Characteristics of Hybrid Bioglass-Chitosan Coatings on the Plasma Activated PEEK Polymer

A comprehensive review on the State of the Art in the research and development of poly-ether-ether-ketone (PEEK) biomaterial-based implants

Polyetheretherketone (PEEK) is a preferred high-performance polymer in the spine, orthopedic, and craniomaxillofacial implant industry. However, despite its commendable mechanical properties, its bioinert nature limits the implants from integrating with neighboring tissues, impacting the implant's long-term performance. To address this limitation, various kinds of surface functionalization techniques have been developed over the years. Noteworthy efforts have been made to incorporate bioactive fillers in the PEEK matrix to develop standalone bioactive composites. In personalized medicine, significant advances have been made in the 3D Printing of PEEK implants. 3D-printed PEEK implants are now being developed at Point-of-Care, significantly reducing manufacturing and logistic time. Given the recent clinical follow-up updates and advancements in PEEK-based implants, PEEK implants are witnessing an important phase in its history. Recognizing this vital phase, this paper aims to comprehensively review the advancements of PEEK implants over the past decade. The review starts with an overview of the clinical impact of varying PEEK implants, followed by PEEK's surface functionalization techniques and engineering of PEEK-based bioactive composites. Next, this review describes the advancements made in the 3D printing of PEEK implants and points out the essential considerations that should be considered when developing 3D-printed PEEK-based implants. Finally, the review ends with an estimated projection about the future of PEEK-based implants. Readers are expected to gain an all-encompassing and in-depth understanding of PEEK biomedical implants' past, present, and future, enabling researchers to advance the research and development of PEEK-based implants in the required direction. STATEMENT OF SIGNIFICANCE: PEEK is a preferred high-performance polymer in the implant industry, with notable benefits over metallic and ceramic implants, such as bone-matching stiffness and durability. Significant strides have been made in the last decade to make PEEK implants bioactive and utilize 3D Printing to develop patient-specific implants. Given the recent advancements in PEEK-based implants, this review aims to provide an all-encompassing and in-depth understanding of PEEK biomedical implants' past, present, and future. It will comprehensively discuss the know-how gained from the clinical follow-up, the strategies to address the limitations of PEEK implants, and the essential considerations in 3D Printing of PEEK implants. This review will enable researchers to advance the research and development of PEEK implants in the required direction.

Chitosan-Surfactant Composite Nanocoatings on Glass and Zinc Surfaces Prepared from Aqueous Solutions

Hydrophobic coatings from chitosan-surfactant composites (ca. 400 nm thick by UV-Vis spectroscopy) for possible corrosion protection were developed on glass and zinc substrates. The surfactants (sodium dodecyl sulfate, SDS or sodium dodecylbenzenesulfonate, and SDBS) were added to the chitosan by two methods: mixing the surfactants with the aqueous chitosan solutions before film deposition or impregnating the deposited chitosan films with surfactants from their aqueous solutions. For the mixed coatings, it was found that the lower surface tension of solutions (40-45 mN/m) corresponded to more hydrophobic (80-90°) coatings in every case. The hydrophobicity of the impregnated coatings was especially significant (88° for SDS and 100° for SDBS). Atomic force microscopy studies revealed a slight increase in roughness (max 1.005) for the most hydrophobic coatings. The accumulation of surfactants in the layer was only significant (0.8-1.0 sulfur atomic %) in the impregnated samples according to X-ray photoelectron spectroscopy. Polarization and electron impedance spectroscopy tests confirmed better barrier properties for these samples (40-50% pseudo-porosity instead of 94%). The degree of swelling in a water vapor atmosphere was significantly lower in the case of the impregnated coatings (ca. 25%) than that of the native ones (ca. 75%), measured by spectroscopic ellipsometry. Accordingly, good barrier layer properties require advantageous bulk properties in addition to surface hydrophobicity.

Strategies to improve the performance of polyetheretherketone (PEEK) as orthopedic implants: from surface modification to addition of bioactive materials

Polyetheretherketone (PEEK), as a high-performance polymer, is widely used for bone defect repair due to its homogeneous modulus of elasticity of human bone, good biocompatibility, excellent chemical stability and projectability. However, the highly hydrophobic surface of PEEK is biologically inert, which makes it difficult for cells and proteins to attach, and is accompanied by the development of infections that ultimately lead to failure of PEEK implants. In order to further enhance the potential of PEEK as an orthopedic implant, researchers have explored modification methods such as surface modification by physical and chemical means and the addition of bioactive substances to PEEK-based materials to enhance the mechanical properties, osteogenic activity and antimicrobial properties of PEEK. However, these current modification methods still have obvious shortcomings in terms of cost, maneuverability, stability and cytotoxicity, which still need to be explored by researchers. This paper reviews some of the modification methods that have been used to improve the performance of PEEK over the last three years in anticipation of the need for researchers to design PEEK orthopedic implants that better meet clinical needs.

Different Polymers for the Base of Removable Dentures? Part II: A Narrative Review of the Dynamics of Microbial Plaque Formation on Dentures

This review focuses on the current disparities and gaps in research on the characteristics of the oral ecosystem of denture wearers, making a unique contribution to the literature on this topic. We aimed to synthesize the literature on the state of current knowledge concerning the biological behavior of the different polymers used in prosthetics. Whichever polymer is used in the composition of the prosthetic base (poly methyl methacrylate acrylic (PMMA), polyamide (PA), or polyether ether ketone (PEEK)), the simple presence of a removable prosthesis in the oral cavity can disturb the balance of the oral microbiota. This phenomenon is aggravated by poor oral hygiene, resulting in an increased microbial load coupled with the reduced salivation that is associated with older patients. In 15-70% of patients, this imbalance leads to the appearance of inflammation under the prosthesis (denture stomatitis, DS). DS is dependent on the equilibrium-as well as on the reciprocal, fragile, and constantly dynamic conditions-between the host and the microbiome in the oral cavity. Several local and general parameters contribute to this balance. Locally, the formation of microbial plaque on dentures (DMP) depends on the phenomena of adhesion, aggregation, and accumulation of microorganisms. To limit DMP, apart from oral and lifestyle hygiene, the prosthesis must be polished and regularly immersed in a disinfectant bath. It can also be covered with an insulating coating. In the long term, relining and maintenance of the prosthesis must also be established to control microbial proliferation. On the other hand, several general conditions specific to the host (aging; heredity; allergies; diseases such as diabetes mellitus or cardiovascular, respiratory, or digestive diseases; and immunodeficiencies) can make the management of DS difficult. Thus, the second part of this review addresses the complexity of the management of DMP depending on the polymer used. The methodology followed in this review comprised the formulation of a search strategy, definition of the inclusion and exclusion criteria, and selection of studies for analysis. The PubMed database was searched independently for pertinent studies. A total of 213 titles were retrieved from the electronic databases, and after applying the exclusion criteria, we selected 84 articles on the possible microbial interactions between the prosthesis and the oral environment, with a particular emphasis on Candida albicans.

Bioglass and Vitamin D3 Coatings for Titanium Implants: Osseointegration and Corrosion Protection

The use of MAPLE synthesized thin films based on BG and VD3 for improving the osseointegration and corrosion protection of Ti-like implant surfaces is reported. The distribution of chemical elements and functional groups was shown by FTIR spectrometry; the stoichiometry and chemical functional integrity of thin films after MAPLE deposition was preserved, optimal results being revealed especially for the BG+VD3_025 samples. The morphology and topography were examined by SEM and AFM, and revealed surfaces with many irregularities, favoring a good adhesion of cells. The thin films' cytotoxicity and biocompatibility were evaluated in vitro at the morphological, biochemical, and molecular level. Following incubation with HDF cells, BG57+VD3_ 025 thin films showed the best degree of biocompatibility, as illustrated by the viability assay values. According to the LDH investigation, all tested samples had higher values compared to the unstimulated cells. The evaluation of cell morphology was performed by fluorescence microscopy following cultivation of HDF cells on the obtained thin films. The cultivation of HDF's on the thin films did not induce major cellular changes. Cells cultured on the BG57+VD3_025 sample had similar morphology to that of unstimulated control cells. The inflammatory profile of human cells cultured on thin films obtained by MAPLE was analyzed by the ELISA technique. It was observed that the thin films did not change the pro- and anti-inflammatory profile of the HDF cells, the IL-6 and IL-10 levels being similar to those of the control sample. The wettability of the MAPLE thin films was investigated by the sessile drop method. A contact angle of 54.65° was measured for the sample coated with BG57+VD3_025. Electrochemical impedance spectroscopy gave a valuable insight into the electrochemical reactions occurring on the surface.

Antimicrobial Peptide Conjugated on Graphene Oxide-Containing Sulfonated Polyetheretherketone Substrate for Effective Antibacterial Activities against Staphylococcus aureus

In the present study, the antimicrobial peptide nisin was successfully conjugated onto the surface of sulfonated polyetheretherketone (SPEEK), which was decorated with graphene oxide (GO) to investigate its biofilm resistance and antibacterial properties. The PEEK was activated with sulfuric acid, resulting in a porous structure. The GO deposition fully covered the porous SPEEK specimen. The nisin conjugation was accomplished using the crosslinker 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC) through a dip-coating method. The surface micrographs of the SPEEK-GO-nisin sample indicated that nisin formed discrete islets on the flat GO surface, allowing both the GO and nisin to perform a bactericidal effect. The developed materials were tested for bactericidal efficacy against Staphylococcus aureus (S. aureus). The SPEEK-GO-nisin sample had the highest antibacterial activity with an inhibition zone diameter of 27 mm, which was larger than those of the SPEEK-nisin (19 mm) and SPEEK-GO (10 mm) samples. Conversely, no inhibitory zone was observed for the PEEK and SPEEK samples. The surface micrographs of the bacteria-loaded SPEEK-GO-nisin sample demonstrated no bacterial adhesion and no biofilm formation. The SPEEK-nisin and SPEEK-GO samples showed some bacterial attachment, whereas the pure PEEK and SPEEK samples had abundant bacterial colonies and thick biofilm formation. These results confirmed the good biofilm resistance and antibacterial efficacy of the SPEEK-GO-nisin sample, which is promising for implantable orthopedic applications.

Strength and bioactivity of PEEK composites containing multiwalled carbon nanotubes and bioactive glass

Polyetheretherketone (PEEK) polymer is a widely accepted implantable biomaterial in the biomedical field. However, PEEK has a low elastic modulus (E-modulus) as well as a bio-inert nature which is not conductive to rapid bone cell attachment, hence, producing delayed or weak bone-implant integration. Multiwalled carbon nanotubes (MWCNTs) represent one of the strongest known materials that could be added to a polymer to improve its mechanical properties. Bioactive glasses (BGs) can form hydroxyapatite deposits on their surfaces and form a tight bond with the bone, thus, their incorporation into the PEEK matrix may improve its bioactivity.

METHODS

Eight groups were formulated according to the type and percentage of modification of PEEK by MWCNTs and BGs. Group 1: Pure PEEK (P), Group 2: P + 3% MWCNTs (PC3), Group 3: P + 5% MWCNTs (PC5), Group 4: P + 5% BGs (PG5), Group 5: P + 10% BGs (PG10), Group 6: P + 3% MWCNTs + 5% BGs (PC3G5), Group 7: P + 3% MWCNTs + 10% BGs (PC3G10), and Group 8: P + 5% MWCNTs + 5% BGs (PC5G5). Characterization of the vacuum-pressed PEEK and PEEK composite specimens was done using FE-SEM, EDS, FT-IR and TF-XRD. Three-point load test was done to obtain the flexural strength (F.S) and the E-modulus of the specimens. Wettability was determined by measuring the contact angle with distilled water. In-vitro bioactivity was determined after immersion of specimens in simulated body fluid (SBF). Moreover, the effect of the specimens on osteoblastic cell viability was evaluated.

RESULTS

Three-point load test results have shown an improvement in both F.S. and E-modulus for groups PC5, PC3G5 and PC5G5. The lowest contact angle was obtained for group PC5G5 followed by the PC3G10 group. All specimens containing BGs showed the formation of hydroxyapatite-like deposits after their immersion in SBF, as well as an improvement in osteoblastic cell viability compared to PEEK.

CONCLUSION

PC3G10, PC3G5 and PG10, groups are promising for the fabrication of patient-specific implants that can be used in low-stress-bearing areas.

Chitosan-Based Smart Biomaterials for Biomedical Applications: Progress and Perspectives

Over the past decade, smart and functional biomaterials have escalated as one of the most rapidly emerging fields in the life sciences because the performance of biomaterials could be improved by careful consideration of their interaction and response with the living systems. Thus, chitosan could play a crucial role in this frontier field because it possesses many beneficial properties, especially in the biomedical field such as excellent biodegradability, hemostatic properties, antibacterial activity, antioxidant properties, biocompatibility, and low toxicity. Furthermore, chitosan is a smart and versatile biopolymer due to its polycationic nature with reactive functional groups that allow the polymer to form many interesting structures or to be modified in various ways to suit the targeted applications. In this review, we provide an up-to-date development of the versatile structures of chitosan-based smart biomaterials such as nanoparticles, hydrogels, nanofibers, and films, as well as their application in the biomedical field. This review also highlights several strategies to enhance biomaterial performance for fast growing fields in biomedical applications such as drug delivery systems, bone scaffolds, wound healing, and dentistry.

Preparation and Surface Characterization of Chitosan-Based Coatings for PET Materials

Poly(ethylene terephthalate)-PET-is one of the most frequently used polymers in biomedical applications. Due to chemical inertness, PET surface modification is necessary to gain specific properties, making the polymer biocompatible. The aim of this paper is to characterize the multi-component films containing chitosan (Ch), phospholipid 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC), immunosuppressant cyclosporine A (CsA) and/or antioxidant lauryl gallate (LG) which can be utilized as a very attractive material for developing the PET coatings. Chitosan was employed owing to its antibacterial activity and also its ability to promote cell adhesion and proliferation favorable for tissue engineering and regeneration purposes. Moreover, the Ch film can be additionally modified with other substances of biological importance (DOPC, CsA and LG). The layers of varying compositions were prepared using the Langmuir-Blodgett (LB) technique on the air plasma-activated PET support. Then their nanostructure, molecular distribution, surface chemistry and wettability were determined by atomic force microscopy (AFM), time-of-flight secondary ion mass spectrometry (TOF-SIMS), X-ray photoelectron spectroscopy (XPS), contact angle (CA) measurements and the surface free energy and its components' determination, respectively. The obtained results show clearly the dependence of the surface properties of the films on the molar ratio of components and allow for a better understanding of the coating organization and mechanisms of interactions at the molecular level both inside the films and between the films and the polar/apolar liquids imitating the environment of different properties. The organized layers of this type can be helpful in gaining control over the surface properties of the biomaterial, thus getting rid of the limitations in favor of increased biocompatibility. This is a good basis for further investigations on the correlation of the immune system response to the presence of biomaterial and its physicochemical properties.