Bioinspired Surface Functionalization of Poly(ether ether ketone) for Enhancing Osteogenesis and Bacterial Resistance

Methods to improve antibacterial properties of PEEK: A review

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

Advances in reparative materials for infectious bone defects and their applications in maxillofacial regions

Infectious bone defects are characterized by the partial loss or destruction of bone tissue resulting from bacterial contaminations subsequent to diseases or external injuries. Traditional bone transplantation and clinical methods are insufficient in meeting the treatment demands for such diseases. As a result, researchers have increasingly focused on the development of more sophisticated biomaterials for improved therapeutic outcomes in recent years. This review endeavors to investigate specific reparative materials utilized for the treatment of infectious bone defects, particularly those present in the maxillofacial region, with a focus on biomaterials capable of releasing therapeutic substances, functional contact biomaterials, and novel physical therapy materials. These biomaterials operate via heightened antibacterial or osteogenic properties in order to eliminate bacteria and/or stimulate bone cells regeneration in the defect, ultimately fostering the reconstitution of maxillofacial bone tissue. Based upon some successful applications of new concept materials in bone repair of other parts, we also explore their future prospects and potential uses in maxillofacial bone repair later in this review. We highlight that the exploration of advanced biomaterials holds promise in establishing a solid foundation for the development of more biocompatible, effective, and personalized treatments for reconstructing infectious maxillofacial defects.

Probing the Effects of Antimicrobial-Lysozyme Derivatization on Enzymatic Degradation of Poly(ε-caprolactone) Film and Fiber

Surface derivatization is essential for incorporating unique functionalities into biodegradable polymers. Nonetheless, its precise effects on enzymatic biodegradation still lack comprehensive understanding. In this study, a facile solution-based method is employed to surface derivatize poly(ε-caprolactone) films and electrospun fibers with lysozyme, aiming to impart antimicrobial properties and examine the impact on enzymatic degradation. The derivatized films and fibers have shown high antibacterial efficacy against Escherichia coli and Staphylococcus aureus. Through gravimetric analysis, it is observed that the degradation rate experiences a slight decrease upon lysozyme derivatization. However, this reduction is effectively countered by the inclusion of Tween-20, as affirmed by isothermal titration calorimetry. Comparing films and fibers, the latter undergoes degradation at a more accelerated pace, coupled with a rapid decline in molecular weight. This study provides valuable insights into the factors influencing the degradation of surface-derivatized biopolymers through electrospinning, offering a simple strategy to mitigate biomaterial-associated infections.

Numerical Simulation and Experimental Study Regarding the Cross-Sectional Morphology of PEEK Monofilament Deposition During FDM-Based 3D Printing

Polyether-ether-ketone (PEEK) is widely used in the field of biomedical engineering because of its excellent mechanical properties, chemical stability, and biocompatibility. Fused deposition modeling (FDM), which is a typical 3D printing process, can achieve low-cost and high-efficiency printing of complex PEEK structures. However, poor monofilament deposition quality leads to rough surfaces on macroscopic printed parts, low dimensional accuracy, and weak interlayer bonding, which are urgent problems to be solved. In this study, considering the shear thinning characteristic of PEEK, a numerical model for monofilament deposition was constructed by using the finite volume method. This model revealed the influences of process parameters on the monofilament cross-sectional profiles and achieved predictions of monofilament cross-sectional profiles during FDM-based 3D printing of PEEK. The average relative error of the monofilament cross-sectional area predictions was 7.68%. The average relative error of the monofilament cross-sectional aspect ratio predictions was 12.06%. It was also found that there are three typical deposited monofilament cross-sectional profile shapes, i.e., a capsule shape, a bread shape, and a circular shape. These three shapes occurred because of the combined effect of the layer thickness and the extrusion width during the extrusion and deposition of PEEK. These revealed monofilament cross-sectional profiles provide the basis for accurate nozzle motion trajectory planning, and they lay a foundation for surface roughness predictions and dimensional accuracy control during the FDM-based 3D printing of PEEK.

Biocompatibility and osteoinductive ability of casein phosphopeptide modified polyetheretherketone

Polyetheretherketone (PEEK) is a potential implant material for dental application due to its excellent mechanical properties. However, its biological inertness and poor osteoinductive ability limited its clinical application. Based on a lay-by-layer self-assembly technique, here we incorporated casein phosphopeptide (CPP) onto PEEK surface by a simple two-step strategy to address the poor osteoinductive ability of PEEK implants. In this study, the PEEK specimens were positively charged by 3-ammoniumpropyltriethoxysilane (APTES) modification, then the CPP was adsorbed onto the positively charged PEEK surface electrostatically to obtain CPP-modified PEEK (PEEK-CPP) specimens. The surface characterization, layer degradation, biocompatibility and osteoinductive ability of the PEEK-CPP specimens were studied in vitro. After CPP modification, the PEEK-CPP specimens had a porous and hydrophilic surface and presented enhanced cell adhesion, proliferation, and osteogenic differentiation of MC3T3-E1 cells. These findings indicated that CPP modification could significantly improve the biocompatibility and osteoinductive ability of PEEK-CPP implants in vitro. In a word, CPP modification is a promising strategy for the PEEK implants to achieve osseointegration.

Metal-Phenolic Networks Assembled on TiO2 Nanospikes for Antimicrobial Peptide Deposition and Osteoconductivity Enhancement in Orthopedic Applications

The lack of antimicrobial and osteoconductive activities of titanium (Ti) for orthopedic implants has led to problems such as infection and structural looseness, which bring physical and psychological sufferings to patients as well as economic burden on the healthcare system. To endow Ti implants with anti-infective function and bioactivity, in this study, we successfully constructed TiO2 nanospike (TNS) structure on the surface of Ti followed by assembling metal-polyphenol networks (MPNs) and depositing antimicrobial peptides (AMPs). The TNSs' structure can disrupt the bacteria by physical puncture, and it was also proved to have excellent photothermal conversion performance upon near-infrared light irradiation. Furthermore, with the assistance of contact-active chemo bactericidal efficacy of AMPs, TNS-MPN-AMP nanocoating achieved physical/photothermal/chemo triple-synergistic therapy against pathogenic bacteria. The anti-infective efficiency of this multimodal treatment was obviously improved, with an antibacterial ratio of >99.99% in vitro and 95.03% in vivo. Moreover, the spike-like nanostructure of TNSs and the bioactive groups from MPNs and AMPs not only demonstrated desirable biocompatibility but also promoted the surface hydroxyapatite formation in simulated body fluid for further osseointegration enhancement. Altogether, this multifaceted TNS-MPN-AMP nanocoating endowed Ti implants with enhanced antibacterial activity, excellent cytocompatibility, and desirable osteoconductive ability.

Dual-Functional Polyetheretherketone Surface with an Enhanced Osteogenic Capability and an Antibacterial Adhesion Property In Vitro by Chitosan Modification

A chitosan layer was covalently bonded to a polyetheretherketone (PEEK) surface using a simple facile self-assembly method to address inadequate biological activity and infection around the implant. The surface characterization, layer degradation, biological activity, and antibacterial adhesion properties of chitosan-modified PEEK (PEEK-CS) were studied. Through chitosan grafting, the surface morphology changed, the surface roughness increased, and the contact angle decreased significantly. PEEK-CS boosted cell adhesion, proliferation, increased alkaline phosphate activity, extracellular matrix mineralization, and expression of osteogenic genes. PEEK-CS demonstrated less adhesion to Porphyromonas gingivalis as well as less bacterial adhesion to P. gingivalis and Streptococcus mutans. According to our findings, chitosan modification significantly improved the osteogenic ability and antibacterial adhesion of PEEK in vitro.