Bond strength of silicone to polyurethane following immersion of silicone in cleaning solutions

Efficacy of incorporating silver nanoparticles into maxillofacial silicone against Staphylococcus aureus, Candida albicans, and polymicrobial biofilms

STATEMENT OF PROBLEM

The presence of biofilms on maxillofacial silicone increases the risk of infections and reduces durability. Whether silver nanoparticles (AgNPs) with potent antimicrobial effects help reduce biofilm formation is unclear.

PURPOSE

The purpose of this in vitro study was to assess the antimicrobial effect of sub 10-nm AgNPs in maxillofacial silicone against Staphylococcus aureus, Candida albicans, and mixed species biofilms containing both and to test the effectiveness of different AgNP concentrations against all 3 biofilms in vitro.

MATERIAL AND METHODS

Silicone disks (M511; Technovent Ltd) containing 0.0% (control), 0.1%, and 0.5% AgNPs were fabricated and treated with S. aureus, C. albicans, and mixed species strains of both in 24-well culture plates containing appropriate media. Each well received a 0.1-mL aliquot of the standardized suspension of microorganisms. The plates were incubated for 21 consecutive days, and colony-forming units per milliliter (CFU/mL) were measured on the first, third, fifth, seventh, fifteenth, and twenty-first day with the Miles and Misra method. Data were analyzed by 2-way ANOVA and the paired t test to evaluate the relationship between AgNP concentration, microbial strain, and time (α=.05). Mean CFU/mL differences for each time and for each biofilm category were assessed by repeated measure ANOVA.

RESULTS

AgNPs decreased the mean CFU/mL in both concentrations compared with the control. The 0.1% concentration showed sustained efficacy throughout the test, while the 0.5% concentration had high efficacy initially with a gradual decrease. However, the results were inconsistent for the mixed biofilm. The paired sample t test at day 3 and 15 and day 3 and 21 showed statistically significantly different results (P<.001) in all but 1 group in the 0.5% concentration. The 2-way mixed ANOVA showed statistically significant (P<.001) interaction between AgNP concentration and time in all groups. The 1-way ANOVA of AgNP concentrations was statistically significantly different (P<.001) for all time points. A statistically significant (P<.001) effect of time on CFU/mL was found for all the AgNP concentration groups in all 3 biofilms.

CONCLUSIONS

Silicone elastomers with sub 10-nm AgNPs displayed antimicrobial properties in vitro against S. aureus, C. albicans, and mixed species strains. AgNPs (0.1%) were effective against both microbial strains and can provide a baseline for further long-term studies regarding antimicrobial efficacy, silver ion leaching, and cellular internalization. Mixed species biofilm needs further exploration with standardized study parameters.

Past, Present, and Future of Soft-Tissue Prosthetics: Advanced Polymers and Advanced Manufacturing

Millions of people worldwide experience disfigurement due to cancers, congenital defects, or trauma, leading to significant psychological, social, and economic disadvantage. Prosthetics aim to reduce their suffering by restoring aesthetics and function using synthetic materials that mimic the characteristics of native tissue. In the 1900s, natural materials used for thousands of years in prosthetics were replaced by synthetic polymers bringing about significant improvements in fabrication and greater realism and utility. These traditional methods have now been disrupted by the advanced manufacturing revolution, radically changing the materials, methods, and nature of prosthetics. In this report, traditional synthetic polymers and advanced prosthetic materials and manufacturing techniques are discussed, including a focus on prosthetic material degradation. New manufacturing approaches and future technological developments are also discussed in the context of specific tissues requiring aesthetic restoration, such as ear, nose, face, eye, breast, and hand. As advanced manufacturing moves from research into clinical practice, prosthetics can begin new age to significantly improve the quality of life for those suffering tissue loss or disfigurement.

Advancements in Soft-Tissue Prosthetics Part B: The Chemistry of Imitating Life

Each year, congenital defects, trauma or cancer often results in considerable physical disfigurement for many people worldwide. This adversely impacts their psychological, social and economic outlook, leading to poor life experiences and negative health outcomes. In many cases of soft tissue disfigurement, highly personalized prostheses are available to restore both aesthetics and function. As discussed in part A of this review, key to the success of any soft tissue prosthetic is the fundamental properties of the materials. This determines the maximum attainable level of aesthetics, attachment mechanisms, fabrication complexity, cost, and robustness. Since the early-mid 20th century, polymers have completely replaced natural materials in prosthetics, with advances in both material properties and fabrication techniques leading to significantly improved capabilities. In part A, we discussed the history of polymers in prosthetics, their ideal properties, and the application of polymers in prostheses for the ear, nose, eye, breast and finger. We also reviewed the latest developments in advanced manufacturing and 3D printing, including different fabrication technologies and new and upcoming materials. In this review, Part B, we detail the chemistry of the most commonly used synthetic polymers in soft tissue prosthetics; silicone, acrylic resin, vinyl polymer, and polyurethane elastomer. For each polymer, we briefly discuss their history before detailing their chemistry and fabrication processes. We also discuss degradation of the polymer in the context of their application in prosthetics, including time and weathering, the impact of skin secretions, microbial growth and cleaning and disinfecting. Although advanced manufacturing promises new fabrication capabilities using exotic synthetic polymers with programmable material properties, silicones and acrylics remain the most commonly used materials in prosthetics today. As research in this field progresses, development of new variations and fabrication techniques based on these synthetic polymers will lead to even better and more robust soft tissue prosthetics, with improved life-like aesthetics and lower cost manufacturing.

Effects of bond primers on bending strength and bonding of glass fibers in fiber-embedded maxillofacial silicone prostheses

PURPOSE

To evaluate the effect of three commonly used bond primers on the bending strength of glass fibers and their bond strength to maxillofacial silicone elastomer after 360 hours of accelerated daylight aging.

MATERIALS AND METHODS

Eighty specimens were fabricated by embedding resin-impregnated fiber bundles (1.5-mm diameter, 20-mm long) into maxillofacial silicone elastomer M511 (Cosmesil). Twenty fiber bundles served as control and did not receive surface treatment with primers, whereas the remaining 60 fibers were treated with three primers (n = 20): G611 (Principality Medical), A-304 (Factor II), and A-330-Gold (Factor II). Forty specimens were dry stored at room temperature (23 ± 1°C) for 24 hours, and the remaining specimens were aged using an environmental chamber under accelerated exposure to artificial daylight for 360 hours. The aging cycle included continuous exposure to quartz-filtered visible daylight (irradiance 760 W/m(2) ) under an alternating weathering cycle (wet for 18 minutes, dry for 102 minutes). Pull-out tests were performed to evaluate bond strength between fiber bundles and silicone using a universal testing machine at 1 mm/min crosshead speed. A 3-point bending test was performed to evaluate the bending strength of the fiber bundles. One-way Analysis of Variance (ANOVA), Bonferroni post hoc test, and an independent t-test were carried out to detect statistical significances (p < 0.05).

RESULTS

Mean (SD) values of maximum pull-out forces (N) before aging for groups: no primer, G611, A-304, A-330-G were: 13.63 (7.45), 20.44 (2.99), 22.06 (6.69), and 57.91 (10.15), respectively. All primers increased bond strength in comparison to control specimens (p < 0.05). Primer A-330-G showed the greatest increase among all primers (p < 0.05); however, bonding degraded after aging (p < 0.05), and pull-out forces were 13.58 (2.61), 6.17 (2.89), 6.95 (2.61), and 11.72 (3.03). Maximum bending strengths of fiber bundles at baseline increased after treatment with primers and light aging in comparison with control specimens (p < 0.05), and were in the range of 917.72 to 1095.25 and 1124.06 to 1596.68 MPa at both baseline and after 360 hours aging (p < 0.05).

CONCLUSIONS

The use of A-330-G primer in conjunction with silicone Cosmesil M511 produced the greatest bond strength for silicone-glass fiber surfaces at baseline; however, bond strength was significantly degraded after accelerated daylight aging. Treatment with primer and accelerated daylight aging increased bending strength of glass fibers.

The effects of primers and surface bonding characteristics on the adhesion of polyurethane to two commonly used silicone elastomers

PURPOSE

When restoring facial defects, maxillofacial prosthodontists and anaplastologists are often limited by material deficiencies. Silicone elastomers bonded to a polyurethane liner best satisfy the functional and esthetic requirements necessary for facial prostheses; however, patients using silicone prostheses with polyurethane liners often experience varying degrees of debonding at the polyurethane-silicone interfaces. This may result in failure of such prostheses. The purpose of this investigation was to evaluate the effects of five primers on bonding between polyurethane and two commonly used silicone elastomers.

MATERIAL AND METHODS

Six bonding regimens were used to join polyurethane and silicone materials. Each treatment group consisted of 12 specimens. Bonding regimens included (1) a 40:60 mixture of MDX4-4210 and Silastic Medical Adhesive Type A, in conjunction with Dow Corning 1205 primer (Udagama's technique); (2) silicone A-2000 with Dow Corning 1205 primer; (3) silicone A-2000 with A-330-G primer; (4) silicone A-2000 with Mucopren primer; (5) silicone A-2000 with Sofreliner T primer; and (6) silicone A-2000 with Sofreliner MS primer. Following fabrication, specimens were attached to a universal testing machine and separated in tension at a crosshead speed of 25.4 mm/min. One examiner performed the assessment of T-peel strength (N/mm), peak load (N), and peel distance (mm) for all specimens. Mean data were analyzed using one-way ANOVA followed by Fisher's protected significant difference multiple comparison of the means (alpha= 0.05).

RESULTS

A statistically significant difference (p < 0.05) in T-peel strength was found among specimen groups. Post hoc analysis indicated that Sofreliner MS primer (1.32 +/- 0.13 N/mm) and Sofreliner T primer (1.25 +/- 0.11 N/mm) increased the bond strengths significantly compared to A-330-G primer (0.91 +/- 0.10 N/mm) and Udagama's technique (0.13 +/- 0.02 N/mm). Cohesive failure between silicone A-2000 and polyurethane liner was observed when Sofreliner MS primer and Sofreliner T were used.

CONCLUSION

Within the limitations of this study, the use of Sofreliner MS primer and Sofreliner T primer produced significant increases in the bond strength of silicone elastomer to polyurethane liner material. Based on T-peel strength, peel distance, and peak load data, the combination of silicone A-2000 and Sofreliner MS primer resulted in the greatest mean bond strength for silicone-to-polyurethane applications.