Easy, Flexible and Standardizable Anti-Nascent Biofilm Activity Assay to Assess Implant Materials.

Medical implants have improved the quality of life of many patients. However, surgical intervention may eventually lead to implant microbial contamination. The aims of this research were to develop an easy, robust, quantitative assay to assess surface antimicrobial activities, especially the anti-nascent biofilm activity, and to identify control surfaces, allowing for international comparisons. Using new antimicrobial assays to assess the inhibition of nascent biofilm during persistent contact or after transient contact with bacteria, we show that the 5 cent Euro coin or other metal-based antibacterial coins can be used as positive controls, as more than 4 log reduction on bacterial survival was observed when using either S. aureus or P. aeruginosa as targets. The methods and controls described here could be useful to develop an easy, flexible and standardizable assay to assess relevant antimicrobial activities of new implant materials developed by industries and academics.

Development of Antibacterial Ti-Cux Alloys for Dental Applications: Effects of Ageing for Alloys with Up to 10 wt% Cu.

Peri-implantitis, a disease caused by bacteria, affects dental implants in patients. It is widely treated with antibiotics, however, with growing antibiotic resistance new strategies are required. Titanium-copper alloys are prospective antibacterial biomaterials, with the potential to be a remedy against peri-implantitis and antibiotic resistance. The aim of this study was to investigate Ti-Cux alloys, exploring how Cu content (up to 10 wt%) and ageing affect the material properties. Electron microscopy, X-ray diffraction, hardness testing, bacteriological culture, and electrochemical testing were employed to characterize the materials. It was found that alloys with above 3 wt% Cu had two phases and ageing increased the volume fraction of Ti2Cu. An un-aged alloy of 5 wt% Cu showed what could be Ti3Cu, in addition to the α-Ti phase. The hardness gradually increased with increased Cu additions, while ageing only affected the alloy with 10 wt% Cu (due to changes in microstructure). Ageing resulted in faster passivation of the alloys. After two hours the aged 10 wt% Cu alloy was the only material with an antibacterial effect, while after six hours, bacteria killing occurred in all alloys with above 5 wt% Cu. In conclusion, it was possible to tune the material and antibacterial properties of Ti-Cux alloys by changing the Cu concentration and ageing, which makes further optimization towards an antibacterial material promising.

Investigation of Copper Alloying in a TNTZ-Cux Alloy.

Alloying copper into pure titanium has recently allowed the development of antibacterial alloys. The alloying of biocompatible elements (Nb, Ta and Zr) into pure titanium has also achieved higher strengths for a new alloy of Ti-1.6 wt.% Nb-10 wt.% Ta-1.7 wt.% Zr (TNTZ), where strength was closer to Ti-6Al-4V and higher than grade 4 titanium. In the present study, as a first step towards development of a novel antibacterial material with higher strength, the existing TNTZ was alloyed with copper to investigate the resultant microstructural changes and properties. The initial design and modelling of the alloy system was performed using the calculation of phase diagrams (CALPHAD) methods, to predict the phase transformations in the alloy. Following predictions, the alloys were produced using arc melting with appropriate heat treatments. The alloys were characterized using energy dispersive X-ray spectroscopy in scanning transmission electron microscopy (STEM-EDS) with transmission Kikuchi diffraction (TKD). The manufactured alloys had a three-phased crystal structure that was found in the alloys with 3 wt.% Cu and higher, in line with the modelled alloy predictions. The phases included the α-Ti (HCP-Ti) with some Ta present in the crystal, Ti2Cu, and a bright phase with Ti, Cu and Ta in the crystal. The Ti2Cu crystals tended to precipitate in the grain boundaries of the α-Ti phase and bright phase. The hardness of the alloys increased with increased Cu addition, as did the presence of the Ti2Cu phase. Further studies to optimize the alloy could result in a suitable material for dental implants.

Effect of Copper Ion Concentration on Bacteria and Cells.

In the oral cavity, dental implants-most often made of commercially pure titanium-come in contact with bacteria, and antibacterial management has been researched extensively to improve patient care. With antibiotic resistance becoming increasingly prevalent, this has resulted in copper being investigated as an antibacterial element in alloys. In this study, the objective was to investigate the copper ion concentrations at which cyto-toxicity is avoided while bacterial inhibition is ensured, by comparing Cu ion effects on selected eukaryotes and prokaryotes. To determine relevant copper ion concentrations, ion release rates from copper and a 10 wt. % Cu Ti-alloy were investigated. Survival studies were performed on MC3T3 cells and Staphylococcus epidermidis bacteria, after exposure to Cu ions concentrations ranging from 9 × 10-3 to 9 × 10-12 g/mL. Cell survival increased from <10% to >90% after 24 h of exposure, by reducing Cu concentrations from 9 × 10-5 to 9 × 10-6 g/mL. Survival of bacteria also increased in the same range of Cu concentrations. The maximum bacteria growth was found at 9 × 10-7 g/mL, probably due to stress response. In conclusion, the minimum inhibitory concentrations of Cu ions for these prokaryotes and eukaryotes were found in the range from 9 × 10-5 to 9 × 10-6 g/mL. Interestingly, the Cu ion concentration correlating to the release rate of the 10 wt. % Cu alloy (9 × 10-8 g/mL) did not kill the bacteria, although this alloy has previously been found to be antibacterial. Further studies should investigate in depth the bacteria-killing mechanism of copper.

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.