The antibacterial property of zinc oxide/graphene oxide modified porous polyetheretherketone against S. sanguinis, F. nucleatum and P. gingivalis

Review of carbonaceous nanoparticles for antibacterial uses in various dental infections

The mouth cavity is the second most complex microbial community in the human body. It is composed of bacteria, viruses, fungi, and protozoa. An imbalance in the oral microbiota may lead to various conditions, including caries, soft tissue infections, periodontitis, root canal infections, peri-implantitis (PI), pulpitis, candidiasis, and denture stomatitis. Additionally, several locally administered antimicrobials have been suggested for dentistry in surgical and non-surgical applications. The main drawbacks are increased antimicrobial resistance, the risk of upsetting the natural microbiota, and hypersensitivity responses. Because of their unique physiochemical characteristics, nanoparticles (NPs) can circumvent antibiotic-resistance mechanisms and exert antimicrobial action via a variety of new bactericidal routes. Because of their anti-microbial properties, carbon-based NPs are becoming more and more effective antibacterial agents. Periodontitis, mouth infections, PI, dentin and root infections, and other dental diseases are among the conditions that may be treated using carbon NPs (CNPs) like graphene oxide and carbon dots. An outline of the scientific development of multifunctional CNPs concerning oral disorders will be given before talking about the significant influence of CNPs on dental health. Some of these illnesses include Periodontitis, oral infections, dental caries, dental pulp disorders, dentin and dental root infections, and PI. We also review the remaining research and application barriers for carbon-based NPs and possible future problems.

Biomaterials science and surface engineering strategies for dental peri-implantitis management

Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption, ultimately resulting in implant failure. Dental implants for clinical use barely have antibacterial properties, and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis. Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque. However, it is particularly important to prevent the occurrence of peri-implantitis rather than treatment. Therefore, the current research spot has focused on improving the antibacterial properties of dental implants, such as the construction of specific micro-nano surface texture, the introduction of diverse functional coatings, or the application of materials with intrinsic antibacterial properties. The aforementioned antibacterial surfaces can be incorporated with bioactive molecules, metallic nanoparticles, or other functional components to further enhance the osteogenic properties and accelerate the healing process. In this review, we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration. Furthermore, we summarized the obstacles existing in the process of laboratory research to reach the clinic products, and propose corresponding directions for future developments and research perspectives, so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy, biological safety, and osteogenic property.

A self-assembling graphene oxide coating for enhanced bactericidal and osteogenic properties of poly-ether-ether-ketone

Poly-ether-ether-ketone (PEEK) is a biomedical plastic that can be used for orthopedic implants, but it offers poor antibacterial properties and bioactivity. In this study, PEEK was sulfonated with the obtained porous structure adsorbing graphene oxide (GO). The surface microstructures and properties of the original PEEK, sulfonated PEEK (SPEEK), and GO-grafted PEEK (GO-SPEEK) were characterized. The results revealed that the GO-SPEEK surface is a 3D porous structure exhibiting superior hydrophilicity to the original PEEK. Although SPEEK was shown to possess antimicrobial properties against both Escherichia coli and Staphylococcus aureus, the bactericidal effect was even more significant for GO-SPEEK, at about 86% and 94%, respectively. In addition, the in vitro simulated-body-fluid immersion and cell experiments indicated that GO-SPEEK had much better hydroxyapatite (HA)-precipitation induction capacity and cell-material interactions (e.g., cell adhesion, proliferation, osteodifferentiation, and extracellular matrix mineralization. The tensile test revealed that the mechanical properties of PEEK were maintained after surface modification, as GO-SPEEK has comparable values of elastic modulus and tensile strength to PEEK. Our investigation sought a method to simultaneously endow PEEK with both good antimicrobial properties and bioactivity as well as mechanical properties, providing a theoretical basis for developing high-performance orthopedic implants in the clinic.

Methods to improve antibacterial properties of PEEK: A review

As a thermoplastic and bioinert polymer, polyether ether ketone (PEEK) serves as spine implants, femoral stems, cranial implants, and joint arthroplasty implants due to its mechanical properties resembling the cortical bone, chemical stability, and radiolucency. Although there are standards and antibiotic treatments for infection control during and after surgery, the infection risk is lowered but can not be eliminated. The antibacterial properties of PEEK implants should be improved to provide better infection control. This review includes the strategies for enhancing the antibacterial properties of PEEK in four categories: immobilization of functional materials and functional groups, forming nanocomposites, changing surface topography, and coating with antibacterial material. The measuring methods of antibacterial properties of the current studies of PEEK are explained in detail under quantitative, qualitative, andin vivomethods. The mechanisms of bacterial inhibition by reactive oxygen species generation, contact killing, trap killing, and limited bacterial adhesion on hydrophobic surfaces are explained with corresponding antibacterial compounds or techniques. The prospective analysis of the current studies is done, and dual systems combining osteogenic and antibacterial agents immobilized on the surface of PEEK are found the promising solution for a better implant design.

Amplifying bactericidal activity: Surfactant-mediated AgBr thin film coating over two-dimensional vertically aligned ZnO nanorods for dark-light dual mode disinfection

Thin film coatings with potent antibacterial properties find critical applications in diverse domains such as medical devices, frequently touched surfaces, and food packaging for combating microbial proliferation across diverse scenarios. Two-dimensional photocatalytic antimicrobial coatings, offering a substantial actual-to-apparent surface ratio, hold immense potential for achieving this objective. However, realizing antibacterial performance not just under light but also in dark conditions remains a challenge. To address this, we present AgBr-coated vertically aligned ZnO nanorods (NRs) thin film architecture, employing a unique surfactant-mediated solution-phase spin-coating approach for achieving uniform deposition of AgBr onto ZnO NRs. The resulting ZnO NRs/AgBr heterojunction architectures have been characterized for their microstructural, morphological, elemental, optical, and wettability attributes. The studies have ascertained the tunability of AgBr content by modulating the concentration of its surfactant-based precursor solution. Further, valence band (VB) analyses revealed an increase in the electron density near to the VB edge. The dual role of AgBr as an antimicrobial agent and a photosensitizer, effectively enhancing the visible-light photodisinfection efficacy of ZnO NRs, has been evident through the dark-light dual mode antibacterial studies. Electron paramagnetic resonance measurements have shown hydroxyl radicals being majorly responsible for the visible-light photodisinfection performance. Encouragingly, reusability assessments showcase significant promise, while artificial sweat-wiping studies on the structures unveil heightened photodisinfection efficacy. This enhancement could be attributed to components like urea and lactic acid, speculated to augment the photocatalytic efficiency by minimizing charge recombination.

Can Graphene Pave the Way to Successful Periodontal and Dental Prosthetic Treatments? A Narrative Review

Graphene, as a promising material, holds the potential to significantly enhance the field of dental practices. Incorporating graphene into dental materials imparts enhanced strength and durability, while graphene-based nanocomposites offer the prospect of innovative solutions such as antimicrobial dental implants or scaffolds. Ongoing research into graphene-based dental adhesives and composites also suggests their capacity to improve the quality and reliability of dental restorations. This narrative review aims to provide an up-to-date overview of the application of graphene derivatives in the dental domain, with a particular focus on their application in prosthodontics and periodontics. It is important to acknowledge that further research and development are imperative to fully explore the potential of graphene and ensure its safe use in dental practices.

Graphene and its derivatives: "one stone, three birds" strategy for orthopedic implant-associated infections

Orthopedic implants provide an avascular surface for microbial attachment and biofilm formation, impeding the entry of immune cells and the diffusion of antibiotics. The above is an important cause of dental and orthopedic implant-associated infection (IAI). For the prevention and treatment of IAI, the drawbacks of antibiotic resistance and surgical treatment are increasingly apparent. Due to their outstanding biological properties such as biocompatibility, immunomodulatory effects, and antibacterial properties, graphene-based nanomaterials (GBNs) have been applied to bone tissue engineering to deal with IAI, and in particular have great potential application in drug/gene carriers, multi-functional platforms, and coating forms. Here we review the latest research progress and achievements in GBNs for the prevention and treatment of IAI, mainly including their biomedical applications for antibacterial and immunomodulation effects, and for inducing osteogenesis. Furthermore, the biosafety of graphene family materials in bone tissue regeneration and the feasibility of clinical application are critically analyzed and discussed.

The Bio-Aging of Biofilms on Behalf of Various Oral Status on Different Titanium Implant Materials

The properties of titanium implants are affected by bio-aging due to long-term exposure to the oral microenvironment. This study aimed to investigate probable changes in titanium plates after different biofilm bio-aging processes, representing various oral status. Titanium plates with different surface treatments were used, including polish, sandblasted with large grit and acid etched (SLA), microarc oxidation (MAO), and hydroxyapatite coating (HA). We established dual-species biofilms of Staphylococcus aureus (S. aureus)-Candida albicans (C. albicans) and saliva biofilms from the healthy and patients with stage III-IV periodontitis, respectively. After bio-aging with these biofilms for 30 days, the surface morphology, chemical composition, and water contact angles were measured. The adhesion of human gingival epithelial cells, human gingival fibroblasts, and three-species biofilms (Streptococcus sanguis, Porphyromonas gingivalis, and Fusobacterium nucleatum) were evaluated. The polished specimens showed no significant changes after bio-aging with these biofilms. The MAO- and SLA-treated samples showed mild corrosion after bio-aging with the salivary biofilms. The HA-coated specimens were the most vulnerable. Salivary biofilms, especially saliva from patients with periodontitis, exhibited a more distinct erosion on the HA-coating than the S. aureus-C. albicans dual-biofilms. The coating became thinner and even fell from the substrate. The surface became more hydrophilic and more prone to the adhesion of bacteria. The S. aureus-C. albicans dual-biofilms had a comparatively mild corrosion effect on these samples. The HA-coated samples showed more severe erosion after bio-aging with the salivary biofilms from patients with periodontitis compared to those of the healthy, which emphasized the importance of oral hygiene and periodontal health to implants in the long run.

Size-dependent molecular interaction of nontraditional 2D antibiotics withStaphylococcus aureus

The application of nanomaterials for their antibacterial properties is the subject of many studies due to antibiotic resistance of pathogen bacteria and the necessity of omitting them from food and water resources. Graphene oxide (GO) is one of the most popular candidates for antibacterial application. However, the optimum condition for such an effect is not yet clear for practical purposes. To shed light on how GO and bacteria interaction depends on size, a wide range of GO flake sizes from hundreds of µm²going down to nano-scale as low as 10 N m²was produced. In anin-vitrosystematic study to inhibitStaphylococcus aureusgrowth, the correlation between GO flake size, thickness, functional group density, and antibacterial activity was investigated. The GO suspension with the average size of 0.05 µm², in the order of the size of the bacteria itself, had the best bacteriostatic effect onS. aureuswith the minimum inhibitory concentration value of 8 μg ml^-1, well within the acceptable range for practical use. The bacteriostatic effect was measured to be a 76.2% reduction of the colony count over 2 h of incubation and the mechanism of action was the wrapping and isolation of cells from the growth environment. Furthermore,in-vivoanimal studies revealed that 16 μg ml^-1of the optimum GO has efficient antibacterial performance against the methicillin-resistant strains of the bacteria with an enhanced wound healing rate and tensiometrial parameters which is important for realized targets.

In Vitro Studies of Graphene for Management of Dental Caries and Periodontal Disease: A Concise Review

Graphene is a single-layer two-dimensional carbon-based nanomaterial. It presents as a thin and strong material that has attracted many researchers’ attention. This study provides a concise review of the potential application of graphene materials in caries and periodontal disease management. Pristine or functionalized graphene and its derivatives exhibit favorable physicochemical, mechanical, and morphological properties applicable to biomedical applications. They can be activated and functionalized with metal and metal nanoparticles, polymers, and other small molecules to exhibit multi-differentiation activities, antimicrobial activities, and biocompatibility. They were investigated in preventive dentistry and regenerative dentistry. Graphene materials such as graphene oxide inhibit cariogenic microbes such as Streptococcus mutans. They also inhibit periodontal pathogens that are responsible for periodontitis and root canal infection. Graphene-fluorine promotes enamel and dentin mineralization. These materials were also broadly studied in regenerative dental research, such as dental hard and soft tissue regeneration, as well as periodontal tissue and bone regeneration. Graphene oxide-based materials, such as graphene oxide-fibroin, were reported as promising in tissue engineering for their biocompatibility, bioactivity, and ability to enhance cell proliferation properties in periodontal ligament stem cells. Laboratory research showed that graphene can be used exclusively or by incorporating it into existing dental materials. The success of laboratory studies can translate the application of graphene into clinical use.

Dental resin composites with improved antibacterial and mineralization properties via incorporating zinc/strontium-doped hydroxyapatite as functional fillers

This study intends to improve the antibacterial and mineralization performance of photocurable dental resin composites (DRCs) to reduce the possibility of repair failure caused by secondary caries. To the end, functionalized hydroxyapatite (HAp), including Zn-doped (Zn/HAp) and Sr-doped HAp (Sr/HAp), were added into the bisphenol A glycidyl methacrylate and triethylene glycol dimethacrylate mixture, providing the DRCs with antibacterial and mineralization capacity, respectively. By controlling the total amount of inorganic filler at 70 wt%, these HAp powders were introduced into the resin matrix with barium glass powder (BaGP), while the ratios of HAp to aGP varied from 0:70 to 8:62. And the 8 wt% of HAp could be pure HAp, Zn/HAp, Sr/HAp, or Zn/HAp +Sr/HAp in different ratios (i.e. 2:6, 4:4, 6:2). Though the fillers varied, the obtained DRCs displayed similar micro-morphology, flexural strength (∼110 MPa) and modulus (∼7 GPa), and Vickers hardness (∼65). When the doping amounts of Sr²⁺/Zn²⁺reached 15 mol% of Ca²⁺in the Sr/HAp and Zn/HAp, the DRCs displayed a high antibacterial activity by killing ∼95%Staphylococcus aureus, and induced rich mineral deposition on surface in simulated body fluid. The incorporation of the Zn/HAp and Sr/HAp into the DRCs did not cause significant cytotoxicity, with L929 fibroblasts remaining >99% viability as cultured in extracts made from the DRCs. Therein, the DRC preparations containing both Zn/HAp and Sr/HAp have achieved improvements in both the biomineralization and antibacterial performance, as well as, having sufficient mechanical properties and excellent biocompatibility for dental restoration.