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Abdulghafor MA, Mahmood MK, Tassery H, Tardivo D, Falguiere A, Lan R. Biomimetic Coatings in Implant Dentistry: A Quick Update. J Funct Biomater 2023; 15:15. [PMID: 38248682 PMCID: PMC10816551 DOI: 10.3390/jfb15010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Biomimetic dental implants are regarded as one of the recent clinical advancements in implant surface modification. Coatings with varying thicknesses and roughness may affect the dental implant surface's chemical inertness, cell adhesion, and antibacterial characteristics. Different surface coatings and mechanical surface changes have been studied to improve osseointegration and decrease peri-implantitis. The surface medication increases surface energy, leading to enhanced cell proliferation and growth factors, and, consequently, to a rise in the osseointegration process. This review provides a comprehensive update on the numerous biomimetic coatings used to improve the surface characteristics of dental implants and their applications in two main categories: coating to improve osseointegration, including the hydroxyapatite layer and nanocomposites, growth factors (BMPs, PDGF, FGF), and extracellular matrix (collagen, elastin, fibronectin, chondroitin sulfate, hyaluronan, and other proteoglycans), and coatings for anti-bacterial performance, covering drug-coated dental implants (antibiotic, statin, and bisphosphonate), antimicrobial peptide coating (GL13K and human beta defensins), polysaccharide antibacterial coatings (natural chitosan and its coupling agents) and metal elements (silver, zinc, and copper).
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Affiliation(s)
| | - Mohammed Khalid Mahmood
- Faculty of Dentistry, Aix-Marseille University, CNRS, EFS, ADES, 13284 Marseille, France;
- College of Dentistry, The American University of Iraq, Sulaimani 46001, Kurdistan, Iraq
| | | | - Delphine Tardivo
- Faculty of Dentistry, Aix-Marseille University, CNRS, EFS, ADES, 13284 Marseille, France;
| | - Arthur Falguiere
- Oral Surgery Department, Timone Hospital, Aix-Marseille University, APHM, 13284 Marseille, France
| | - Romain Lan
- Oral Surgery Department, Timone Hospital, Aix-Marseille University, APHM, CNRS, EFS, ADES, 13284 Marseille, France;
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Hegyi A, Lăzărescu AV, Ciobanu AA, Ionescu BA, Grebenişan E, Chira M, Florean C, Vermeşan H, Stoian V. Study on the Possibilities of Developing Cementitious or Geopolymer Composite Materials with Specific Performances by Exploiting the Photocatalytic Properties of TiO 2 Nanoparticles. Materials (Basel) 2023; 16:ma16103741. [PMID: 37241366 DOI: 10.3390/ma16103741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/06/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023]
Abstract
Starting from the context of the principles of Sustainable Development and Circular Economy concepts, the paper presents a synthesis of research in the field of the development of materials of interest, such as cementitious composites or alkali-activated geopolymers. Based on the reviewed literature, the influence of compositional or technological factors on the physical-mechanical performance, self-healing capacity and biocidal capacity obtained was analyzed. The inclusion of TiO2 nanoparticles in the matrix increase the performances of cementitious composites, producing a self-cleaning capacity and an anti-microbial biocidal mechanism. As an alternative, the self-cleaning capacity can be achieved through geopolymerization, which provides a similar biocidal mechanism. The results of the research carried out indicate the real and growing interest for the development of these materials but also the existence of some elements still controversial or insufficiently analyzed, therefore concluding the need for further research in these areas. The scientific contribution of this study consists of bringing together two apparently distinct research directions in order to identify convergent points, to create a favorable framework for the development of an area of research little addressed so far, namely, the development of innovative building materials by combining improved performance with the possibility of reducing environmental impact, awareness and implementation of the concept of a Circular Economy.
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Affiliation(s)
- Andreea Hegyi
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floresti, 400524 Cluj-Napoca, Romania
| | | | | | | | - Elvira Grebenişan
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floresti, 400524 Cluj-Napoca, Romania
| | - Mihail Chira
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floresti, 400524 Cluj-Napoca, Romania
| | - Carmen Florean
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Floresti, 400524 Cluj-Napoca, Romania
- NIRD URBAN-INCERC Iaşi Branch, 6 Anton Şesan Street, 700048 Iaşi, Romania
| | - Horaţiu Vermeşan
- Faculty of Materials and Environmental Engineering, Technical University of Cluj-Napoca, 103-105 Muncii Boulevard, 400641 Cluj-Napoca, Romania
| | - Vlad Stoian
- Department of Microbiology, Facutly of Agriculture, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 3-5 Calea Mănăştur, 400372 Cluj-Napoca, Romania
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3
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Lundin PM, Fiser BL, Blackledge MS, Pickett HL, Copeland AL. Functionalized Self-Assembled Monolayers: Versatile Strategies to Combat Bacterial Biofilm Formation. Pharmaceutics 2022; 14:1613. [PMID: 36015238 PMCID: PMC9415113 DOI: 10.3390/pharmaceutics14081613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
Bacterial infections due to biofilms account for up to 80% of bacterial infections in humans. With the increased use of antibiotic treatments, indwelling medical devices, disinfectants, and longer hospital stays, antibiotic resistant infections are sharply increasing. Annual deaths are predicted to outpace cancer and diabetes combined by 2050. In the past two decades, both chemical and physical strategies have arisen to combat biofilm formation on surfaces. One such promising chemical strategy is the formation of a self-assembled monolayer (SAM), due to its small layer thickness, strong covalent bonds, typically facile synthesis, and versatility. With the goal of combating biofilm formation, the SAM could be used to tether an antibacterial agent such as a small-molecule antibiotic, nanoparticle, peptide, or polymer to the surface, and limit the agent’s release into its environment. This review focuses on the use of SAMs to inhibit biofilm formation, both on their own and by covalent grafting of a biocidal agent, with the potential to be used in indwelling medical devices. We conclude with our perspectives on ongoing challenges and future directions for this field.
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Abstract
Implant-related infection is a disastrous complication. Surface modification of titanium is considered as an important strategy to prevent implant-related infection. However, there is no recognized surface modification strategy that can be applied in clinic so far. We explored a new strategy of coating. The clindamycin-loaded titanium was constructed by layer-by-layer self-assembly. The release of clindamycin from titanium was detected through high performance liquid chromatography. Different titanium was co-cultured with Staphylococcus aureus for 24 h in vitro, then the effect of different titanium on bacterial colonization and biofilm formation was determined by spread plate method and scanning electron microscopy. Cytotoxicity and cytocompatibility of clindamycin-loaded titanium on MC3T3-E1 cells were measured by CCK8. The antibacterial ability of clindamycin-loaded titanium in vivo was also evaluated using a rat model of osteomyelitis. The number of osteoclasts in bone defect was observed by tartrate-resistant acid phosphatase staining. Bacterial burden of surrounding tissues around the site of infection was calculated by tissue homogenate and colony count. Clindamycin-loaded titanium could release clindamycin slowly within 160 h. It reduced bacterial colonization by three orders of magnitude compare to control (p < .05) and inhibits biofilm formation in vitro. Cells proliferation and adhesion were similar on three titanium surfaces (p > .05). In vivo, clindamycin-loaded titanium improved bone healing, reduced microbial burden, and decreased the number of osteoclasts compared control titanium in the rat model of osteomyelitis. This study demonstrated that clindamycin-loaded titanium exhibited good biocompatibility, and showed antibacterial activity both in vivo and in vitro. It is promising and might have potential for clinical application.
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Affiliation(s)
- Youbin Li
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Shaochuan Wang
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Shidan Li
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Jun Fei
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China.,12525State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, Chongqing, China
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Cheng OT, Stein AP, Babajanian E, Hoppe KR, Li S, Jung H, Abrol A, Akkus A, Younesi M, Altawallbeh G, Ghannoum MA, Bonfield T, Akkus O, Zender CA. Heparin-mediated antibiotic delivery from an electrochemically-aligned collagen sheet. Biomed Mater Eng 2021; 32:159-170. [PMID: 33780355 DOI: 10.3233/bme-201133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Implantable medical devices and hardware are prolific in medicine, but hardware associated infections remain a major issue. OBJECTIVE To develop and evaluate a novel, biologic antimicrobial coating for medical implants. METHODS Electrochemically compacted collagen sheets with and without crosslinked heparin were synthesized per a protocol developed by our group. Sheets were incubated in antibiotic solution (gentamicin or moxifloxacin) overnight, and in vitro activity was assessed with five-day diffusion assays against Pseudomonas aeruginosa. Antibiotic release over time from gentamicin-infused sheets was determined using in vitro elution and high performance liquid chromatography (HPLC). RESULTS Collagen-heparin-antibiotic sheets demonstrated larger growth inhibition zones against P. aeruginosa compared to collagen-antibiotic alone sheets. This activity persisted for five days and was not impacted by rinsing sheets prior to evaluation. Rinsed collagen-antibiotic sheets did not produce any inhibition zones. Elution of gentamicin from collagen-heparin-gentamicin sheets was gradual and remained above the minimal inhibitory concentration for gentamicin-sensitive organisms for 29 days. Conversely, collagen-gentamicin sheets eluted their antibiotic load within 24 hours. Overall, heparin-associated sheets demonstrated larger inhibition zones against P. aeruginosa and prolonged elution profile via HPLC. CONCLUSION We developed a novel, local antibiotic delivery system that could be used to coat medical implants/hardware in the future and reduce post-operative infections.
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Affiliation(s)
- Olivia T Cheng
- Case Western Reserve University (CWRU) School of Medicine, Cleveland, OH, USA
| | - Andrew P Stein
- Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Eric Babajanian
- Case Western Reserve University (CWRU) School of Medicine, Cleveland, OH, USA
| | - Kathryn R Hoppe
- Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Shawn Li
- Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Hyungjin Jung
- Department of Biomedical Engineering, CWRU, Cleveland, OH, USA
| | - Anish Abrol
- Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Anna Akkus
- Department of Macromolecular Science & Engineering, CWRU, Cleveland, OH, USA
| | - Mousa Younesi
- Department of Biomedical Engineering, CWRU, Cleveland, OH, USA
| | | | - Mahmoud A Ghannoum
- Center for Medical Mycology, CWRU and University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | | | - Ozan Akkus
- Department of Biomedical Engineering, CWRU, Cleveland, OH, USA
| | - Chad A Zender
- Department of Otolaryngology, University of Cincinnati, Cincinnati, OH, USA
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Kligman S, Ren Z, Chung CH, Perillo MA, Chang YC, Koo H, Zheng Z, Li C. The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation. J Clin Med 2021; 10:1641. [PMID: 33921531 PMCID: PMC8070594 DOI: 10.3390/jcm10081641] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant's surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.
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Affiliation(s)
- Stefanie Kligman
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Zhi Ren
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Michael Angelo Perillo
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Yu-Cheng Chang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Hyun Koo
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
- Center for Innovation & Precision Dentistry, School of Dental Medicine and School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhong Zheng
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
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7
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Hegyi A, Lăzărescu AV, Szilagyi H, Grebenişan E, Goia J, Mircea A. Influence of TiO 2 Nanoparticles on the Resistance of Cementitious Composite Materials to the Action of Bacteria. Materials (Basel) 2021; 14:ma14051074. [PMID: 33669089 PMCID: PMC7956814 DOI: 10.3390/ma14051074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 01/12/2023]
Abstract
The formation of biofilms on cementitious building surfaces can cause visible discoloration and premature deterioration, and it can also represent a potential health threat to building occupants. The use of embedded biofilm-resistant photoactivated TiO2 nanoparticles at low concentrations in the cementitious composite matrix is an effective method to increase material durability and reduce maintenance costs. Zone of inhibition studies of TiO2-infused cementitious samples showed efficacy toward both Gram-negative and Gram-positive bacteria.
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Affiliation(s)
- Andreea Hegyi
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Florești, 400524 Cluj-Napoca, Romania; (A.H.); (H.S.); (E.G.)
| | - Adrian-Victor Lăzărescu
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Florești, 400524 Cluj-Napoca, Romania; (A.H.); (H.S.); (E.G.)
- Correspondence: (A.-V.L.); (A.M.)
| | - Henriette Szilagyi
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Florești, 400524 Cluj-Napoca, Romania; (A.H.); (H.S.); (E.G.)
| | - Elvira Grebenişan
- NIRD URBAN-INCERC Cluj-Napoca Branch, 117 Calea Florești, 400524 Cluj-Napoca, Romania; (A.H.); (H.S.); (E.G.)
| | - Jana Goia
- Municipal Hospital, 14–16 1 Mai Street, 405200 Dej, Romania;
| | - Andreea Mircea
- Facultatea de Construcţii, Technical University of Cluj-Napoca, 28 Memorandumului, 400114 Cluj-Napoca, Romania
- Correspondence: (A.-V.L.); (A.M.)
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8
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Zhang E, Zhao X, Hu J, Wang R, Fu S, Qin G. Antibacterial metals and alloys for potential biomedical implants. Bioact Mater 2021; 6:2569-2612. [PMID: 33615045 PMCID: PMC7876544 DOI: 10.1016/j.bioactmat.2021.01.030] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/11/2021] [Accepted: 01/27/2021] [Indexed: 02/07/2023] Open
Abstract
Metals and alloys, including stainless steel, titanium and its alloys, cobalt alloys, and other metals and alloys have been widely used clinically as implant materials, but implant-related infection or inflammation is still one of the main causes of implantation failure. The bacterial infection or inflammation that seriously threatens human health has already become a worldwide complaint. Antibacterial metals and alloys recently have attracted wide attention for their long-term stable antibacterial ability, good mechanical properties and good biocompatibility in vitro and in vivo. In this review, common antibacterial alloying elements, antibacterial standards and testing methods were introduced. Recent developments in the design and manufacturing of antibacterial metal alloys containing various antibacterial agents were described in detail, including antibacterial stainless steel, antibacterial titanium alloy, antibacterial zinc and alloy, antibacterial magnesium and alloy, antibacterial cobalt alloy, and other antibacterial metals and alloys. Researches on the antibacterial properties, mechanical properties, corrosion resistance and biocompatibility of antibacterial metals and alloys have been summarized in detail for the first time. It is hoped that this review could help researchers understand the development of antibacterial alloys in a timely manner, thereby could promote the development of antibacterial metal alloys and the clinical application. This paper focuses the recent development of several antibacterial metals and alloys as biomedical materials. The possible antibacterial mechanisms of antibacterial metals and alloys are summarized in this paper. This review discusses the feasibility of antibacterial metals and alloys as biomedical implants in the future.
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Affiliation(s)
- Erlin Zhang
- Key Lab. for Anisotropy and Texture of Materials, Education Ministry of China, School of Materials Science and Engineering, Northeastern University, Shenyang, 150819, China.,Research Center for Metallic Wires, Northeastern University, Shenyang, 110819, China
| | - Xiaotong Zhao
- Key Lab. for Anisotropy and Texture of Materials, Education Ministry of China, School of Materials Science and Engineering, Northeastern University, Shenyang, 150819, China
| | - Jiali Hu
- Key Lab. for Anisotropy and Texture of Materials, Education Ministry of China, School of Materials Science and Engineering, Northeastern University, Shenyang, 150819, China
| | - Ruoxian Wang
- Key Lab. for Anisotropy and Texture of Materials, Education Ministry of China, School of Materials Science and Engineering, Northeastern University, Shenyang, 150819, China
| | - Shan Fu
- Key Lab. for Anisotropy and Texture of Materials, Education Ministry of China, School of Materials Science and Engineering, Northeastern University, Shenyang, 150819, China
| | - Gaowu Qin
- Key Lab. for Anisotropy and Texture of Materials, Education Ministry of China, School of Materials Science and Engineering, Northeastern University, Shenyang, 150819, China.,Research Center for Metallic Wires, Northeastern University, Shenyang, 110819, China
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Abstract
Implant devices have = proven a successful treatment modality in reconstructive surgeries. However, increasing rates of peri-implant diseases demand further examination of their pathogenesis. Polymicrobial biofilm formation on titanium surfaces has been considered the main risk factor for inflammatory processes on tissues surrounding implant devices, which often lead to implant failure. To overcome microbial accumulation on titanium surfaces biofilm targeting strategies have been developed to modify the surface and incorporate antimicrobial coatings. Because antibiotics are widely used to treat polymicrobial infections, these agents have recently started to be incorporated on titanium surface. This review discusses the biofilm formation on titanium dental implants and key factors to be considered in therapeutic and preventative strategies. Moreover, a systematic review was conducted on coatings developed for titanium surfaces using different antibiotics. This review will also shed light on potential alternative strategies aiming to reduce microbial loads and control polymicrobial infection on implanted devices.
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Affiliation(s)
- João Gabriel Silva Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
- Dental Research Division, Guarulhos University, Guarulhos, SP 07023-070, Brazil
- Dentistry Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais, 39401-303, Brazil
| | - Martinna Mendonça Bertolini
- Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Bruna Egumi Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Anna Dongari-Bagtzoglou
- Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
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Li P, Gao Z, Tan Z, Xiao J, Wei L, Chen Y. New developments in anti-biofilm intervention towards effective management of orthopedic device related infections (ODRI's). Biofouling 2021; 37:1-35. [PMID: 33618584 DOI: 10.1080/08927014.2020.1869725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
Orthopedic device related infections (ODRI's) represent a difficult to treat situation owing to their biofilm based nature. Biofilm infections once established are difficult to eradicate even with an aggressive treatment regimen due to their recalcitrance towards antibiotics and immune attack. The involvement of antibiotic resistant pathogens as the etiological agent further worsens the overall clinical picture, pressing on the need to look into alternative treatment strategies. The present review highlightes the microbiological challenges associated with treatment of ODRI's due to biofilm formation on the implant surface. Further, it details the newer anti-infective modalities that work either by preventing biofilm formation and/or through effective disruption of the mature biofilms formed on the medical implant. The study, therefore aims to provide a comprehensive insight into the newer anti-biofilm interventions (non-antibiotic approaches) and a better understanding of their mechanism of action essential for improved management of orthopedic implant infections.
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Affiliation(s)
- Ping Li
- Department of Orthopedics, Ya'an People's Hospital, Yaan City, China
| | - Zhenwu Gao
- Department of Orthopedics, Shanxi Bethune Hospital, Taiyuan City, China
| | - Zhenwei Tan
- Department of Orthopedics, Western Theater Air Force Hospital of PLA, Chengdu, China
| | - Jun Xiao
- Department of Orthopedics, Ya'an People's Hospital, Yaan City, China
| | - Li Wei
- Nursing Department, Three Gorges Hospital Affiliated to Chongqing University, Chongqing, China
| | - Yirui Chen
- Department of Orthopedics, Three Gorges Hospital Affiliated to Chongqing University, Chongqing, China
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11
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Bai R, Peng L, Sun Q, Zhang Y, Zhang L, Wei Y, Han B. Metallic Antibacterial Surface Treatments of Dental and Orthopedic Materials. Materials (Basel) 2020; 13:ma13204594. [PMID: 33076495 PMCID: PMC7658793 DOI: 10.3390/ma13204594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 12/12/2022]
Abstract
The oral cavity harbors complex microbial communities, which leads to biomaterial-associated infections (BAI) during dental and orthopedic treatments. Conventional antibiotic treatments have met great challenges recently due to the increasing emergency of drug-resistant bacteria. To tackle this clinical issue, antibacterial surface treatments, containing surface modification and coatings, of dental and orthopedic materials have become an area of intensive interest now. Among various antibacterial agents used in surface treatments, metallic agents possess unique properties, mainly including broad-spectrum antibacterial properties, low potential to develop bacterial resistance, relative biocompatibility, and chemical stability. Therefore, this review mainly focuses on underlying antibacterial applications and the mechanisms of metallic agents in dentistry and orthopedics. An overview of the present review indicates that much work remains to be done to deepen the understanding of antibacterial mechanisms and potential side-effects of metallic agents.
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Affiliation(s)
- Rushui Bai
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China; (R.B.); (L.P.); (Q.S.); (Y.Z.); (L.Z.)
| | - Liying Peng
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China; (R.B.); (L.P.); (Q.S.); (Y.Z.); (L.Z.)
| | - Qiannan Sun
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China; (R.B.); (L.P.); (Q.S.); (Y.Z.); (L.Z.)
| | - Yunfan Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China; (R.B.); (L.P.); (Q.S.); (Y.Z.); (L.Z.)
| | - Lingyun Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China; (R.B.); (L.P.); (Q.S.); (Y.Z.); (L.Z.)
| | - Yan Wei
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China
- Correspondence: (Y.W.); (B.H.); Tel.: +86-010-82195584 (Y.W.); +86-010-82195381 (B.H.)
| | - Bing Han
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, China; (R.B.); (L.P.); (Q.S.); (Y.Z.); (L.Z.)
- Correspondence: (Y.W.); (B.H.); Tel.: +86-010-82195584 (Y.W.); +86-010-82195381 (B.H.)
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12
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Abstract
The limited lifetime of implants entails having patients undergo replacement surgeries, several times throughout life in young patients, with significant risks for them and extensive cost for healthcare service. The overcoming of such inconvenience is still today a hard challenge for the scholars of the biomedical and biomaterial fields. The improvement of the currently employed implants through surface modification by coatings application is the main strategy proposed to avoid implants failure, and the sol-gel coating is an ideal technology to achieve this goal. Therefore, the present review aims to provide an overview of the most important problems leading to implant failure, the sol-gel coating technology, and its use as a strategy to overcome such issues.
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13
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Qin S, Xu K, Nie B, Ji F, Zhang H. Approaches based on passive and active antibacterial coating on titanium to achieve antibacterial activity. J Biomed Mater Res A 2019; 106:2531-2539. [PMID: 29603857 DOI: 10.1002/jbm.a.36413] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/02/2018] [Accepted: 03/15/2018] [Indexed: 12/26/2022]
Abstract
Titanium (Ti) and its alloys are widely applied as orthopedic implants for hip and knee prosthesis, fixation, and dental implants. However, Ti and its alloys are bioinert and susceptible to bacteria and biofilm formation. Strategies for improving the antibacterial properties of Ti can be divided into two approaches, namely, passive coating and active coating on the Ti surface. Passive coating on Ti mainly kills the bacteria in contact but does not kill plankton or bacteria dwell in the bone tissue around the Ti implant. Active coating mainly involves the release of antibacterial agents to kill the bacteria, but this may result in the development of bacterial resistance. Both strategies include advantages and disadvantages. This article reviews the current and potential future approaches for improving antibacterial activity on Ti. We mainly focus on current approaches for fabricating antibacterial Ti and its limitations and countermeasures, and provide direction for further studies of biofunctionalization of Ti with antibacterial properties. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A:2531-2539, 2018.
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Affiliation(s)
- Sheng Qin
- Department of Orthopedics, Changhai hospital Affiliated to the Navy Military Medical University, Shanghai, People's Republic of China
| | - Kaihang Xu
- Department of Orthopedics, Changhai hospital Affiliated to the Navy Military Medical University, Shanghai, People's Republic of China
| | - Binen Nie
- Department of Bone and Joint Surgery, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Fang Ji
- Department of Orthopedics, Changhai hospital Affiliated to the Navy Military Medical University, Shanghai, People's Republic of China
| | - Hao Zhang
- Department of Orthopedics, Changhai hospital Affiliated to the Navy Military Medical University, Shanghai, People's Republic of China
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14
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Chouirfa H, Bouloussa H, Migonney V, Falentin-Daudré C. Review of titanium surface modification techniques and coatings for antibacterial applications. Acta Biomater 2019; 83:37-54. [PMID: 30541702 DOI: 10.1016/j.actbio.2018.10.036] [Citation(s) in RCA: 408] [Impact Index Per Article: 81.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 10/09/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023]
Abstract
Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. However, implant-related infections remain among the leading reasons for failure. The most critical pathogenic event in the development of infection on biomaterials is biofilm formation, which starts immediately after bacterial adhesion. In the last decade, numerous studies reported the ability of titanium surface modifications and coatings to minimize bacterial adhesion, inhibit biofilm formation and provide effective bacterial killing to protect implanted biomaterials. In the present review, the different strategies to prevent infection onto titanium surfaces are reported: surface modification and coatings by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers. STATEMENT OF SIGNIFICANCE: Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. Microbial infection is one of the main causes of implant failure. Currently, the global infection risk is 2-5% in orthopedic surgery. Numerous solutions exist to render titanium surfaces antibacterial. The LBPS team is an expert on the functionalization of titanium surfaces by using bioactive polymers to improve the biologiocal response. In this review, the different strategies to prevent infection are reported onto titanium and titanium alloy surfaces such as surface modification by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers.
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15
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Peeters E, Hooyberghs G, Robijns S, De Weerdt A, Kucharíková S, Tournu H, Braem A, Čeh K, Majdič G, Španič T, Pogorevc E, Claes B, Dovgan B, Girandon L, Impellizzeri F, Erdtmann M, Krona A, Vleugels J, Fröhlich M, Garcia-Forgas J, De Brucker K, Cammue BPA, Thevissen K, Van Dijck P, Vanderleyden J, Van der Eycken E, Steenackers HP. An antibiofilm coating of 5-aryl-2-aminoimidazole covalently attached to a titanium surface. J Biomed Mater Res B Appl Biomater 2018; 107:1908-1919. [PMID: 30549192 DOI: 10.1002/jbm.b.34283] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 12/25/2022]
Abstract
Biofilms, especially those formed by Staphylococcus aureus, play a key role in the development of orthopedic implant infections. Eradication of these infections is challenging due to the elevated tolerance of biofilm cells against antimicrobial agents. In this study, we developed an antibiofilm coating consisting of 5-(4-bromophenyl)-N-cyclopentyl-1-octyl-1H-imidazol-2-amine, designated as LC0024, covalently bound to a titanium implant surface (LC0024-Ti). We showed in vitro that the LC0024-Ti surface reduces biofilm formation of S. aureus in a specific manner without reducing the planktonic cells above the biofilm, as evaluated by plate counting and fluorescence microscopy. The advantage of compounds that only inhibit biofilm formation without affecting the viability of the planktonic cells, is that reduced development of bacterial resistance is expected. To determine the antibiofilm activity of LC0024-Ti surfaces in vivo, a biomaterial-associated murine infection model was used. The results indicated a significant reduction in S. aureus biofilm formation (up to 96%) on the LC0024-Ti substrates compared to pristine titanium controls. Additionally, we found that the LC0024-Ti substrates did not affect the attachment and proliferation of human cells involved in osseointegration and bone repair. In summary, our results emphasize the clinical potential of covalent coatings of LC0024 on titanium implant surfaces to reduce the risk of orthopedic implant infections. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1908-1919, 2019.
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Affiliation(s)
- Elien Peeters
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Geert Hooyberghs
- Department of Chemistry, Laboratory for Organic and Microwave-Assisted Chemistry (LOMAC), KU Leuven, Celestijnenlaan 200F, 3001 Leuven, Belgium
| | - Stijn Robijns
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Ami De Weerdt
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Soňa Kucharíková
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium.,Department of Biology, Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium
| | - Hélène Tournu
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium.,Department of Biology, Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium
| | - Annabel Braem
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44 Box 2450, 3001 Leuven, Belgium
| | - Katerina Čeh
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Gregor Majdič
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Tanja Španič
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Estera Pogorevc
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Birgit Claes
- Centre for Surface Chemistry and Catalysis, KU Leuven, Kasteelpark Arenberg 23, 3001 Leuven, Belgium
| | | | | | | | | | - Annika Krona
- RISE - Research Institutes of Sweden, Bioscience and Materials, Box 5401, 402 29 Gothenburg, Sweden
| | - Jef Vleugels
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44 Box 2450, 3001 Leuven, Belgium
| | - Mirjam Fröhlich
- Educell Ltd., Prevale 9, 1236 Trzin, Slovenia.,Faculty of Medicine, Institute of Cell Biology, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | | | - Katrijn De Brucker
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Bruno P A Cammue
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium.,VIB Center for Plant Systems Biology, Technologiepark 927, 9052 Ghent, Belgium
| | - Karin Thevissen
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Patrick Van Dijck
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium.,Department of Biology, Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium
| | - Jozef Vanderleyden
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Erik Van der Eycken
- Department of Chemistry, Laboratory for Organic and Microwave-Assisted Chemistry (LOMAC), KU Leuven, Celestijnenlaan 200F, 3001 Leuven, Belgium
| | - Hans P Steenackers
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
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16
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Abstract
With the increase in numbers of joint replacements, spinal surgeries, and dental implantations, there is an urgent need to combat implant-associated infection. In addition to stringent sterile techniques, an efficacious way to prevent this destructive complication is to create new implants with antimicrobial properties. Specifically, these implants must be active in the dental implant environment where the implant is bathed in the glycoprotein-rich salivary fluids that enhance bacterial adhesion, and propagation, and biofilm formation. However, in designing an antimicrobial surface, a balance must be struck between antimicrobial activity and the need for the implant to interact with the bone environment. Three types of surfaces have been designed to combat biofilm formation, while attempting to maintain osseous interactions: 1) structured surfaces where topography, usually at the nanoscale, decreases bacterial adhesion sufficiently to retard establishment of infection; 2) surfaces that actively elute antimicrobials to avert bacterial adhesion and promote killing; and 3) surfaces containing permanently bonded agents that generate antimicrobial surfaces that prevent long-term bacterial adhesion. Both topographical and elution surfaces exhibit varying, albeit limited, antimicrobial activity in vitro. With respect to covalent coupling, we present studies on the ability of the permanent antimicrobial surfaces to kill organisms while fostering osseointegration. All approaches have significant drawbacks with respect to stability and efficacy, but the permanent surfaces may have an edge in creating a long-term antibacterial environment.
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Affiliation(s)
- N J Hickok
- 1 Department of Orthopaedic Surgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - I M Shapiro
- 1 Department of Orthopaedic Surgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - A F Chen
- 1 Department of Orthopaedic Surgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.,2 The Rothman Institute, Philadelphia, PA, USA
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17
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Abstract
Metal surface nanostructuring to guide cell behavior is an attractive strategy to improve parts of medical implants, lab-on-a-chip, soft robotics, self-assembled microdevices, and bionic devices. Here, we discus important parameters, relevant trends, and specific examples of metal surface nanostructuring to guide cell behavior on metal-based hybrid surfaces. Surface nanostructuring allows precise control of cell morphology, adhesion, internal organization, and function. Pre-organized metal nanostructuring and dynamic stimuli-responsive surfaces are used to study various cell behaviors. For cells dynamics control, the oscillating stimuli-responsive layer-by-layer (LbL) polyelectrolyte assemblies are discussed to control drug delivery, coating thickness, and stiffness. LbL films can be switched "on demand" to change their thickness, stiffness, and permeability in the dynamic real-time processes. Potential applications of metal-based hybrids in biotechnology and selected examples are discussed.
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Affiliation(s)
- Yulia Zhukova
- Biomaterials Department; Max Planck Institute of Colloids and Interfaces; Am Mühlenberg 1 Potsdam 14424 Germany
| | - Ekaterina V. Skorb
- Biomaterials Department; Max Planck Institute of Colloids and Interfaces; Am Mühlenberg 1 Potsdam 14424 Germany
- Laboratory of Solution Chemistry of Advanced Materials and Technologies (SCAMT); ITMO University; St. Petersburg 197101 Russian Federation
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18
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Nie B, Long T, Ao H, Zhou J, Tang T, Yue B. Covalent Immobilization of Enoxacin onto Titanium Implant Surfaces for Inhibiting Multiple Bacterial Species Infection and In Vivo Methicillin-Resistant Staphylococcus aureus Infection Prophylaxis. Antimicrob Agents Chemother 2017; 61:e01766-16. [PMID: 27799220 DOI: 10.1128/AAC.01766-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/25/2016] [Indexed: 12/19/2022] Open
Abstract
Infection is one of the most important causes of titanium implant failure in vivo A developing prophylactic method involves the immobilization of antibiotics, especially vancomycin, onto the surface of the titanium implant. However, these methods have a limited effect in curbing multiple bacterial infections due to antibiotic specificity. In the current study, enoxacin was covalently bound to an amine-functionalized Ti surface by use of a polyethylene glycol (PEG) spacer, and the bactericidal effectiveness was investigated in vitro and in vivo The titanium surface was amine functionalized with 3-aminopropyltriethoxysilane (APTES), through which PEG spacer molecules were covalently immobilized onto the titanium, and then the enoxacin was covalently bound to the PEG, which was confirmed by X-ray photoelectron spectrometry (XPS). A spread plate assay, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM) were used to characterize the antimicrobial activity. For the in vivo study, Ti implants were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) and implanted into the femoral medullary cavity of rats. The degree of infection was assessed by radiography, micro-computed tomography, and determination of the counts of adherent bacteria 3 weeks after surgery. Our data demonstrate that the enoxacin-modified PEGylated Ti surface effectively prevented bacterial colonization without compromising cell viability, adhesion, or proliferation in vitro Furthermore, it prevented MRSA infection of the Ti implants in vivo Taken together, our results demonstrate that the use of enoxacin-modified Ti is a potential approach to the alleviation of infections of Ti implants by multiple bacterial species.
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19
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Gerits E, Kucharíková S, Van Dijck P, Erdtmann M, Krona A, Lövenklev M, Fröhlich M, Dovgan B, Impellizzeri F, Braem A, Vleugels J, Robijns SCA, Steenackers HP, Vanderleyden J, De Brucker K, Thevissen K, Cammue BPA, Fauvart M, Verstraeten N, Michiels J. Antibacterial activity of a new broad-spectrum antibiotic covalently bound to titanium surfaces. J Orthop Res 2016; 34:2191-2198. [PMID: 27003909 DOI: 10.1002/jor.23238] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/17/2016] [Indexed: 02/04/2023]
Abstract
Biofilm-associated infections, particularly those caused by Staphylococcus aureus, are a major cause of implant failure. Covalent coupling of broad-spectrum antimicrobials to implants is a promising approach to reduce the risk of infections. In this study, we developed titanium substrates on which the recently discovered antibacterial agent SPI031, a N-alkylated 3, 6-dihalogenocarbazol 1-(sec-butylamino)-3-(3,6-dichloro-9H-carbazol-9-yl)propan-2-ol, was covalently linked (SPI031-Ti). We found that SPI031-Ti substrates prevent biofilm formation of S. aureus and Pseudomonas aeruginosa in vitro, as quantified by plate counting and fluorescence microscopy. To test the effectiveness of SPI031-Ti substrates in vivo, we used an adapted in vivo biomaterial-associated infection model in mice in which SPI031-Ti substrates were implanted subcutaneously and subsequently inoculated with S. aureus. Using this model, we found a significant reduction in biofilm formation (up to 98%) on SPI031-Ti substrates compared to control substrates. Finally, we demonstrated that the functionalization of the titanium surfaces with SPI031 did not influence the adhesion and proliferation of human cells important for osseointegration and bone repair. In conclusion, these data demonstrate the clinical potential of SPI031 to be used as an antibacterial coating for implants, thereby reducing the incidence of implant-associated infections. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2191-2198, 2016.
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Affiliation(s)
- Evelien Gerits
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
| | - Soňa Kucharíková
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 box 2438, 3001 Leuven, Belgium.,Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 box 2438, 3001 Leuven, Belgium
| | - Patrick Van Dijck
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 box 2438, 3001 Leuven, Belgium.,Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 box 2438, 3001 Leuven, Belgium
| | | | - Annika Krona
- Department of Structure and Material Design, SP Food and Bioscience, Box 5401, 402 29 Gothenburg, Sweden
| | - Maria Lövenklev
- Department of Structure and Material Design, SP Food and Bioscience, Box 5401, 402 29 Gothenburg, Sweden
| | - Mirjam Fröhlich
- Educell Ltd, Prevale 9, 1236 Trzin, Slovenia.,Faculty of Medicine, Institute of Cell Biology, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | | | | | - Annabel Braem
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44 box 2450, 3001 Leuven, Belgium
| | - Jef Vleugels
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44 box 2450, 3001 Leuven, Belgium
| | - Stijn C A Robijns
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
| | - Hans P Steenackers
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
| | - Jozef Vanderleyden
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
| | - Katrijn De Brucker
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
| | - Karin Thevissen
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
| | - Bruno P A Cammue
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium.,Department of Plant Systems Biology, VIB, Technologiepark 927, 9052 Ghent, Belgium
| | - Maarten Fauvart
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium.,Department of Life Science Technologies, imec, Smart Systems and Emerging Technologies Unit, Kapeldreef 75, 3001 Leuven, Belgium
| | - Natalie Verstraeten
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
| | - Jan Michiels
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20 box 2460, 3001 Leuven, Belgium
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20
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Nie B, Ao H, Long T, Zhou J, Tang T, Yue B. Immobilizing bacitracin on titanium for prophylaxis of infections and for improving osteoinductivity: An in vivo study. Colloids Surf B Biointerfaces 2016; 150:183-191. [PMID: 27914255 DOI: 10.1016/j.colsurfb.2016.11.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 11/07/2016] [Accepted: 11/25/2016] [Indexed: 11/16/2022]
Abstract
Bacitracin immobilized on the titanium (Ti) surface significantly improves anti-bacterial activity and biocompatibility in vitro. In the current study, we investigated the biologic performance (bactericidal effect and bone-implant integration) of bacitracin-modified Ti in vivo. A rat osteomyelitis model with femoral medullary cavity placement of Ti rods was employed to analyze the prophylactic effect of bacitracin-modified Ti (Ti-BC). Thirty-six female Sprague Dawley (SD) rats were used to establish the Ti implant-associated infection. The Ti and Ti-BC rods were incubated with and without Staphylococcus aureus to mimic the contaminated Ti rod and were implanted into the medullary cavity of the left femur, and sterile Ti rods were used as the blank control. After 3 weeks, the bone pathology was evaluated using X-ray and micro-computed tomography (micro-CT) analysis. For the investigation of the Ti-BC implant osseointegration in vivo, fifteen SD rats were divided into three groups (N=5), namely Ti, Ti-dopamine immobilized (Ti-DOPA), and Ti-BC. Ti rods were implanted into the left femoral cavity and micro-CT and histological evaluation was conducted after 12 weeks. The in vivo study indicated that Ti-immobilized bacitracin owned the prophylaxis potential for the infection associated with the Ti implants and allowed for the osseointegration. Thus, the multiple biofunctionalized Ti implants could be realized via immobilization of bacitracin, making them promising candidates for preventing the Ti implant-associated infections while retaining the osseointegration effects.
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Affiliation(s)
- Bin'en Nie
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Haiyong Ao
- School of Materials Science and Engineering, East China Jiaotong University, Nanchang, PR China
| | - Teng Long
- Department of Joint Surgery and Sports Medicine, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Jianliang Zhou
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Nanchang University, PR China
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Bing Yue
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China; Department of Joint Surgery and Sports Medicine, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, PR China.
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21
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Affiliation(s)
- Bryan R. Coad
- Future Industries Institute, University of South Australia, Mawson Lakes, South Australia, Australia
| | - Hans J. Griesser
- Future Industries Institute, University of South Australia, Mawson Lakes, South Australia, Australia
| | - Anton Y. Peleg
- Infection and Immunity Program and the Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, Central Clinical School, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Ana Traven
- Infection and Immunity Program and the Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
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22
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Nie B, Ao H, Zhou J, Tang T, Yue B. Biofunctionalization of titanium with bacitracin immobilization shows potential for anti-bacteria, osteogenesis and reduction of macrophage inflammation. Colloids Surf B Biointerfaces 2016; 145:728-739. [PMID: 27289314 DOI: 10.1016/j.colsurfb.2016.05.089] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 05/10/2016] [Accepted: 05/28/2016] [Indexed: 12/21/2022]
Abstract
Titanium has been widely used in the orthopedic and dental fields, however, the inert nature of Ti makes it unsuitable for application in promoting bone cell growth,osteogenic differentiation and antibacterial ability. The aims of the current study were to investigate the antimicrobial activity and biofunction of the polypeptide antibiotic bacitracin, and obtain a multi-biofunctional titanium implant by covalently-immobilizing titanium with the bacitracin. The results showed that the bacitracin possessed low minimum inhibitory concentration (MIC) to both Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus (MRSA), with the non-cytotoxicity concentration up to 500μg/mL to human bone marrow mesenchymal stem cells (hBMSCs), furthermore, the bacitracin could improve the osteogenic differentiation of hBMSCs. The results of Scanning electron microscope (SEM) and X-ray photoelectron spectroscopy (XPS) indicated that bacitracin had been covalently immobilized on the surface of titanium. Immobilized bacitracin could improve the hydrophilic of immobilized titanium. The results of antimicrobial assay demonstrated that the covalently-immobilized bacitracin also had excellent antimicrobial property, and the bacitracin immobilized titanium could inhibit bacterial adhesion and colonization. The results of cell biology experiments proved that the bacitracin immobilized titanium could improve hBMSCs' adhesion, proliferation and osteogenic differentiation. We also found that the macrophages were difficult to spread or activate on the surface of bacitracin immobilized titanium, and the secretion of inflammatory factors had been inhibited. In conclusion, the novel bacitracin immobilized titanium has multi-biofunctions including outstanding antibacterial properties, excellent cell biology performance, and restraining inflammation, which has exciting application prospect.
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Affiliation(s)
- Bin'en Nie
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Haiyong Ao
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Jianliang Zhou
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, PR China
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Bing Yue
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China.
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23
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Affiliation(s)
- Jasmin GRISCHKE
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School
| | - Jörg EBERHARD
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School
| | - Meike STIESCH
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School
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Kucharíková S, Gerits E, De Brucker K, Braem A, Ceh K, Majdič G, Španič T, Pogorevc E, Verstraeten N, Tournu H, Delattin N, Impellizzeri F, Erdtmann M, Krona A, Lövenklev M, Knezevic M, Fröhlich M, Vleugels J, Fauvart M, de Silva WJ, Vandamme K, Garcia-Forgas J, Cammue BPA, Michiels J, Van Dijck P, Thevissen K. Covalent immobilization of antimicrobial agents on titanium prevents Staphylococcus aureus and Candida albicans colonization and biofilm formation. J Antimicrob Chemother 2015; 71:936-45. [PMID: 26702917 DOI: 10.1093/jac/dkv437] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/16/2015] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Biofilm-associated implant infections represent a serious public health problem. Covalent immobilization of antimicrobial agents on titanium (Ti), thereby inhibiting biofilm formation of microbial pathogens, is a solution to this problem. METHODS Vancomycin (VAN) and caspofungin (CAS) were covalently bound on Ti substrates using an improved processing technique adapted to large-scale coating of implants. Resistance of the VAN-coated Ti (VAN-Ti) and CAS-coated Ti (CAS-Ti) substrates against in vitro biofilm formation of the bacterium Staphylococcus aureus and the fungal pathogen Candida albicans was determined by plate counting and visualized by confocal laser scanning microscopy. The efficacy of the coated Ti substrates was also tested in vivo using an adapted biomaterial-associated murine infection model in which control-Ti, VAN-Ti or CAS-Ti substrates were implanted subcutaneously and subsequently challenged with the respective pathogens. The osseointegration potential of VAN-Ti and CAS-Ti was examined in vitro using human bone marrow-derived stromal cells, and for VAN-Ti also in a rat osseointegration model. RESULTS In vitro biofilm formation of S. aureus and C. albicans on VAN-Ti and CAS-Ti substrates, respectively, was significantly reduced compared with biofilm formation on control-Ti. In vivo, we observed over 99.9% reduction in biofilm formation of S. aureus on VAN-Ti substrates and 89% reduction in biofilm formation of C. albicans on CAS-Ti substrates, compared with control-Ti substrates. The coated substrates supported osseointegration in vitro and in vivo. CONCLUSIONS These data demonstrate the clinical potential of covalently bound VAN and CAS on Ti to reduce microbial biofilm formation without jeopardizing osseointegration.
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Affiliation(s)
- Soňa Kucharíková
- Department of Molecular Microbiology, VIB, Kasteelpark Arenberg 31, Box 2438, 3001 Leuven, Belgium Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31, Box 2438, 3001 Leuven, Belgium
| | - Evelien Gerits
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium
| | - Katrijn De Brucker
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium
| | - Annabel Braem
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44, Box 2450, 3001 Leuven, Belgium
| | - Katerina Ceh
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Gregor Majdič
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Tanja Španič
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Estera Pogorevc
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Natalie Verstraeten
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium
| | - Hélène Tournu
- Department of Molecular Microbiology, VIB, Kasteelpark Arenberg 31, Box 2438, 3001 Leuven, Belgium Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31, Box 2438, 3001 Leuven, Belgium
| | - Nicolas Delattin
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium
| | | | | | - Annika Krona
- SP Food and Bioscience, Department of Structure and Material Design, Box 5401, 402 29 Gothenburg, Sweden
| | - Maria Lövenklev
- SP Food and Bioscience, Department of Structure and Material Design, Box 5401, 402 29 Gothenburg, Sweden
| | | | - Mirjam Fröhlich
- Educell, d.o.o., Prevale 9, 1236 Trzin, Slovenia Department of Biochemistry and Molecular and Structural Biology, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia
| | - Jef Vleugels
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44, Box 2450, 3001 Leuven, Belgium
| | - Maarten Fauvart
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium
| | - Wander Jose de Silva
- Department of Oral Health Sciences-Biomaterials BIOMAT, KU Leuven, Kapucijnenvoer 33, Box 7001, 3000 Leuven, Belgium FOP-UNICAMP, Department of Prosthodontics and Periodontology, Av. Limeira, 901, 13414-903, Piracicaba-SP, Brazil
| | - Katleen Vandamme
- Department of Oral Health Sciences-Biomaterials BIOMAT, KU Leuven, Kapucijnenvoer 33, Box 7001, 3000 Leuven, Belgium
| | | | - Bruno P A Cammue
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium Department of Plant Systems Biology, VIB, Technologiepark 927, 9052 Ghent, Belgium
| | - Jan Michiels
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium
| | - Patrick Van Dijck
- Department of Molecular Microbiology, VIB, Kasteelpark Arenberg 31, Box 2438, 3001 Leuven, Belgium Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31, Box 2438, 3001 Leuven, Belgium
| | - Karin Thevissen
- Centre of Microbial and Plant Genetics, KU Leuven, Kasteelpark Arenberg 20, Box 2460, 3001 Leuven, Belgium
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Schienle S, Al-Ahmad A, Kohal RJ, Bernsmann F, Adolfsson E, Montanaro L, Palmero P, Fürderer T, Chevalier J, Hellwig E, Karygianni L. Microbial adhesion on novel yttria-stabilized tetragonal zirconia (Y-TZP) implant surfaces with nitrogen-doped hydrogenated amorphous carbon (a-C:H:N) coatings. Clin Oral Investig 2015; 20:1719-32. [DOI: 10.1007/s00784-015-1655-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/09/2015] [Indexed: 12/14/2022]
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