond strength tests (SBS) and failure modes analysis. Statistical analysis was performed by one-way ANOVA followed by the SNK-q post hoc test (p < 0.05). The etched pores on the PEEK surface were broadened and deepened under SEM over time. Printed PEEK etched for 30 s obtained the best SBS-to-veneering-resin ratio (27.90 ± 3.48 MPa) among the printed subgroups (p < 0.05) and had no statistical differences compared with milled PEEK etched for 30 s. The SBS of the milled subgroups etched from 5 to 120 s were over 29 MPa without significant between-group statistical differences. Hence, printed PEEK can be coarsened effectively by 30 s of sulfuric acid etching. The adhesion efficacy of printed PEEK to veneering resin was qualified for clinical requirements of polymer-based fixed dentures.

A sulfonate-based polypeptide toward infection-resistant coatings

Multifunctional coatings have gained significant attention for their promising potential to address the issue of medical device-related infections. However, they usually have multiple components in one layer which decreases the density of functional groups on surfaces and hence reduces the biological properties. Herein, we report a mono-component and sulfonate-based anionic polypeptide coating with on-demand antibacterial activity, antifouling property, and biocompatibility. The anionic polypeptide was prepared by ring-opening polymerization of L-cysteine-based N-carboxyanhydride (NCA) with allyl groups and a subsequent thiol-ene reaction to incorporate the sulfonate pendants. It adopted a 17.1-19.5% β-sheet conformation and self-assembled into a spherical nanoparticle. The polypeptide coating showed excellent in vitro antibacterial activity against both Gram-positive (i.e., S. aureus) and Gram-negative bacteria (i.e., E. coli) with >99% killing efficacy after acidic solution treatment and prominent antifouling property and biocompatibility after weak base treatment. An in vivo study revealed that the sulfonate-based polypeptide-coated polydimethylsiloxane (PDMS) exhibited good anti-infection property and histocompatibility.

Biocompatible Sulphonated PEEK Spheres: Influence of Processing Conditions on Morphology and Swelling Behavior

This work aimed to develop and evaluate the influence of processing variables on the morphology and swelling of sulfonated poly(ether ether ketone) (SPEEK) spheres for possible applications as a biomaterial. We used the drip method to obtain spheres with the polymer starting solutions SPEEK-6 (w/v: 6%) and SPEEK-10 (w/v: 10%), drip rates (20 and 30 mL/h), and drip heights (5 and 10 cm) in experimental planning. The samples were characterized by Fourier-transform infrared spectroscopy (FTIR), optical microscopy (OM), the absorption capacity of phosphate-buffered saline (PBS) by swelling (%), and statistical analysis of data through Design of Experiments (DOE). The obtained results evidenced that the processing variables influenced the morphology and swelling. Spheres with a bigger concentration of the polymer solution presented a greater degree of sulfonation (DS). We verified that the diameter of the spheres was directly related to the variable height and the sphericity was associated with the speed and viscosity of the solution. Bigger and more pores in a greater amount were observed in the spheres with a greater DS, influencing the behavior of the swelling in PBS. The better variable combinations with a high DS, regular sphericity, a smaller diameter, and greater swelling were the samples S₂-10-20-5 e S₁₀-10-20-5. The cytotoxicity indicated that the best samples obtained in the experimental planning (S₂-10-20-5 and S₁₀-10-20-5) were not toxic. In that regard, the evaluated spheres presented cell viability and swelling capacity, suggesting their possible applications as biomaterials.

Surface Bioactivation of Polyether Ether Ketone (PEEK) by Sulfuric Acid and Piranha Solution: Influence of the Modification Route in Capacity for Inducing Cell Growth

The aim of this study was to promote bioactivity of the PEEK surface using sulfuric acid and piranha solution. PEEK was functionalized by a sulfuric acid treatment for 90 s and by piranha solution for 60 and 90 s. Chemical modification of the PEEK surface was evaluated by infrared spectroscopy, contact angle analysis, cytotoxicity, cell adhesion and proliferation. The spectroscopy characteristic band associated with sulfonation was observed in all treated samples. PEEK with piranha solution 60 s showed an increase in the intensity of the bands, which was even more significant for the longer treatment (90 s). The introduction of the sulfonic acid functional group reduced the contact angle. In cytotoxicity assays, for all treatments, the number of viable cells was higher when compared to those of untreated PEEK. PEEK treated with sulfuric acid and piranha solution for 60 s were the treatments that showed the highest percentage of cell viability with no statistically significant differences between them. The modified surfaces had a greater capacity for inducing cell growth, indicative of effective cell adhesion and proliferation. The proposed chemical modifications are promising for the functionalization of PEEK-based implants, as they were effective in promoting bioactivation of the PEEK surface and in stimulating cell growth and proliferation.

In Vivo Biological Evaluation of Biodegradable Nanofibrous Membranes Incorporated with Antibiofilm Compounds

Guided bone regeneration involves excluding non-osteogenic cells from the surrounding soft tissues and allowing osteogenic cells originating from native bone to inhabit the defect. The aim of this work was to fabricate, analyze antibiofilm activity and evaluate in vivo biological response of poly (lactic-co-glycolic acid) (PLGA) electrospun membranes incorporated with tea tree oil and furan-2(5H)-one. Samples were exposed to Streptococcus mutans culture and after 48 h incubation, biofilm was evaluated by colony forming units (CFU/mL) followed by scanning electron microscopy. Additionally, seventy-five Balb-C mice were divided into five experimental groups for subcutaneous implantation: tea tree oil loaded PLGA electrospun fiber membrane, furanone loaded PLGA electrospun fiber membrane, neat PLGA electrospun fiber membrane, a commercially available PLGA membrane –Pratix^® and Sham (no-membrane implantation). Post implantation period of each experimental group (1, 3 and 9 weeks), samples were collected and processed for by histological descriptive and semiquantitative evaluation. Results showed a significant reduction of bacterial attachment on tea tree oil and furan-2(5H)-one incorporated membranes. Macrophage counts were significant found in all the materials implanted, although giant cells were predominantly associated with electrospun fiber membranes. The incorporation of antibiofilm compounds in nanofibers membranes did not incite inflammatory response significantly different in comparison with pure PLGA electrospun membranes, indicating its potential for development of novel functionalized membranes targeting the inhibition of bacterial biofilms on membrane-grafting materials.

Evaluation of the Grafting Efficacy of Active Biomolecules of Phosphatidylcholine and Type I Collagen on Polyether Ether Ketone: In Vitro and In Vivo

Biomolecule grafting on polyether ether ketone (PEEK) was used to improve cell affinity caused by surface inertness. This study demonstrated the sequence-polished (P) and sulfonated (SA) PEEK modification to make a 3D structure, active biomolecule graftings through PEEK silylation (SA/SI) and then processed with phosphatidylcholine (with silylation of SA/SI/PC; without SA/PC) and type I collagen (COL I, with silylation of SA/SI/C; without SA/C). Different modified PEEKs were implanted for 4, 8, and 12 weeks for histology. Sulfonated PEEK of SA showed the surface roughness was significantly increased; after the silylation of SA/SI, the hydrophilic nature was remarkably improved. The biomolecules were effectively grafted through silylation, and the cells showed improved attachment after 1 h. Furthermore, the SA/SI/PC group showed good in vitro mineralization. The new bone tissues were integrated into the 3D porous structures of SA/SI/PC and SA/SI/C in vivo making PEEK a potential alternative to metals in orthopedic implants.

Development of bioactive sodium alginate/sulfonated polyether ether ketone/hydroxyapatite nanocomposites: Synthesis and in-vitro studies

Developing bioactive composites to fill bone cavities caused by disease, injury or surgery still remains a challenge. The aim of this research was to develop a new nanostructured sodium alginate/sulfonated polyether ether ketone/nano-hydroxyapatite (Alg/SPEEK/HA) biocomposite via a simple chemical precipitation strategy. Structural analysis was carried out using X-ray diffraction (XRD), Fourier transformation infrared spectroscopy (FTIR). Thermogravimetric analysis (TGA) was used to compare the HA content of the composites. The in-vitro bioactivity of the composites with different content of HA was investigated by immersing the specimens in the simulated body fluid (SBF) for 15 days. The presence of HA in the composite structure gave rise to the precipitation of an apatite layer on the surface, which was increased by increase in the content of HA. The formation of the HA layer on the composite surface was scrutinized via FESEM and EDX analysis. Transmission electron microscopy (TEM) images exhibited the presence of HA nanoparticles with less than 30 nm in size. The in-vitro cytotoxicity evaluation was also carried out using MG-63 cells via the MTT assay, which revealed that the cytocompatibility of all specimens was increased with raising the HA content. However, the higher concentration (100 μg/ml) of the composites displayed some toxicity against MG-63 cells. These findings, therefore, proposed that the achieved novel nanocomposites could be regarded as promising materials to serve as bone filler.

On the synergistic effect of sulfonic functionalization and acidic adhesive conditioning to enhance the adhesion of PEEK to resin-matrix composites

OBJECTIVE

The objective of this study was to evaluate the combined effect of the sulfuric acid etching and an acidic adhesive conditioning on the shear bond strength of PEEK to a resin-matrix composite.

MATERIALS AND METHODS

Forty PEEK specimens were assigned randomly to 4 groups for H₂SO₄ etching followed by universal adhesive (pH at 2.5) conditioning for 0, 1, 3, and 5 min. Thirty PEEK specimens were divided into 3 groups for only acidic adhesive conditioning for 0, 1, 3, and 5 min. After the light-curing of the adhesive, a nanohybrid resin composite was applied onto the surfaces and then light-cured following the manufacturer`s guidelines. All specimens were stored in distilled water at 37 °C for 24 h mechanical testing. Shear bond strength tests were performed using a universal testing machine. Surfaces were analyzed by SEM, light interferometry, FTIR, and liquid contact angle measurement. Statistical analysis was performed by one-way ANOVA and Tukey's post hoc tests (p < 0.05).

RESULTS

No adhesion was achieved between untreated PEEK a resin-matrix composite, regardless of the adhesive conditioning time points. Shear bond strength of H₂SO₄-etched PEEK to resin-matrix composite increased with time (0 mmin. 4.95 ± 2.86 MPa < 1 min: 9.35 ± 2.26 MPa < 3 min: 17.84 ± 2.82 MPa < 5 min: 21.43 ± 5.00 MPa). SEM images revealed a significant modification of PEEK surface topography after the H₂SO₄ etching.

SIGNIFICANCE

The acidic adhesive was unable to modify the untreated PEEK surface to establish an effective adhesion although a synergistic effect was noticed when the universal (acidic) adhesive was applied over a H₂SO₄-etched PEEK surface, thus improving the PEEK to resin-matrix composite adhesion.

Review on Development and Dental Applications of Polyetheretherketone-Based Biomaterials and Restorations

Polyetheretherketone (PEEK) is an important high-performance thermoplastic. Its excellent strength, stiffness, toughness, fatigue resistance, biocompatibility, chemical stability and radiolucency have made PEEK attractive in dental and orthopedic applications. However, PEEK has an inherently hydrophobic and chemically inert surface, which has restricted its widespread use in clinical applications, especially in bonding with dental resin composites. Cutting edge research on novel methods to improve PEEK applications in dentistry, including oral implant, prosthodontics and orthodontics, is reviewed in this article. In addition, this article also discusses innovative surface modifications of PEEK, which are a focus area of active investigations. Furthermore, this article also discusses the necessary future studies and clinical trials for the use of PEEK in the human oral environment to investigate its feasibility and long-term performance.

Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry-A Comprehensive Review

Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were Escherichia coli and Staphylococcus aureus. Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.

Fabrication and evaluation of electrospun biomimetic sulphonated PEEK nanofibrous scaffold for human skin cell proliferation and wound regeneration potential

Regeneration of skin wound is a challenging process since functional and architectural restoration of the damaged skin tissue is an arduous task. The use of springing up biomaterials with nano-topographic and bio-mimicking characteristics resembling natural skin's extra cellular matrix (ECM) would be a favorable approach to regenerate such an injured skin tissue. In this study an attempt has been carried out to design and develop sulphonated polyether ether ketone (SPEEK) nanofibrous scaffold to explore its role on skin cell proliferation potential. 2 h-SPEEK portrayed the highest proliferative potential for HaCaT keratinocytes and fibroblasts. It was aimed for the tailored release of bio-actives from the spatiotemporally designed Aloe vera incorporated 2 h-SPEEK nanoscaffold to accelerate the skin wound regeneration. FTIR, EDX and XRD analyses revealed the effective incorporation of Aloe vera in the electrospun nanofibers. SEM analysis revealed the nano-topographical morphology with highly porous, dense and interconnected fibrous structures mimicking the skin ECM. The regulated delivery of Aloe vera demonstrated the biocompatibility of the nanofibrous scaffold in skin keratinocytes (HaCaT) and fibroblasts (3T3) cells through in vitro analysis proving its non-toxic properties. Further, the fabricated nanoscaffolds exhibited excellent anti-microbial efficacy towards the tested human skin pathogenic microbes. The results of in vivo studies in Wistar rat model exhibited scar-less wound healing with complete wound closure. Thus, this nanofiber based drug delivery system implicitly acts as a skin like ECM, bio-mimicking the topographical and chemical cues of the natural skin tissues paving way for a complete regeneration and integration of the injured area strengthening the functional restoration of insulted cells around the wound area.

Macro-Microporous Surface with Sulfonic Acid Groups and Micro-Nano Structures of PEEK/Nano Magnesium Silicate Composite Exhibiting Antibacterial Activity and Inducing Cell Responses

Purpose

To improve the surface bio-properties of polyetheretherketone (PEEK)/nano magnesium silicate (n-MS) composite (PC).

Materials and Methods

The surface of PC was firstly treated by particle impact (PCP) and subsequently modified by concentrated sulfuric acid (PCPS).

Results

PCPS surface exhibited not only macropores with sizes of about 150 μm (fabricated by particle impact) but also micropores with sizes of about 2 μm (created by sulfonation of PEEK) on the macroporous walls, and sulfonic acid (-SO₃H) groups were introduced on PCPS surface. In addition, many n-MS nanoparticles were exposed on the microporous walls, which formed micro-nano structures. Moreover, the surface roughness and hydrophilicity of PCPS were obviously enhanced as compared with PC and PCP. Moreover, the apatite mineralization of PCPS in simulated body fluid (SBF) was obviously improved as compared with PC. Furthermore, compared with PC and PCP, PCPS exhibited antibacterial performances due to the presence of -SO₃H groups. In addition, the responses (eg, adhesion and proliferation as well as differentiation) of bone marrow mesenchymal stem cell of rat to PCPS were significantly promoted as compared with PC and PCP.

Conclusion

PCPS with macro-microporous surface containing -SO₃H groups and micro-nano structures exhibited antibacterial activity and induced cell responses, which might possess large potential for bone substitute and repair.

Porous Titanium Surfaces to Control Bacteria Growth: Mechanical Properties and Sulfonated Polyetheretherketone Coatings as Antibiofouling Approaches

Here, titanium porous substrates were fabricated by a space holder technique. The relationship between microstructural characteristics (pore equivalent diameter, mean free-path between pores, roughness and contact surface), mechanical properties (Young’s modulus, yield strength and dynamic micro-hardness) and bacterial behavior are discussed. The bacterial strains evaluated are often found on dental implants: Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. The colony-forming units increased with the size of the spacer for both types of studied strains. An antibiofouling synthetic coating based on a sulfonated polyetheretherketone polymer revealed an effective chemical surface modification for inhibiting MRSA adhesion and growth. These findings collectively suggest that porous titanium implants designed with a pore size of 100–200 µm can be considered most suitable, assuring the best biomechanical and bifunctional anti-bacterial properties.

Polymer coatings based on sulfonated-poly-ether-ether-ketone films for implant dentistry applications

Poly-ether-ether-ketone (PEEK) is one of the most important biocompatible polymers and its sulfonation has been studied for biomedical applications. The aim of the present study is to produce, to characterize and to assess bioactivity of PEEK coatings with sulfonated PEEK (SPEEK) films. Biomedical grade PEEK (Invibio®, Batch: D0602, grade: NI1) was functionalized using sulfuric acid 98%. SPEEK was dissolved into DMSO or into DMF, both at 10% mass/volume. PEEK bars (N = 18) and cylinders (N = 27) were manufactured by compression molding and heating. SPEEK/DMSO and SPEEK/DMF were drop casted at PEEK bars and dip coated at PEEK cylinders (PEEK + SPEEK/DMSO and PEEK + SPEEK/DMF). Characterization was performed through Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XRD), Scanning Electron Microscope (SEM) and contact angle measurements. Bioactivity was assessed by immersion of samples at SBF for 1, 7 and 21 days, followed by SEM, energy-dispersive analysis (EDX) and FTIR analysis. Statistical analysis was carried out by one-way analysis of variance (ANOVA) (p = 0.05). Characteristic bands of PEEK and SPEEK, were identified through FTIR spectrum analysis, while semicrystallinity was confirmed by XRD. PEEK + SPEEK/DMF showed more evident physicochemical modifications. PEEK + SPEEK/DMSO provided a more regular and hydrophobic surface, observed through SEM and contact angle measurements. SEM/EDX showed that precipitates of calcium were formed at PEEK + SPEEK/DMSO and PEEK + SPEEK/DMF at all experimental times, but materials were not considered bioactive. Interesting surface properties were achieved with SPEEK coatings but the production of SPEEK films at PEEK surface has to be further improved and biologically tested. Schematic diagram showing the methodology applied in this study to prepare PEEK and SPEEK samples, as well as the promising application of the material.