Antibacterial Behavior of Additively Manufactured Porous Titanium with Nanotubular Surfaces Releasing Silver Ions.
Additive manufacturing (3D printing) has enabled fabrication of geometrically complex and fully interconnected porous biomaterials with huge surface areas that could be used for biofunctionalization to achieve multifunctional biomaterials. Covering the huge surface area of such porous titanium with nanotubes has been already shown to result in improved bone regeneration performance and implant fixation. In this study, we loaded TiO2 nanotubes with silver antimicrobial agents to equip them with an additional biofunctionality, i.e., antimicrobial behavior. An optimized anodizing protocol was used to create nanotubes on the entire surface area of direct metal printed porous titanium scaffolds. The nanotubes were then loaded by soaking them in three different concentrations (i.e., 0.02, 0.1, and 0.5 M) of AgNO3 solution. The antimicrobial behavior and cell viability of the developed biomaterials were assessed. As far as the early time points (i.e., up to 1 day) are concerned, the biomaterials were found to be extremely effective in preventing biofilm formation and decreasing the number of planktonic bacteria particularly for the middle and high concentrations of silver ions. Interestingly, nanotubes not loaded with antimicrobial agents also showed significantly smaller numbers of adherent bacteria at day 1, which may be attributed to the bactericidal effect of high aspect ratio nanotopographies. The specimens with the highest concentrations of antimicrobial agents adversely affected cell viability at day 1, but this effect is expected to decrease or disappear in the following days as the rate of release of silver ions was observed to markedly decrease within the next few days. The antimicrobial effects of the biomaterials, particularly the ones with the middle and high concentrations of antimicrobial agents, continued until 2 weeks. The potency of the developed biomaterials in decreasing the number of planktonic bacteria and hindering the formation of biofilms make them promising candidates for combating peri-operative implant-associated infections.
Department of Orthopedics, University Medical Centre Utrecht , 3584 CX Utrecht, The Netherlands.|Department of Biomechanical Engineering, Delft University of Technology , 2628 CD Delft, The Netherlands.
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Amin Yavari
Department of Orthopedics, University Medical Centre Utrecht , 3584 CX Utrecht, The Netherlands.
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Loozen
Department of Medical Microbiology, University Medical Center Utrecht , 3584 CX Utrecht, The Netherlands.
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Paganelli
Department of Biomechanical Engineering, Delft University of Technology , 2628 CD Delft, The Netherlands.
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Bakhshandeh
3D Systems-LayerWise NV, 3001 Leuven, Belgium.|Department of Materials Engineering, Katholieke Universiteit Leuven , 3000 Leuven, Belgium.
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Lietaert
Department of Medical Microbiology, University Medical Center Utrecht , 3584 CX Utrecht, The Netherlands.
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JA
Groot
Department of Medical Microbiology, University Medical Center Utrecht , 3584 CX Utrecht, The Netherlands.
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Fluit
Department of Medical Microbiology, University Medical Center Utrecht , 3584 CX Utrecht, The Netherlands.
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CH
Boel
Department of Orthopedics, University Medical Centre Utrecht , 3584 CX Utrecht, The Netherlands.
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Alblas
Department of Orthopedics, University Medical Centre Utrecht , 3584 CX Utrecht, The Netherlands.
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Vogely
Department of Orthopedics, University Medical Centre Utrecht , 3584 CX Utrecht, The Netherlands.|Department of Biomechanical Engineering, Delft University of Technology , 2628 CD Delft, The Netherlands.|Department of Rheumatology, University Medical Centre Utrecht , 3584 CX Utrecht, The Netherlands.
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Weinans
Department of Biomechanical Engineering, Delft University of Technology , 2628 CD Delft, The Netherlands.
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Zadpoor
D000900:Anti-Bacterial Agents; D007477:Ions; D016062:Porosity; D012834:Silver / Q000737:chemistry*; D014025:Titanium
D000900:Anti-Bacterial Agents; D007477:Ions; D012834:Silver; D014025:Titanium
additive manufacturing; antibacterial surfaces/coatings; multifunctional biomaterials; nanotopography; porous implants