Bimodal Nanocomposite Platform with Antibiofilm and Self-Powering Functionalities for Biomedical Applications

Piezoelectric Biomaterial with Advanced Design for Tissue Infection Repair

Bacterial infection has become the most dangerous factor in tissue repair, which strongly affects the tissue regeneration efficiency and wellness of patients. Piezoelectric materials exhibit the outstanding advantage of producing electrons without external power supply. The ability of electron enrichment and reactive oxygen species generation through noninvasive stimulations enables piezoelectric materials the potential applications of antibacterial. Many studies have proved the feasibility of piezoelectric materials as a functional addition in antibacterial biomaterial. In fact, numerous piezoelectric materials with ingenious designs are reported to be effective in antibacterial processes. This review summarizes the antibacterial mechanisms of piezoelectric, illuminating their potential in combating bacteria. Recent advancement in the design and construction of piezoelectric biomaterial including defect engineering, heterojunction, synergy with metal and the composite scaffold configuration are thoroughly reviewed. Moreover, the applications and therapeutic effects of piezoelectric materials in common tissues with antibacterial requirements are introduced, such as orthopedics, dental, and wound healing. Finally, the development prospects and points deserving further exploration are listed. This review is expected to provide valuable insight into the relationship between antibacterial processes and piezoelectric materials, further inspiring constructive development in this emerging scientific discipline.

Piezoelectric materials for anti-infective bioapplications

Bacterial infection severely limits the effectiveness of biomaterials for tissue repair, posing a major challenge to modern medicine. Despite advances in novel antibiotics and their application in treatment, challenges remain in clinical practice. To address this issue, biomaterials are engineered to achieve desirable anti-infective performance and compatibility via adjusting their surface physicochemical properties. Recently, numerous studies on piezoelectric materials have been performed for anti-infective and regenerative therapies, but a comprehensive review is still lacking. This article provides a brief overview of the different types of piezoelectric materials and their characteristics. Building on this understanding, this review highlights the antibacterial mechanisms including orchestrating electric field and optimizing piezoelectric catalysis, which promote infective tissue regeneration, as well as discusses the anti-infective bioapplication of piezoelectric materials. Furthermore, this review concludes with perspectives into the challenges and future research directions of piezoelectric biomaterials.

Intelligent and Bioactive Osseointegration of the Implanted Piezoelectric Bone Cement with the Host Bone Is Realized by Biomechanical Energy

Poly methyl methacrylate (PMMA) bone cement is widely used in orthopedic surgeries, including total hip/knee arthroplasty and vertebral compression fracture treatment. However, loosening due to bone resorption is a common mid-to-late complication. Therefore, developing bioactive bone cement that promotes bone growth and integration is key to reducing aseptic loosening. In this study, we developed a piezoelectric bone cement comprising PMMA and BaTiO3 with excellent electrobioactivity and further analyzed its ability to promote bone integration. Experiments demonstrate that the PMMA and 15 wt % BaTiO3 cement generated an open-circuit voltage of 37.109 V under biomimetic mechanical stress, which effectively promoted bone regeneration and interfacial bone integration. In vitro experiments showed that the protein expression levels of ALP and RUNX-2 in the 0.65 Hz and 20 min group increased by 1.74 times and 2.31 times. In vivo experiments confirmed the osteogenic ability of PMMA and 15 wt % BaTiO3, with the increment of bone growth in the non-movement and movement groups being 4.67 and 4.64 times, respectively, at the second month after surgery. Additionally, Fluo-4 AM fluorescence staining and protein blotting experiments verified that PMMA and 15 wt % BaTiO3 electrical stimulation promoted osteogenic differentiation of BMSCs by activating calcium-sensitive receptors and increasing calcium ion inflow by 1.41 times when the stimulation reached 30 min. Therefore, piezoelectric bioactive PMMA and 15 wt % BaTiO3 cement has excellent application value in orthopedic surgery systems where stress transmission is prevalent.

Preparation of Nanocomposites for Antibacterial Orthodontic Invisible Appliance Based on Piezoelectric Catalysis

Compared to fixed orthodontic appliances with brackets, thermoplastic invisible orthodontic aligners offer several advantages, such as high aesthetic performance, good comfort, and convenient oral health maintenance, and are widely used in orthodontic fields. However, prolonged use of thermoplastic invisible aligners may lead to demineralization and even caries in most patients' teeth, as they enclose the tooth surface for an extended period. To address this issue, we have created PETG composites that contain piezoelectric barium titanate nanoparticles (BaTiO₃NPs) to obtain antibacterial properties. First, we prepared piezoelectric composites by incorporating varying amounts of BaTiO₃NPs into PETG matrix material. The composites were then characterized using techniques such as SEM, XRD, and Raman spectroscopy, which confirmed the successful synthesis of the composites. We cultivated biofilms of Streptococcus mutans (S. mutans) on the surface of the nanocomposites under both polarized and unpolarized conditions. We then activated piezoelectric charges by subjecting the nanocomposites to 10 Hz cyclic mechanical vibration. The interactions between the biofilms and materials were evaluated by measuring the biofilm biomass. The addition of piezoelectric nanoparticles had a noticeable antibacterial effect on both the unpolarized and polarized conditions. Under polarized conditions, nanocomposites demonstrated a greater antibacterial effect than under unpolarized conditions. Additionally, as the concentration of BaTiO₃NPs increased, the antibacterial rate also increased, with the surface antibacterial rate reaching 67.39% (30 wt% BaTiO₃NPs). These findings have the potential for application in wearable, invisible appliances to improve clinical services and reduce the need for cleaning methods.

Smart dental materials for antimicrobial applications

Smart biomaterials can sense and react to physiological or external environmental stimuli (e.g., mechanical, chemical, electrical, or magnetic signals). The last decades have seen exponential growth in the use and development of smart dental biomaterials for antimicrobial applications in dentistry. These biomaterial systems offer improved efficacy and controllable bio-functionalities to prevent infections and extend the longevity of dental devices. This review article presents the current state-of-the-art of design, evaluation, advantages, and limitations of bioactive and stimuli-responsive and autonomous dental materials for antimicrobial applications. First, the importance and classification of smart biomaterials are discussed. Second, the categories of bioresponsive antibacterial dental materials are systematically itemized based on different stimuli, including pH, enzymes, light, magnetic field, and vibrations. For each category, their antimicrobial mechanism, applications, and examples are discussed. Finally, we examined the limitations and obstacles required to develop clinically relevant applications of these appealing technologies.

A Comprehensive Review on Barium Titanate Nanoparticles as a Persuasive Piezoelectric Material for Biomedical Applications: Prospects and Challenges

Stimulation of cells with electrical cues is an imperative approach to interact with biological systems and has been exploited in clinical practices over a wide range of pathological ailments. This bioelectric interface has been extensively explored with the help of piezoelectric materials, leading to remarkable advancement in the past two decades. Among other members of this fraternity, colloidal perovskite barium titanate (BaTiO₃ ) has gained substantial interest due to its noteworthy properties which includes high dielectric constant and excellent ferroelectric properties along with acceptable biocompatibility. Significant progression is witnessed for BaTiO₃ nanoparticles (BaTiO₃ NPs) as potent candidates for biomedical applications and in wearable bioelectronics, making them a promising personal healthcare platform. The current review highlights the nanostructured piezoelectric bio interface of BaTiO₃ NPs in applications comprising drug delivery, tissue engineering, bioimaging, bioelectronics, and wearable devices. Particular attention has been dedicated toward the fabrication routes of BaTiO₃ NPs along with different approaches for its surface modifications. This review offers a comprehensive discussion on the utility of BaTiO₃ NPs as active devices rather than passive structural unit behaving as carriers for biomolecules. The employment of BaTiO₃ NPs presents new scenarios and opportunity in the vast field of nanomedicines for biomedical applications.

Coulombic Surface-Ion Interactions Induce Nonlinear and Chemistry-Specific Charging Kinetics

While important for many industrial applications, chemical reactions responsible for the charging of solids in water are often poorly understood. We theoretically investigate the charging kinetics of solid-liquid interfaces and find that the time-dependent equilibration of surface charge contains key information not only on the reaction mechanism, but also on the valency of the reacting ions. We construct a nonlinear differential equation describing surface charging by combining chemical Langmuir kinetics and electrostatic Poisson-Boltzmann theory. Our results reveal a clear distinction between late-time (near-equilibrium) and short-time (far-from-equilibrium) relaxation rates, the ratio of which contains information on the charge valency and ad- or desorption mechanism of the charging process. Similarly, we find that single-ion reactions can be distinguished from two-ion reactions, as the latter show an inflection point during equilibration. Interestingly, such inflection points are characteristic of autocatalytic reactions, and we conclude that the Coulombic ion-surface interaction is an autocatalytic feedback mechanism.

Effect of surface stiffness in initial adhesion of oral microorganisms under various environmental conditions

Biofilms are three-dimensional structures formed as a result of microorganism's adhesion on a biotic or abiotic surface. Once a biofilm is established, it is onerous to eradicate it or kill the pathogens therein. Thus, targeting the microbial adhesion process, the initial stage of biofilm formation, is a reasonable approach to avoid challenges associated with subsequently formed biofilms. While many properties of interacting material that play significant roles in initial bacterial adhesion have been widely studied, the effect of surface stiffness on bacterial adhesion was relatively underexplored. In this study, we aimed to investigate the effect of surface stiffness on the adhesion of microbial species found in the oral cavity by employing representative oral bacteria, Streptococcus mutans and Streptococcus oralis, and the fungus, Candida albicans. We compared the adhesion behavior of these species alone or in combination toward various surface stiffness (0.06 - 3.01 MPa) by assessing the adhered and planktonic cell numbers at an early (4 h) adhesion stage under various carbon sources and the presence of conditioning film. Our data revealed that in general, a higher amount of microbial cells adhered to softer PDMS surfaces than stiffer ones, which indicates that surface stiffness plays a role in the adhesion of tested species (either single or co-cultured). This pattern was more obvious under sucrose conditions than glucose + fructose conditions. Interestingly, in monospecies, saliva coating did not alter the effect of surface stiffness on S. mutans adhesion while it diminished S. oralis and C. albicans adhesion. However, in the multispecies model, saliva coating rendered the percentage of all adhered microbes to varied PDMS not distinct. The data provide new insights into the role of surface stiffness on microbial mechanosensing and their initial adhesion behavior which may set a scientific foundation for future anti-adhesion strategies.

Engineering Dental Tissues Using Biomaterials with Piezoelectric Effect: Current Progress and Future Perspectives

Dental caries and traumatic injuries to teeth may cause irreversible inflammation and eventual death of the dental pulp. Nevertheless, predictably, repair and regeneration of the dentin-pulp complex remain a formidable challenge. In recent years, smart multifunctional materials with antimicrobial, anti-inflammatory, and pro-regenerative properties have emerged as promising approaches to meet this critical clinical need. As a unique class of smart materials, piezoelectric materials have an unprecedented advantage over other stimuli-responsive materials due to their inherent capability to generate electric charges, which have been shown to facilitate both antimicrobial action and tissue regeneration. Nonetheless, studies on piezoelectric biomaterials in the repair and regeneration of the dentin-pulp complex remain limited. In this review, we summarize the biomedical applications of piezoelectric biomaterials in dental applications and elucidate the underlying molecular mechanisms contributing to the biological effect of piezoelectricity. Moreover, we highlight how this state-of-the-art can be further exploited in the future for dental tissue engineering.

A dental implant-on-a-chip for 3D modeling of host-material-pathogen interactions and therapeutic testing platforms

The precise spatiotemporal control and manipulation of fluid dynamics on a small scale granted by lab-on-a-chip devices provide a new biomedical research realm as a substitute for in vivo studies of host-pathogen interactions. While there has been a rise in the use of various medical devices/implants for human use, the applicability of microfluidic models that integrate such functional biomaterials is currently limited. Here, we introduced a novel dental implant-on-a-chip model to better understand host-material-pathogen interactions in the context of peri-implant diseases. The implant-on-a-chip integrates gingival cells with relevant biomaterials - keratinocytes with dental resin and fibroblasts with titanium while maintaining a spatially separated co-culture. To enable this co-culture, the implant-on-a-chip's core structure necessitates closely spaced, tall microtrenches. Thus, an SU-8 master mold with a high aspect-ratio pillar array was created by employing a unique backside UV exposure with a selective optical filter. With this model, we successfully replicated the morphology of keratinocytes and fibroblasts in the vicinity of dental implant biomaterials. Furthermore, we demonstrated how photobiomodulation therapy might be used to protect the epithelial layer from recurrent bacterial challenges (∼3.5-fold reduction in cellular damage vs. control). Overall, our dental implant-on-a-chip approach proposes a new microfluidic model for multiplexed host-material-pathogen investigations and the evaluation of novel treatment strategies for infectious diseases.

Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants

Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.

A 3D-Printed Customizable Platform for Multiplex Dynamic Biofilm Studies

Biofilms are communities of microbes that colonize surfaces. While several biofilm experimental models exist, they often have limited replications of spatiotemporal dynamics surrounding biofilms. For a better understanding dynamic and complex biofilm development, this manuscript presents a customizable platform compatible with off-the-shelf well plates that can monitor microbial adhesion, growth, and associated parameters under various relevant scenarios by taking advantage of 3D printing. The system i) holds any substrate in a stable, vertical position, ii) subjects samples to flow at different angles, iii) switches between static and dynamic modes during an experiment, and iv) allows multiplexing and real-time monitoring of biofilm parameters. Simulated fluid dynamics is employed to estimate flow patterns around discs and shear stresses at disc surfaces. A 3D printed peristaltic pump and a customized pH measurement system for real-time tracking of spent biofilm culture media are equipped with a graphical user interface that grants control over all experimental parameters. The system is tested under static and dynamic conditions with Streptococcus mutans using different carbon sources. By monitoring the effluent pH and characterizing biochemical, microbiological, and morphological properties of cultured biofilms, distinct properties are demonstrated. This novel platform liberates designing experimental strategies for investigations of biofilms under various conditions.

In it together: Candida-bacterial oral biofilms and therapeutic strategies

Under natural environmental settings or in the human body, the majority of microorganisms exist in complex polymicrobial biofilms adhered to abiotic and biotic surfaces. These microorganisms exhibit symbiotic, mutualistic, synergistic, or antagonistic relationships with other species during biofilm colonization and development. These polymicrobial interactions are heterogeneous, complex and hard to control, thereby often yielding worse outcomes than monospecies infections. Concerning fungi, Candida spp., in particular, Candida albicans is often detected with various bacterial species in oral biofilms. These Candida-bacterial interactions may induce the transition of C. albicans from commensal to pathobiont or dysbiotic organism. Consequently, Candida-bacterial interactions are largely associated with various oral diseases, including dental caries, denture stomatitis, periodontitis, peri-implantitis, and oral cancer. Given the severity of oral diseases caused by cross-kingdom consortia that develop hard-to-remove and highly drug-resistant biofilms, fundamental research is warranted to strategically develop cost-effective and safe therapies to prevent and treat cross-kingdom interactions and subsequent biofilm development. While studies have shed some light, targeting fungal-involved polymicrobial biofilms has been limited. This mini-review outlines the key features of Candida-bacterial interactions and their impact on various oral diseases. In addition, current knowledge on therapeutic strategies to target Candida-bacterial polymicrobial biofilms is discussed.