Thromboinflammation as bioactivity assessment of H2O2-alkali modified titanium surfaces.

The release of growth factors from platelets, mediated by the coagulation and the complement system, plays an important role in the bone formation around implants. This study aimed at exploring the thromboinflammatory response of H2O2-alkali soaked commercially pure titanium grade 2 discs exposed to whole human blood, as a way to assess the bioactivity of the discs. Commercially pure titanium grade 2 discs were modified by soaking in H2O2, NaOH and Ca(OH)2. The platelet aggregation, coagulation activation and complement activation was assessed by exposing the discs to fresh whole blood from human donors. The platelet aggregation was examined by a cell counter and the coagulation and complement activation were assessed by ELISA-measurements of the concentration of thrombin-antithrombin complex, C3a and terminal complement complex. The modified surface showed a statistically significant increased platelet aggregation, coagulation activation and complement activation compared to unexposed blood. The surface also showed a statistically significant increase of coagulation activation compared to PVC. The results of this study showed that the H2O2-alkali soaked surfaces induced a thromboinflammatory response that indicates that the surfaces are bioactive.

Titanium surface modification to enhance antibacterial and bioactive properties while retaining biocompatibility.

Bacterial infections associated with metal implants are severe problems affecting a considerable amount of people with dental or orthopedic implants. This study aims to examine the antibacterial effect of a Titanium-peroxy gel layer on the modified surface of commercially pure titanium grade 2. Variations in a multi-step surface modification procedure were tested to determine the best combination that provided an antibacterial effect while enhancing bioactivity without compromising biocompatibility. Soaking the surfaces in 30 wt% hydrogen peroxide held at 80 °C provided antibacterial activity while subsequent surface treatments in concentrated sodium and calcium hydroxide solutions were preformed to enhance bioactivity. Staphylococcus epidermidis was used to determine the antibacterial effect through both direct contact and biofilm inhibition tests while human dermal fibroblast cells and MC3T3 pre osteoblast cells were utilized to test biocompatibility. The greatest antibacterial effect was observed with only hydrogen peroxide treatment, but the resulting surface was neither bioactive nor biocompatible. It was found that subsequent surface treatments with sodium hydroxide followed by calcium hydroxide provided a bioactive surface that was also biocompatible. Additionally, a final treatment with autoclaving showed positive effects with regards to enhanced bioactivity. This multi-step surface modification procedure offers a promising, non-antibiotic, solution for combatting infections associated with biomedical implants.

Antibacterial investigation of titanium-copper alloys using luminescent Staphylococcus epidermidis in a direct contact test.

Commercially pure titanium (CP-Ti), used as oral implants, is often populated by various bacterial colonies in the oral cavity. These bacteria can cause Peri-implantitis, leading to loss of bone tissue and failure of implants. With the increased awareness of antibiotic resistance, research has been directed towards alternative solutions and recent findings have indicated titanium­copper (Ti-Cu) alloys as a promising antibacterial material. The aim of this study was to produce homogeneous Ti-Cu alloys, with various concentrations of copper, and to characterise their antibacterial properties through direct contact tests, using luminescent bacteria, in addition to traditional materials characterisation techniques. Samples of CP-Ti and four different Ti-Cu alloys (1, 2.5, 3 and 10 wt%Cu) were produced in an arc-furnace, heated treated and rapidly quenched. X-ray diffraction revealed that Ti2Cu, was present only in the 10 wt%Cu alloy, however, scanning electron microscopy (SEM) indicated precipitates at the grain boundaries of the 3 wt%Cu alloy, which were confirmed to be of a copper rich phase by energy dispersive x-ray spectroscopy (EDS) analysis. EDS line scans confirmed that the alloys were homogenous. After 6 h, a trend between copper content and antibacterial rate could be observed, with the 10 wt%Cu alloy having the highest rate. SEM confirmed fewer bacteria on the 3 wt%Cu and especially the 10 wt%Cu samples. Although the 10 wt%Cu alloy gave the best antibacterial results, it is desired that the Cu concentration is below ~3 wt%Cu to maintain similar mechanical and corrosive performance as CP-Ti. Therefore, it is proposed that future work focuses on the 3 wt%Cu alloy.

Debridement of Bacterial Biofilms with TiO2/H2O2 Solutions and Visible Light Irradiation.

OBJECTIVES: The aim of the study was to explore the debridement efficacy of different solutions of H2O2 and rutile particles against Staphylococcus epidermidis and Pseudomonas aeruginosa biofilms attached to titanium surfaces when exposed to visible light. MATERIALS AND METHODS: Titanium discs cultivated with biofilms of Staphylococcus epidermidis or Pseudomonas aeruginosa were subjected for 1 min to suspensions consisting of rutile particles mixed with high (950 mM) or low (2 mM) concentrations of H2O2 under visible light irradiation (405 nm; 2.1 mW/cm2). Discs were rinsed and the degree of debridement was determined through scanning electron microscopy and viability assessment of the remaining bacteria using luminescence measurements and/or a metabolic activity assay. RESULTS: Cleaning mixtures containing the higher concentration of H2O2 showed a significantly improved debridement compared to the negative control in all experiments. The addition of rutile particles was shown to have a statistically significant effect in one test with S. epidermidis. Limited evidence of the catalytic effect of visible light irradiation was seen, but effects were relatively small and statistically insignificant. CONCLUSIONS: H2O2 at a concentration of 950 mM proved to be the strongest contribution to the debridement and bactericidal effect of the cleaning techniques tested in this study.

Organic degradation potential of a TiO2/H2O2/UV-vis system for dental applications.

OBJECTIVES: The combination of TiO2 and H2O2 under light activation constitutes a promising method for disinfection of dental prosthetics and implants, due to production of reactive oxygen species (ROS). The aim of this work was to investigate the organic degradation ability of TiO2 particles in combination with H2O2 and under light activation utilizing the organic dye rhodamine B (RhB). METHODS: Five different types of TiO2 particles, consisting of anatase, rutile, or a mixture of these crystalline phases, were combined with H2O2 and RhB, and subsequently exposed to UV (365nm) or visible (405nm) light at an irradiance of 2.1mW/cm2. RESULTS: It was found that rutile in combination with low concentrations of H2O2 (1.0-3.5mM) resulted in a degradation of RhB of 96% and 77% after 10min exposure to 365nm and 405nm light, respectively, which was the highest degradation of all test groups. Control measurements performed without light irradiation or irradiation at 470nm, or without TiO2 particles resulted in little or no degradation of RhB. CONCLUSIONS: Low H2O2 concentrations (1.0mM-3.5mM) and visible light (405nm) used in combination with rutile TiO2 particles showed the highest RhB degradation capacity. CLINICAL SIGNIFICANCE: A combination of TiO2 particles and H2O2 exposed to low energy UV or high energy visible light has an organic degradation capability that could be utilized in applications to kill or inactivate bacteria on medical devices such as dental implants for treatment against, e.g., peri-implantitis.