title: Balancing microbial and mammalian cell functions on calcium ion-modified implant surfaces.
abstract: Implant integration is a complex process mediated by the interaction of the implant surface with the surrounding ions, proteins, bacteria, and tissue cells. Although most implants achieve long-term bone-tissue integration, preventing pervasive implant-centered infections demands further advances, particularly in surfaces design. In this work, we analyzed classical microrough implant surfaces (only acid etched, AE; sandblasted then acid etching, SB + AE) and a new calcium-ion-modified implant surface (AE + Ca) in terms of soft- and hard-tissue integration, bacterial adhesion, and biofilm formation. We cultured on the surfaces primary oral cells from gingiva and alveolar bone, and three representative bacterial strains of the oral cavity, emulating oral conditions of natural saliva and blood plasma. With respect to gingiva and bone cells and in the presence of platelets and plasma proteins, AE + Ca surfaces yielded in average 86% higher adhesion, 44% more proliferation, and triggered 246% more synthesis of extracellular matrix biomolecules than AE-unmodified controls. Concomitantly, AE + Ca surfaces regardless of conditioning with saliva and/or blood plasma showed significantly less bacterial adhesion (67% reduction in average) and biofilm formation (40% reduction in average) than unmodified surfaces. These results highlight the importance of a calcium-rich hydrated interface to favor mammalian cell functions over microbial colonization at implant surfaces. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 421-432, 2018.
authors.affiliation: Private Practice in Implantology and Oral Rehabilitation, 01007, Vitoria-Gasteiz, Spain.|BTI Biotechnology Institute IMASD, 01510, Miñano, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Anitua
authors.affiliation: BTI Biotechnology Institute IMASD, 01510, Miñano, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Tejero
authors.affiliation: Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.|Department of Applied Physics, Faculty of Science-UEx, 06006, Badajoz, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Pacha-Olivenza
authors.affiliation: Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.|Department of Biomedical Sciences, Faculty of Medicine-UEx, 06006, Badajoz, Spain.
authors.forename: María Coronada
authors.initials: MC
authors.lastname: Fernández-Calderón
authors.affiliation: Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.|Department of Biomedical Sciences, Faculty of Medicine-UEx, 06006, Badajoz, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Delgado-Rastrollo
authors.affiliation: BTI Biotechnology Institute IMASD, 01510, Miñano, Spain.
authors.forename: Mari Mar
authors.initials: MM
authors.lastname: Zalduendo
authors.affiliation: BTI Biotechnology Institute IMASD, 01510, Miñano, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Troya
authors.affiliation: Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.|Department of Biomedical Sciences, Faculty of Medicine-UEx, 06006, Badajoz, Spain.
authors.forename: Ciro
authors.initials: C
authors.lastname: Pérez-Giraldo
authors.affiliation: Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.|Department of Applied Physics, Faculty of Science-UEx, 06006, Badajoz, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: González-Martín
mesh_terms: D018441:Biofilms / Q000254:growth & development*; D002118:Calcium / Q000737:chemistry*; D005260:Female; D005347:Fibroblasts / Q000166:cytology / Q000378:metabolism*; D006094:Gram-Positive Bacteria / Q000502:physiology*; D006801:Humans; D020007:Implants, Experimental; D008297:Male; D010006:Osteoblasts / Q000166:cytology / Q000378:metabolism*; D013499:Surface Properties
chemical_list: D002118:Calcium
keywords: antimicrobial surfaces; bacterial adherence; calcium ions; cell-material interactions; implant surface