Silver Nanoparticles in Orthopedic Applications: New Insights on Their Effects on Osteogenic Cells

Exploring the bioactivity and antibacterial properties of silver and cerium co-doped borosilicate bioactive glass

Bone defects resulting from trauma or diseases that lead to bone loss have created a growing need for innovative materials suitable for treating bone-related conditions. The purpose of this study is, therefore, to synthesize and analyse the synergistic effects of cerium (Ce) and cerium-silver (Ce-Ag) doping of borosilicate bioactive glass (BBG) on the bioactivity, antibacterial properties, and biocompatibility for potential applications in bone tissue engineering. This study utilized a sol-gel Stöber method to synthesize doped BBGs based on S49B4. Characterization techniques were utilized to evaluate the thermal stability, elemental composition, structural integrity, and morphological properties of the synthesized Ce and AgCe-BBGs. Cytotoxicity was evaluated using a GMSM-K gingival cell line, while antimicrobial tests were conducted using clinical isolates of Escherichia coli and Staphylococcus aureus. The characterization results confirmed the successful incorporation of Ce and Ag, resulting in elongated pineal to spherical nanosized BG particles (33-68 nm). Thermal analysis indicated that silver exhibited lower thermal stability compared to cerium. Bioactivity tests indicated that while silver has intrinsic bioactive qualities, elevated cerium levels above 0.5 wt% may inhibit or delay apatite formation by generating insoluble cerium phosphate ions. Lactate dehydrogenase assays demonstrated that among other BBGs, SBAgCe1 showed the highest LDH activity, suggesting mild cytotoxicity. The co-doped BBG exhibited strong antibacterial activity through a complex interaction between Ag and Ce ionic exchange. Nonetheless, a careful balance of Ce and Ag concentrations is critical, as high levels can compromise bioactivity and increase cytotoxicity. The results highlight the potential of SBAgCe0.5 as a candidate for bone tissue engineering applications due to its favourable bioactivity, and antibacterial and cytocompatible properties, emphasizing the importance of optimizing dopant concentrations for therapeutic applications in favour of good health and the well-being of humanity.

An In Vitro Study on the Application of Silver-Doped Platelet-Rich Plasma in the Prevention of Post-Implant-Associated Infections

Implant therapy is a common treatment option in dentistry and orthopedics, but its application is often associated with an increased risk of microbial contamination of the implant surfaces that cause bone tissue impairment. This study aims to develop two silver-enriched platelet-rich plasma (PRP) multifunctional scaffolds active at the same time in preventing implant-associated infections and stimulating bone regeneration. Commercial silver lactate (L) and newly synthesized silver deoxycholate:β-Cyclodextrin (B), were studied in vitro. Initially, the antimicrobial activity of the two silver soluble forms and the PRP enriched with the two silver forms has been studied on microbial planktonic cells. At the same time, the biocompatibility of silver-enriched PRPs has been assessed by an MTT test on human primary osteoblasts (hOBs). Afterwards, an investigation was conducted to evaluate the activity of selected concentrations and forms of silver-enriched PRPs in inhibiting microbial biofilm formation and stimulating hOB differentiation. PRP-L (0.3 µg/mm2) and PRP-B (0.2 µg/mm2) counteract Staphylococcus aureus, Staphylococcus epidermidis and Candida albicans planktonic cell growth and biofilm formation, preserving hOB viability without interfering with their differentiation capability. Overall, the results obtained suggest that L- and B-enriched PRPs represent a promising preventive strategy against biofilm-related implant infections and demonstrate a new silver formulation that, together with increasing fibrin binding protecting silver in truncated cone-shaped cyclic oligosaccharides, achieved comparable inhibitory results on prokaryotic cells at a lower concentration.

Is Silver Addition to Scaffolds Based on Polycaprolactone Blended with Calcium Phosphates Able to Inhibit Candida albicans and Candida auris Adhesion and Biofilm Formation?

Candida spp. periprosthetic joint infections are rare but difficult-to-treat events, with a slow onset, unspecific symptoms or signs, and a significant relapse risk. Treatment with antifungals meets with little success, whereas prosthesis removal improves the outcome. In fact, Candida spp. adhere to orthopedic devices and grow forming biofilms that contribute to the persistence of this infection and relapse, and there is insufficient evidence that the use of antifungals has additional benefits for anti-biofilm activity. To date, studies on the direct antifungal activity of silver against Candida spp. are still scanty. Additionally, polycaprolactone (PCL), either pure or blended with calcium phosphate, could be a good candidate for the design of 3D scaffolds as engineered bone graft substitutes. Thus, the present research aimed to assess the antifungal and anti-biofilm activity of PCL-based constructs by the addition of antimicrobials, for instance, silver, against C. albicans and C. auris. The appearance of an inhibition halo around silver-functionalized PCL scaffolds for both C. albicans and C. auris was revealed, and a significant decrease in both adherent and planktonic yeasts further demonstrated the release of Ag+ from the 3D constructs. Due to the combined antifungal, osteoproliferative, and biodegradable properties, PCL-based 3D scaffolds enriched with silver showed good potential for bone tissue engineering and offer a promising strategy as an ideal anti-adhesive and anti-biofilm tool for the reduction in prosthetic joints of infections caused by Candida spp. by using antimicrobial molecule-targeted delivery.

Promising applications of phyto-fabricated silver nanoparticles: Recent trends in biomedicine

The prospective contribution of phyto-nanotechnology to the synthesis of silver nanomaterials for biomedical purposes is attracting increasing interest across the world. Green synthesis of silver nanoparticles (Ag-NPs) through plants has been extensively examined recently, and it is now seen to be a green and efficient path for future exploitation and development of practical nano-factories. Fabrication of Ag-NPs is the process involves use of plant extracts/phyto-compounds (e.g.alkaloids, terpenoids, flavonoids, and phenolic compounds) to synthesise nanoparticles in more economical and feasible. Several findings concluded that in the field of medicine, Ag-NPs play a major role in pharmacotherapy (infection and cancer). Indeed, they exhibits novel properties but the reason is unclear (except some theoretical interpretation e.g. size, shape and morphology). But recent technological advancements help to address these questions by predicting the unique properties (composition and origin) by characterizing physical, chemical and biological properties. Due to increased list of publications and their application in the field of agriculture, industries and pharmaceuticals, issues relating to toxicity are unavoidable and question of debate. The present reviews aim to find out the role of plant extracts to synthesise Ag-NPs. It provides an overview of various phytocompounds and their role in the field of biomedicine (antibacterial, antioxidant, anticancer, anti-inflammatory etc.). In addition, this review also especially focused on various applications such as role in infection, oxidative stress, application in medical engineering, diagnosis and therapy, medical devices, orthopedics, wound healing and dressings. Additionally, the toxic effects of Ag-NPs in cell culture, tissue of different model organism, type of toxic reactions and regulation implemented to reduce associated risk are discussed critically. Addressing all above explanations, this review focus on the detailed properties of plant mediated Ag-NPs, its impact on biology, medicine and their commercial properties as well as toxicity.

Translation of nanotechnology-based implants for orthopedic applications: current barriers and future perspective

The objective of bioimplant engineering is to develop biologically compatible materials for restoring, preserving, or altering damaged tissues and/or organ functions. The variety of substances used for orthopedic implant applications has been substantially influenced by modern material technology. Therefore, nanomaterials can mimic the surface properties of normal tissues, including surface chemistry, topography, energy, and wettability. Moreover, the new characteristics of nanomaterials promote their application in sustaining the progression of many tissues. The current review establishes a basis for nanotechnology-driven biomaterials by demonstrating the fundamental design problems that influence the success or failure of an orthopedic graft, cell adhesion, proliferation, antimicrobial/antibacterial activity, and differentiation. In this context, extensive research has been conducted on the nano-functionalization of biomaterial surfaces to enhance cell adhesion, differentiation, propagation, and implant population with potent antimicrobial activity. The possible nanomaterials applications (in terms of a functional nanocoating or a nanostructured surface) may resolve a variety of issues (such as bacterial adhesion and corrosion) associated with conventional metallic or non-metallic grafts, primarily for optimizing implant procedures. Future developments in orthopedic biomaterials, such as smart biomaterials, porous structures, and 3D implants, show promise for achieving the necessary characteristics and shape of a stimuli-responsive implant. Ultimately, the major barriers to the commercialization of nanotechnology-derived biomaterials are addressed to help overcome the limitations of current orthopedic biomaterials in terms of critical fundamental factors including cost of therapy, quality, pain relief, and implant life. Despite the recent success of nanotechnology, there are significant hurdles that must be overcome before nanomedicine may be applied to orthopedics. The objective of this review was to provide a thorough examination of recent advancements, their commercialization prospects, as well as the challenges and potential perspectives associated with them. This review aims to assist healthcare providers and researchers in extracting relevant data to develop translational research within the field. In addition, it will assist the readers in comprehending the scope and gaps of nanomedicine's applicability in the orthopedics field.

Influence of Dynamic Strain Sweep on the Degradation Behavior of FeMnSi-Ag Shape Memory Alloys

Iron-based SMAs can be used in the medical field for both their shape memory effect (SME) and biodegradability after a specific period, solving complicated chirurgical problems that are partially now addressed with shape-memory polymers or biodegradable polymers. Iron-based materials with (28-32 wt %) Mn and (4-6 wt %) Si with the addition of 1 and 2 wt % Ag were obtained using levitation induction melting equipment. Addition of silver to the FeMnSi alloy was proposed in order to enhance its antiseptic property. Structural and chemical composition analyses of the newly obtained alloys were performed by X-ray diffraction (confirming the presence of ε phase), scanning electron microscopy (SEM) and energy-dispersive spectroscopy. The corrosion resistance was evaluated through immersion tests and electrolyte pH solution variation. Dynamic mechanical solicitations were performed with amplitude sweep performed on the FeMnSi-1Ag and FeMnSi-2Ag samples, including five deformation cycles at 40 °C, with a frequency of 1 Hz, 5 Hz and 20 Hz. These experiments were meant to simulate the usual behavior of some metallic implants subjected to repetitive mechanical loading. Atomic force microscopy was used to analyze the surface roughness before and after the dynamic mechanical analysis test followed by the characterization of the surface profile change by varying dynamic mechanical stress. Differential scanning calorimetry was performed in order to analyze the thermal behavior of the material in the range of -50-+200 °C. X-ray diffraction and Fourier transform infrared spectroscopy (FTIR) along with Neaspec nano-FTIR experiments were performed to identify and confirm the corrosion compounds (oxides, hydroxides or carbonates) formed on the surface.

The Clinical Use of Osteobiologic and Metallic Biomaterials in Orthopedic Surgery: The Present and the Future

As the area and range of surgical treatments in the orthopedic field have expanded, the development of biomaterials used for these treatments has also advanced. Biomaterials have osteobiologic properties, including osteogenicity, osteoconduction, and osteoinduction. Natural polymers, synthetic polymers, ceramics, and allograft-based substitutes can all be classified as biomaterials. Metallic implants are first-generation biomaterials that continue to be used and are constantly evolving. Metallic implants can be made from pure metals, such as cobalt, nickel, iron, or titanium, or from alloys, such as stainless steel, cobalt-based alloys, or titanium-based alloys. This review describes the fundamental characteristics of metals and biomaterials used in the orthopedic field and new developments in nanotechnology and 3D-printing technology. This overview discusses the biomaterials that clinicians commonly use. A complementary relationship between doctors and biomaterial scientists is likely to be necessary in the future.

Silver Nanoparticles: Bactericidal and Mechanistic Approach against Drug Resistant Pathogens

This review highlights the different modes of synthesizing silver nanoparticles (AgNPs) from their elemental state to particle format and their mechanism of action against multidrug-resistant and biofilm-forming bacterial pathogens. Various studies have demonstrated that the AgNPs cause oxidative stress, protein dysfunction, membrane disruption, and DNA damage in bacteria, ultimately leading to bacterial death. AgNPs have also been found to alter the adhesion of bacterial cells to prevent biofilm formation. The benefits of using AgNPs in medicine are, to some extent, counter-weighted by their toxic effect on humans and the environment. In this review, we have compiled recent studies demonstrating the antibacterial activity of AgNPs, and we are discussing the known mechanisms of action of AgNPs against bacterial pathogens. Ongoing clinical trials involving AgNPs are briefly presented. A particular focus is placed on the mechanism of interaction of AgNPs with bacterial biofilms, which are a significant pathogenicity determinant. A brief overview of the use of AgNPs in other medical applications (e.g., diagnostics, promotion of wound healing) and the non-medical sectors is presented. Finally, current drawbacks and limitations of AgNPs use in medicine are discussed, and perspectives for the improved future use of functionalized AgNPs in medical applications are presented.

A concise review on implications of silver nanoparticles in bone tissue engineering

Skeletal disorders represent a variety of degenerative diseases that affect bone and cartilage homeostasis. The regenerative capacity of bone is affected in osteoporosis, osteoarthritis, rheumatoid arthritis, bone fractures, congenital defects, and bone cancers. There is no viable, non-invasive treatment option and bone regeneration requires surgical intervention with the implantation of bone grafts. Incorporating nanoparticles in bone grafts have improved fracture healing by providing fine structures for bone tissue engineering. It is currently a revolutionary finding in the field of regenerative medicine. Silver nanoparticles (AgNPs) have garnered particular attention due to their well-known anti-microbial and potential osteoinductive properties. In addition, AgNPs have been demonstrated to regulate the proliferation and differentiation of mesenchymal stem cells (MSCs) involved in bone regeneration. Furthermore, AgNPs have shown toxicity towards cancer cells derived from bone. In the last decade, there have been multiple studies focusing on the effect of nanoparticles on the proliferation and/or differentiation of MSCs and bone cancer cells; however, the specific studies with AgNPs are limited. Although the reported investigations show promising in vitro and in vivo potential of AgNPs for application in bone regeneration, more studies are required to ensure their implications in bone tissue engineering. This review aims to highlight the current advances related to the production of AgNPs and their effect on MSCs and bone cancer cells, which will potentiate their possible implications in orthopedics. Moreover, this review article evaluates the future of AgNPs in bone tissue engineering.

Silver as an Antibiotic-Independent Antimicrobial: Review of Current Formulations and Clinical Relevance

Background: The increase of multi-drug-resistant organisms has revived the use of silver as an alternative antibiotic-independent antimicrobial. Although silver's multimodal mechanism of action provides low risk for bacterial resistance, high local and uncontrolled concentrations have shown toxicity. This has resulted in efforts to develop novel silver formulations that are safer and more predictable in their application. Optimization of silver as an antimicrobial is crucial given the growing resistance profile against antibiotics. This article reviews formulations of silver used as antimicrobials, focusing on the mechanisms of action, potential for toxicity, and clinical applications. Methods: A search of four electronic databases (PubMed, Embase, MEDLINE, and Cochrane Library) was conducted for relevant studies up to January 2022. Searches were conducted for the following types of silver: ionic, nanoparticles, colloidal, silver nitrate, silver sulfadiazine, silver oxide, silver carboxylate, and AQUACEL^® (ConvaTec, Berkshire, UK). Sources were compiled based on title and abstract and screened for inclusion based on relevance and study design. Results: A review of the antimicrobial activity and uses of ionic silver, silver nanoparticles, colloidal silver, silver nitrate, silver sulfadiazine, silver oxide, Aquacel, and silver carboxylate was conducted. The mechanisms of action, clinical uses, and potential for toxicity were studied, and general trends between earlier and more advanced formulations noted. Conclusions: Early forms of silver have more limited utility because of their uncontrolled release of silver ions and potential for systemic toxicity. Multiple new formulations show promise; however, there is a need for more prospective in vivo studies to validate the clinical potential of these formulations.

Applications of Gold and Silver Nanoparticles in Theranostics

Nanotechnology sculptures the current scenario of science and technology. The word nano refers 'small' which ranges from 10 to 100 nm in size. Silver and gold nanoparticles can be synthesized at nanoscale and have unique biological properties like antibacterial, antifungal, antiviral, antiparasitic, antiplatelet, anti-inflammatory, and anti-tumor activity. In this mini review, we shall discuss the various applications of silver and gold nanoparticles (AuNPs) in the field of therapy, imaging, biomedical devices and in cancer diagnosis. The usage of silver nanoparticles(AgNPs) in dentistry and dental implants, therapeutic abilities like wound dressings, silver impregnated catheters, ventricular drainage catheters, combating orthopedic infections, and osteointegration will be elaborated. Gold nanoparticles in recent years have garnered large importance in bio medical applications. They are being used in diagnosis and have recently seen a surge in therapeutics. In this mini review, we shall see about the various applications of AuNP and AgNP, and highlight their evolution in theranostics.

Design, Characterization, and Antibacterial Performance of MAPLE-Deposited Coatings of Magnesium Phosphate-Containing Silver Nanoparticles in Biocompatible Concentrations

Bone disorders and traumas represent a common type of healthcare emergency affecting men and women worldwide. Since most of these diseases imply surgery, frequently complicated by exogenous or endogenous infections, there is an acute need for improving their therapeutic approaches, particularly in clinical conditions requiring orthopedic implants. Various biomaterials have been investigated in the last decades for their potential to increase bone regeneration and prevent orthopedic infections. The present study aimed to develop a series of MAPLE-deposited coatings composed of magnesium phosphate (Mg₃(PO₄)₂) and silver nanoparticles (AgNPs) designed to ensure osteoblast proliferation and anti-infective properties simultaneously. Mg₃(PO₄)₂ and AgNPs were obtained through the cooling bath reaction and chemical reduction, respectively, and then characterized through X-ray Diffraction (XRD), Transmission Electron Microscopy (TEM), and Selected Area Electron Diffraction (SAED). Subsequently, the obtained coatings were evaluated by Infrared Microscopy (IRM), Fourier-Transform Infrared Spectroscopy (FT-IR), and Scanning Electron Microscopy (SEM). Their biological properties show that the proposed composite coatings exhibit well-balanced biocompatibility and antibacterial activity, promoting osteoblasts viability and proliferation and inhibiting the adherence and growth of Staphylococcus aureus and Pseudomonas aeruginosa, two of the most important agents of orthopedic implant-associated infections.

Nanomaterial reinforced composite for biomedical implants applications: a mini-review

There is heavy demand for suitable implant materials with improved mechanical and biological properties. Classically, the demand was catered by conventional materials like metals, alloys, and polymer-based materials. Recently, nanomaterial reinforced composites have played a significant role in replacing conventional materials due to their excellent properties such as biocompatibility, bioactivity, high strength to weight ratio, long life, corrosion & wear resistance, and tailor-ability. Herein, we composed a systematic focus review on the role of nanoparticles in the form of composite materials for the advancements in orthopedic implants. Several nano materials-based reinforcements have been reviewed with various matrix materials, including metals, alloys, ceramics, composites, and polymers for biomedical implant applications. Moreover, the improved biological properties, mechanical properties, and other functionalities like infection resistance, drug delivery at the target, sensing, and detection of bone diseases, and corrosion & wear resistance are elaborated. At last, a particular focus has been given to the un-resolved challenges in orthopedic implant development.

The Effect of Low-Processing Temperature on the Physicochemical and Mechanical Properties of Bovine Hydroxyapatite Bone Substitutes

Bovine bone grafts (BBX) require protein removal as part of the manufacturing process to reduce antigenicity and, in consequence, to be safely used in humans. Deproteinisation may have direct effects on the characteristics of the bone material and on in vivo material performance. This research aimed to comprehensively study the physicochemical and mechanical properties of BBX processed at low deproteinisation processing temperatures. Cubes of bovine bone (8 mm³) were treated with temperatures between 100 °C and 220 °C at 30 °C intervals and with pressures ranging from 1.01 to 24.58 Bar. The samples were characterised topographically and mechanically using scanning electron microscopy (SEM), atomic force microscopy (AFM), and uniaxial bending tests. The organic content and the chemical composition were determined using thermogravimetric analysis (TGA) and Fourier-transform infrared spectroscopy (FTIR). X-ray diffraction (XRD) and FTIR were also used to quantitatively determine the specimen crystallinity. Increasing temperature/pressure was associated with decreasing protein levels and compressive strength and increasing surface irregularities and crystallinity. The findings suggest that low-temperature processed bone is likely to exhibit a rapid in vivo degradation rate. The deproteinisation temperature can be adjusted to tailor the graft properties for specific applications.

Nanotechnology in combating biofilm: A smart and promising therapeutic strategy

Since the birth of civilization, people have recognized that infectious microbes cause serious and often fatal diseases in humans. One of the most dangerous characteristics of microorganisms is their propensity to form biofilms. It is linked to the development of long-lasting infections and more severe illness. An obstacle to eliminating such intricate structures is their resistance to the drugs now utilized in clinical practice (biofilms). Finding new compounds with anti-biofilm effect is, thus, essential. Infections caused by bacterial biofilms are something that nanotechnology has lately shown promise in treating. More and more studies are being conducted to determine whether nanoparticles (NPs) are useful in the fight against bacterial infections. While there have been a small number of clinical trials, there have been several in vitro outcomes examining the effects of antimicrobial NPs. Nanotechnology provides secure delivery platforms for targeted treatments to combat the wide range of microbial infections caused by biofilms. The increase in pharmaceuticals' bioactive potential is one of the many ways in which nanotechnology has been applied to drug delivery. The current research details the utilization of several nanoparticles in the targeted medication delivery strategy for managing microbial biofilms, including metal and metal oxide nanoparticles, liposomes, micro-, and nanoemulsions, solid lipid nanoparticles, and polymeric nanoparticles. Our understanding of how these nanosystems aid in the fight against biofilms has been expanded through their use.

Metallic Nanoscaffolds as Osteogenic Promoters: Advances, Challenges and Scope

Bone injuries and fractures are often associated with post-surgical failures, extended healing times, infection, a lack of return to a normal active lifestyle, and corrosion associated allergies. In this regard, this review presents a comprehensive report on advances in nanotechnology driven solutions for bone tissue engineering. The fabrication of metals such as copper, gold, platinum, palladium, silver, strontium, titanium, zinc oxide, and magnetic nanoparticles with tunable physico-chemical and opto-electronic properties for osteogenic scaffolds is discussed here in detail. Furthermore, the rational selection of a polymeric base such as chitosan, collagen, poly (L-lactide), hydroxyl-propyl-methyl cellulose, poly-lactic-co-glycolic acid, polyglucose-sorbitol-carboxymethy ether, polycaprolactone, natural rubber latex, and silk fibroin for scaffold preparation is also discussed. These advanced materials and fabrication strategies not only provide for appropriate mechanical strength but also render integrity, making them appealing for orthopedic applications. Further, such scaffolds can be functionalized with ligands or biomolecules such as hydroxyapatite, polypyrrole (PPy), magnesium, zinc dopants, and growth factors to stimulate osteogenic differentiation, mineralization, and neovascularization to aid in rapid healing. Future directions to co-incorporate bioceramics, biogenic nanoparticles, and fourth generation biomaterials to enhance biocompatibility, mechanical properties, and rapid recovery are also included in this review. Hence, the further development of such biomimetic metal-based nano-scaffolds at a lower cost with reduced risks and greater efficacy at regrowing bone can revolutionize the future of orthopedics.

Advancements in release-active antimicrobial biomaterials: A journey from release to relief

Escalating medical expenses due to infectious diseases are causing huge socioeconomic pressure on mankind globally. The emergence of antibiotic resistance has further aggravated this problem. Drug-resistant pathogens are also capable of forming thick biofilms on biotic and abiotic surfaces to thrive in a harsh environment. To address these clinical problems, various strategies including antibacterial agent delivering matrices and bactericidal coatings strategies have been developed. In this review, we have discussed various types of polymeric vehicles such as hydrogels, sponges/cryogels, microgels, nanogels, and meshes, which are commonly used to deliver antibiotics, metal nanoparticles, and biocides. Compositions of these polymeric matrices have been elaborately depicted by elucidating their chemical interactions and potential activity have been discussed. On the other hand, various implant/device-surface coating strategies which exploit the release-active mechanism of bacterial killing are discussed in elaboration. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.

Nanotechnology as an Anti-Infection Strategy in Periprosthetic Joint Infections (PJI)

Background: Periprosthetic joint infection (PJI) represents a devastating consequence of total joint arthroplasty (TJA) because of its high morbidity and its high impact on patient quality of life. The lack of standardized preventive and treatment strategies is a major challenge for arthroplasty surgeons. The purpose of this article was to explore the potential and future uses of nanotechnology as a tool for the prevention and treatment of PJI. Methods: Multiple review articles from the PubMed, Scopus and Google Scholar databases were reviewed in order to establish the current efficacy of nanotechnology in PJI preventive or therapeutic scenarios. Results: As a prevention tool, anti-biofilm implants equipped with nanoparticles (silver, silk fibroin, poly nanofibers, nanophase selenium) have shown promising antibacterial functionality. As a therapeutic tool, drug-loaded nanomolecules have been created and a wide variety of carrier materials (chitosan, titanium, calcium phosphate) have shown precise drug targeting and efficient control of drug release. Other nanotechnology-based antibiotic carriers (lipid nanoparticles, silica, clay nanotubes), when added to common bone cements, enhanced prolonged drug delivery, making this technology promising for the creation of antibiotic-added cement joint spacers. Conclusion: Although still in its infancy, nanotechnology has the potential to revolutionize prevention and treatment protocols of PJI. Nevertheless, extensive basic science and clinical research will be needed to investigate the potential toxicities of nanoparticles.

Inhibitory Effects of Gold and Silver Nanoparticles on the Differentiation into Osteoclasts In Vitro

Gold nanoparticles (GNPs) have been widely studied to inhibit differentiation into osteoclasts. However, reports of the inhibitory effects of silver nanoparticles (SNPs) during the process of differentiation into osteoclasts are rare. We compared the inhibitory effect of GNPs and SNPs during the process of differentiation into osteoclasts. Bone marrow-derived cells were differentiated into osteoclasts by the receptor activator of the nuclear factor-kappa-Β ligand (RANKL). The inhibitory effect of GNPs or SNPs during the process of differentiation into osteoclasts was investigated using tartrate-resistant acid phosphatase (TRAP) and actin ring staining. The formation of TRAP positive ⁽⁺⁾ multinuclear cells (MNCs) with the actin ring structure was most inhibited in the SNP group. In addition, the expression of specific genes related to the differentiation into osteoclasts, such as c-Fos, the nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1), TRAP, and Cathepsin K (CTSK) were also inhibited in the SNP groups. As a result, the levels related to differentiation into osteoclasts were consistently lower in the SNP groups than in the GNP groups. Our study suggests that SNPs can be a useful material for inhibiting differentiation into osteoclasts and they can be applied to treatments for osteoporosis patients.

A facile synthesis of mono dispersed spherical silver doped bioactive glass nanoparticle

Bioactive glasses have attracted enormous attention in the field of biomaterials for dental and medical applications. Incorporation of antibacterial ions within BGs has been proved to be a promising approach to fortify their bactericidal character. In this study, homogenous BGs containing silver (Ag) ions were synthesized by sol-gel method. Subsequently, the presence of the embedded ions were characterized by X-ray fluorescence (XRF) elemental analysis and energy dispersive X-ray (EDX) spectroscopy. Moreover, released ions were measured in simulated body fluid (SBF) and their antibacterial effectiveness was further verified using minimum bactericidal concentration (MBC) and minimum inhibitory concentration (MIC) tests. A crystalline hydroxyapatite layer was formed on the Ag-BG surfaces at day 5 approved by X-ray diffraction indicating the preserved bioactivity. The resultant uniform, mono-dispersed and dense nanoparticles show 19 great potential for a range of orthopedic and dental applications.

Endocytosed silver nanoparticles degrade in lysosomes to form secondary nanoparticle structures during expression of autophagy genes in osteogenic cells

Silver nanoparticles (AgNPs) are increasingly used in combination with biomaterials, such as bone grafts, to provide antimicrobial properties. Our research focused on the cytotoxic and intracellular uptake mechanism of AgNPs on osteogenic cells, and the affected gene expression of osteoblasts exposed to AgNPs. Osteoblast cells were found to be relatively resistant to AgNP exposure, compared to osteoclasts, with a higher IC₅₀ and fewer adverse morphological features. AgNPs were endocytosed within lysosomes, which resulted in the secondary internal formation of curved Ag^O nano-chains assemblies within the cytosol. Furthermore, osteoblasts demonstrated an oxidative stress response, with autophagic cell death mechanisms, as indicated from qRT²-PCR analysis, with sustained upregulation of the protective gene Heme Oxygenase 1 reaching 86-fold by 48 hours (10 μg/mL). The internalization and fate of AgNPs in osteogenic cells, and the resulting impact on gene expression over time provide further understanding of the nanotoxicity mechanism of AgNPs.

A new Ag-nanostructured hydroxyapatite porous scaffold: Antibacterial effect and cytotoxicity study

We report a new chemical method for the functionalization of Mg-hydroxyapatite (Mg-HA) scaffold with Ag nanoparticles (Ag NPs) integrating in one step both the synthesis of the Ag NPs and their nano-structuring into the HA matrix (Ag-Mg-HA scaffold). This method exploits a green photochemical synthesis and allows the direct growth of Ag NPs on the Mg-HA surface. The surface structure of Ag-Mg-HA scaffold, investigated by scanning electron microscopy, shows no significant changes in the morphology upon Ag NPs incorporation. The presence of Ag was confirmed by EDX analysis. TEM and spectroscopic investigations show Ag NPs spherical shaped with a mean diameter of about 20 nm exhibiting the typical plasmon absorption band with maximum at 420 nm. The antibacterial properties of Ag-Mg-HA scaffolds were tested against two bacterial strains, Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). The results show excellent antibacterial properties achieving up to 99% and 100% reduction of colonies for both bacteria cultures after 24 h of incubation and 100% of reduction after 48 h of incubation. The cytotoxicity of Ag-Mg-HA was also in deep investigated assessing both cell proliferation and differentiation using hADSCs (human Adipose Derived Stem Cells) and testing data point at 0, 7, 14 and 24 days. The results show cytotoxic effect with cell proliferation decreasing up to 90% at 24 days and osteogenic differentiation inhibition. The observed cytotoxicity can be probable ascribed to the oxidative stress by ROS. Indeed, considering the effectiveness of the nanofunctionalization method and the excellent antibacterial properties showed by the Ag-Mg-HA scaffold, future works will be devoted to create nanofunctionalized scaffold satisfying both antimicrobial and osteo-regenerative properties.

Molecular Effects of Silver Nanoparticles on Monogenean Parasites: Lessons from Caenorhabditis elegans

The mechanisms of action of silver nanoparticles (AgNPs) in monogenean parasites of the genus Cichlidogyrus were investigated through a microarray hybridization approach using genomic information from the nematode Caenorhabditis elegans. The effects of two concentrations of AgNPs were explored, low (6 µg/L Ag) and high (36 µg/L Ag). Microarray analysis revealed that both concentrations of AgNPs activated similar biological processes, although by different mechanisms. Expression profiles included genes involved in detoxification, neurotoxicity, modulation of cell signaling, reproduction, embryonic development, and tegument organization as the main biological processes dysregulated by AgNPs. Two important processes (DNA damage and cell death) were mostly activated in parasites exposed to the lower concentration of AgNPs. To our knowledge, this is the first study providing information on the sub-cellular and molecular effects of exposure to AgNPs in metazoan parasites of fish.

Self-Assembled Supramolecular Hybrid Hydrogel Beads Loaded with Silver Nanoparticles for Antimicrobial Applications

This Full Paper reports the formation of silver (Ag) NPs within spatially resolved two-component hydrogel beads, which combine a low-molecular-weight gelator (LMWG) DBS-CONHNH2 and a polymer gelator (PG) calcium alginate. The AgNPs are formed through in situ reduction of AgI , with the resulting nanoparticle-loaded gels being characterised in detail. The antibacterial activity of the nanocomposite gel beads was tested against two drug-resistant bacterial strains, often associated with hospital-acquired infections: vancomycin-resistant Enterococcus faecium (VRE) and Pseudomonas aeruginosa (PA14), and the AgNP-loaded gels showed good antimicrobial properties against both types of bacteria. It is suggested that the gel bead format of these AgNP-loaded hybrid hydrogels makes them promising versatile materials for potential applications in orthopaedics or wound healing.

Antimicrobial Activity of Nano-Magnesium Hydroxide Against Oral Bacteria and Application in Root Canal Sealer

BACKGROUND The goal of the present work was to assess the antibacterial activity of nano-magnesium hydroxide (NMH) against Streptococcus mutans (S. mutans) and to explore the antimicrobial function of AH Plus™ sealer incorporating NMH. MATERIAL AND METHODS The antimicrobial behavior of NMH against S. mutans was evaluated with bactericidal tests. A modified direct contact test was used to assess the antimicrobial activity of unset AH Plus containing NMH after 5 minutes, 20 minutes, and 60 minutes of contact with bacteria. The antimicrobial effects and the amount of surface-adhering bacteria of the solidified materials were explored by SEM and confocal laser scanning microscopy, respectively. RESULTS NMH powder presented excellent antimicrobial activity against S. mutans. Mg²⁺ and OH⁻ were not the main factors resulting in bacterial death. Approximately 93.1% and 98% of the S. mutans were killed in the AH Plus+7% NMH group after incubation for 5 minutes and 20 minutes, respectively. AH Plus with 5% or 7% NMH were more potent against S. mutans compared with AH Plus alone (P<0.05). Moreover, the antibacterial function of AH Plus was lost after setting. NMH enabled the solidified AH Plus to still have antibacterial properties on the seventh day. CONCLUSIONS NMH can be used to modify AH Plus sealer to eradicate residual bacteria and prevent reinfection.

Comprehensive Evaluation of the Biological Properties of Surface-Modified Titanium Alloy Implants

An increasing interest in the fabrication of implants made of titanium and its alloys results from their capacity to be integrated into the bone system. This integration is facilitated by different modifications of the implant surface. Here, we assessed the bioactivity of amorphous titania nanoporous and nanotubular coatings (TNTs), produced by electrochemical oxidation of Ti6Al4V orthopedic implants' surface. The chemical composition and microstructure of TNT layers was analyzed by X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD). To increase their antimicrobial activity, TNT coatings were enriched with silver nanoparticles (AgNPs) with the chemical vapor deposition (CVD) method and tested against various bacterial and fungal strains for their ability to form a biofilm. The biointegrity and anti-inflammatory properties of these layers were assessed with the use of fibroblast, osteoblast, and macrophage cell lines. To assess and exclude potential genotoxicity issues of the fabricated systems, a mutation reversal test was performed (Ames Assay MPF, OECD TG 471), showing that none of the TNT coatings released mutagenic substances in long-term incubation experiments. The thorough analysis performed in this study indicates that the TNT5 and TNT5/AgNPs coatings (TNT5-the layer obtained upon applying a 5 V potential) present the most suitable physicochemical and biological properties for their potential use in the fabrication of implants for orthopedics. For this reason, their mechanical properties were measured to obtain full system characteristics.

Antibacterial Activities of Aliphatic Polyester Nanocomposites with Silver Nanoparticles and/or Graphene Oxide Sheets

Aliphatic polyesters such as poly(lactic acid) (PLA), polycaprolactone (PCL) and poly(lactic-co-glycolic) acid (PLGA) copolymers have been widely used as biomaterials for tissue engineering applications including: bone fixation devices, bone scaffolds, and wound dressings in orthopedics. However, biodegradable aliphatic polyesters are prone to bacterial infections due to the lack of antibacterial moieties in their macromolecular chains. In this respect, silver nanoparticles (AgNPs), graphene oxide (GO) sheets and AgNPs-GO hybrids can be used as reinforcing nanofillers for aliphatic polyesters in forming antimicrobial nanocomposites. However, polymeric matrix materials immobilize nanofillers to a large extent so that they cannot penetrate bacterial membrane into cytoplasm as in the case of colloidal nanoparticles or nanosheets. Accordingly, loaded GO sheets of aliphatic polyester nanocomposites have lost their antibacterial functions such as nanoknife cutting, blanket wrapping and membrane phospholipid extraction. In contrast, AgNPs fillers of polyester nanocomposites can release silver ions for destroying bacterial cells. Thus, AgNPs fillers are more effective than loaded GO sheets of polyester nanocomposiites in inhibiting bacterial infections. Aliphatic polyester nanocomposites with AgNPs and AgNPs-GO fillers are effective to kill multi-drug resistant bacteria that cause medical device-related infections.

A Precautionary Approach to Guide the Use of Transition Metal-Based Nanotechnology to Prevent Orthopedic Infections

The increase of multidrug-resistant bacteria remains a global concern. Among the proposed strategies, the use of nanoparticles (NPs) alone or associated with orthopedic implants represents a promising solution. NPs are well-known for their antimicrobial effects, induced by their size, shape, charge, concentration and reactive oxygen species (ROS) generation. However, this non-specific cytotoxic potential is a powerful weapon effective against almost all microorganisms, but also against eukaryotic cells, raising concerns related to their safe use. Among the analyzed transition metals, silver is the most investigated element due to its antimicrobial properties per se or as NPs; however, its toxicity raises questions about its biosafety. Even though it has milder antimicrobial and cytotoxic activity, TiO₂ needs to be exposed to UV light to be activated, thus limiting its use conjugated to orthopedic devices. By contrast, gold has a good balance between antimicrobial activity as an NP and cytocompatibility because of its inability to generate ROS. Nevertheless, although the toxicity and persistence of NPs within filter organs are not well verified, nowadays, several basic research on NP development and potential uses as antimicrobial weapons is reported, overemphasizing NPs potentialities, but without any existing potential of translation in clinics. This analysis cautions readers with respect to regulation in advancing the development and use of NPs. Hopefully, future works in vivo and clinical trials will support and regulate the use of nano-coatings to guarantee safer use of this promising approach against antibiotic-resistant microorganisms.

Nanotechnology-enabled materials for hemostatic and anti-infection treatments in orthopedic surgery

The hemostatic and anti-infection treatments in the field of orthopedics are always the pivotal yet challenging topics. In the first part of this review, synthesized or naturally derived nanoscale agents and materials for hemostatic treatment in orthopedic surgery are introduced. The hemostatic mechanisms and the safety concerns of these nanotechnology-enabled materials are discussed. Beside the materials to meet hemostatic needs in orthopedic surgery, the need for antimicrobial or anti-infection strategy in orthopedic surgery also becomes urgent. Nanosilver and its derivatives have the most consistent anti-infective effect and thus high translational potential for clinical applications. In the second part, the factors affecting the antimicrobial effect of nanosilver and its application status are summarized. Finally, the status and translational potential of various nanotechnology-enabled materials and agents for hemostatic and anti-infective treatments in orthopedic surgery are discussed.

Biomedical Applications of Silver Nanoparticles: An Up-to-Date Overview

During the past few years, silver nanoparticles (AgNPs) became one of the most investigated and explored nanotechnology-derived nanostructures, given the fact that nanosilver-based materials proved to have interesting, challenging, and promising characteristics suitable for various biomedical applications. Among modern biomedical potential of AgNPs, tremendous interest is oriented toward the therapeutically enhanced personalized healthcare practice. AgNPs proved to have genuine features and impressive potential for the development of novel antimicrobial agents, drug-delivery formulations, detection and diagnosis platforms, biomaterial and medical device coatings, tissue restoration and regeneration materials, complex healthcare condition strategies, and performance-enhanced therapeutic alternatives. Given the impressive biomedical-related potential applications of AgNPs, impressive efforts were undertaken on understanding the intricate mechanisms of their biological interactions and possible toxic effects. Within this review, we focused on the latest data regarding the biomedical use of AgNP-based nanostructures, including aspects related to their potential toxicity, unique physiochemical properties, and biofunctional behaviors, discussing herein the intrinsic anti-inflammatory, antibacterial, antiviral, and antifungal activities of silver-based nanostructures.

Potential antibacterial mechanism of silver nanoparticles and the optimization of orthopedic implants by advanced modification technologies

Infection, as a common postoperative complication of orthopedic surgery, is the main reason leading to implant failure. Silver nanoparticles (AgNPs) are considered as a promising antibacterial agent and always used to modify orthopedic implants to prevent infection. To optimize the implants in a reasonable manner, it is critical for us to know the specific antibacterial mechanism, which is still unclear. In this review, we analyzed the potential antibacterial mechanisms of AgNPs, and the influences of AgNPs on osteogenic-related cells, including cellular adhesion, proliferation, and differentiation, were also discussed. In addition, methods to enhance biocompatibility of AgNPs as well as advanced implants modifications technologies were also summarized.

Metal (Ag/Ti)-Containing Hydrogenated Amorphous Carbon Nanocomposite Films with Enhanced Nanoscratch Resistance: Hybrid PECVD/PVD System and Microstructural Characteristics

This study aimed to develop hydrogenated amorphous carbon thin films with embedded metallic nanoparticles (a–C:H:Me) of controlled size and concentration. Towards this end, a novel hybrid deposition system is presented that uses a combination of Plasma Enhanced Chemical Vapor Deposition (PECVD) and Physical Vapor Deposition (PVD) technologies. The a–C:H matrix was deposited through the acceleration of carbon ions generated through a radio-frequency (RF) plasma source by cracking methane, whereas metallic nanoparticles were generated and deposited using terminated gas condensation (TGC) technology. The resulting material was a hydrogenated amorphous carbon film with controlled physical properties and evenly dispersed metallic nanoparticles (here Ag or Ti). The physical, chemical, morphological and mechanical characteristics of the films were investigated through X-ray reflectivity (XRR), Raman spectroscopy, Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM), Transmission Electron Microscopy (TEM) and nanoscratch testing. The resulting amorphous carbon metal nanocomposite films (a–C:H:Ag and a–C:H:Ti) exhibited enhanced nanoscratch resistance (up to +50%) and low values of friction coefficient (<0.05), properties desirable for protective coatings and/or solid lubricant applications. The ability to form nanocomposite structures with tunable coating performance by potentially controlling the carbon bonding, hydrogen content, and the type/size/percent of metallic nanoparticles opens new avenues for a broad range of applications in which mechanical, physical, biological and/or combinatorial properties are required.

Polyvinyl alcohol/Sodium alginate integrated silver nanoparticles as probable solution for decontamination of microbes contaminated water

It is well known that the pathogenic multidrug resistant microbes are highly distributed and transferred to human through contaminated food and water. Advanced technologies have been developed for controlling these microbes using synthesized nanoparticles. In this study, biosynthesized silver nanoparticles were prepared, characterized and integrated with two synthetic and natural polymers. The polymers-silver nanoparticles were characterized using SEM, FTIR and mechanical properties of the membrane synthesized from either polymers with/without nanosilver. Both of pathogenic bacteria and yeast were tested for their resistance against 10 different antibiotics. The pathogens showed high resistance against 9 antibiotics and only one was recorded as potent. The cytotoxicity of nanosilver integrated polymers were tested against Hamster kidney cells and Human skin fibroblast cells, and the non-cytotoxic dose was checked for its antimicrobial activity against the selected pathogens. The obtained results in this study confirm that the using of the nanomaterials in safe doses could be a good substitution for biogenic antibiotics and chemicals used in water treatment. Moreover, the beads which were used in this study could be lasts for long period in water treatment station with high antibacterial capacity, in addition, it can be gathered easily at the end of the run.