Aug 2026· Journal of Periodontal Research· 0 citations· 41 references
Medicine
TL;DR
The multifunctional coating provides sustained antimicrobial activity alongside immunomodulatory and pro-regenerative effects, supporting its potential to treat implant-related infections while enhancing peri-implant soft tissue remodeling.
Abstract
Aim
This study aimed to assess the antimicrobial performance and biocompatibility of our drug delivery platform, based on layer-by-layer (LbL) coating incorporating tetracycline (TC) complexed with anionic β-cyclodextrin (TCβCD) and a pH-responsive poly(methacrylic acid) (PMAA) film, applied to titanium (Ti) surfaces representing abutment components.
Methods
A rat subcutaneous implant-related infection model was established using a polymicrobial biofilm derived from peri-implantitis patient saliva. Contaminated Ti controls and coated discs were implanted and analyzed after 1 and 7 days through clinical, microbiological, confocal, and histological assessments. In parallel, in vitro experiments using fibroblast cultures were conducted to evaluate the expression of genes associated with collagen synthesis and extracellular matrix remodeling.
Results
Coated implants exhibited minimal inflammatory response, whereas control specimens presented with purulent exudate. Microbiological analysis demonstrated sustained antimicrobial activity, with > 3 log10 reduction in viable bacteria at both time points. Confocal microscopy confirmed strong microbicidal effects, particularly in the PMAA group. Coatings also modulated host responses, decreasing pro-inflammatory cytokines and increasing anti-inflammatory mediators and matrix remodeling markers. Histology revealed enhanced collagen deposition and accelerated connective tissue maturation, especially with LbL/TCβCD/PMAA, consistent with upregulated collagen-related gene expression observed in vitro.
Conclusion
The multifunctional coating provides sustained antimicrobial activity alongside immunomodulatory and pro-regenerative effects, supporting its potential to treat implant-related infections while enhancing peri-implant soft tissue remodeling.
The reduction in microbial adhesion, coupled with enhanced osteoblast attachment, suggests a synergistic effect that may increase the success rate of implant integration at an early stage.
Bartosz Mielan, M. Pajączkowska, Joanna Nowicka et al.· International Journal of Mol...· 0 citations
Background/Aim: Magnesium-based alloys are promising materials for fabrication of bioresorbable medical devices. The application is limited by rapid degradation and associated adverse tissue responses. In this study, nanometer-thin composite polyelectrolyte/wax (PEM/W) coatings were fabricated on magnesium-based implant prototypes to delay their degradation. Materials and Methods: Coatings were applied using a layer-by-layer technique. Cytocompatibility was assessed according to DIN ISO 10993-5 using NIH/3T3 fibroblasts and human umbilical vein endothelial cells (HUVECs). Degradation behavior was monitored by high-resolution micro-computed tomography (μ-CT), while tissue compatibility and host responses were evaluated histologically following DIN EN ISO 10993-6. Results: The coatings were continuous, hydrophobic (water contact angles exceeding 100°), with sub-micrometer thicknesses and were found to improve in vitro cytocompatibility of magnesium biomaterials. In vivo evaluation using a rat subcutaneous implantation model demonstrated that the effectiveness of magnesium degradation modulation depends on the type of employed PEM. Micro-computed tomography analyses revealed that the hyaluronic acid/chitosan/wax coating provided the most robust protection over 60 days, exhibiting the lowest volume loss and superior preservation of implant geometry compared to the uncoated samples. Correspondingly, hydrogen-related gas cavity formation was reduced and temporally delayed in coated implants, indicating a more controlled degradation process. Histopathological analysis shows a moderate inflammatory response characteristic of biodegradable metallic implants, dominated by macrophages and lymphocytes. Importantly, coated implants were associated with reduced late-stage fibrosis and necrosis compared to uncoated magnesium. Conclusion: Overall, composite PEM/W coatings, especially those based on natural polyelectrolytes, represent a promising surface-engineering strategy for improving the safety and performance of resorbable magnesium implants.
Tonya Andreeva, Kim Burkhardt, Ole Jung et al.· In Vivo· 0 citations
Implant-associated infections remain a major challenge due to biofilm formation and uncontrolled antibiotic release from conventional coatings. This study presents an enzyme-responsive nanoparticle-based coating designed to enable localized and on-demand antibiotic delivery on titanium implant surfaces. Hyaluronidase-sensitive ciprofloxacin-loaded mesoporous silica nanoparticles (MSNs) coated with hyaluronic acid (MSN-CIP-HA) were synthesized and deposited onto titanium substrates via electrophoretic deposition (EPD). The nanoparticles and coated surfaces were characterized in terms of morphology, surface properties, and wettability. Drug release behavior was evaluated under physiological (pH 7.4) and infection-mimicking acidic (pH 5) conditions in the presence and absence of hyaluronidase. After 72 h, ciprofloxacin release from coated titanium reached 0.51 μg at pH 7.4 without enzyme and increased to 2.63 μg in the presence of hyaluronidase. Similarly, release at pH 5 increased from 0.93 to 3.31 μg following enzyme addition, indicating effective enzyme-triggered degradation of the HA coating layer. Antibacterial performance against Escherichia coli and Staphylococcus aureus demonstrated reduced bacterial adhesion on coated surfaces and enhanced antibacterial efficacy under enzyme-responsive conditions. The developed coating therefore combines anti-adhesive surface properties with controlled, infection-triggered antibiotic release, limiting unnecessary drug exposure while improving localized antibacterial activity. These findings highlight the potential of HA-coated MSN coatings as smart implant surface modifications for reducing implant-associated infections and biofilm formation.
Merve Yolum, Sakip Önder· Journal of Biomedical Materi...· 0 citations
Biomaterial‐associated infections (BAIs) and insufficient early cellular response remain critical challenges for orthopedic implants. We introduce a comprehensive study that bridges current knowledge gaps by examining an early‐stage antimicrobial effect on the clinically relevant alloy Ti–6Al–4V. It combines pathogenic strains with parallel osteoblast assays and tilted‐view SEM analysis to obtain a qualitative understanding of the adhesion mechanisms. Detailed physicochemical characterization revealed a progressive increase in nanoscale roughness and oxide layer thickness, accompanied by selective Al/V depletion and pronounced hydrophilization. To evaluate biological responses, we used standardized in vitro models with Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli. Bacterial adhesion was quantified by SYTO9 staining, a GFP‐expressing strain as a viability control, and SEM imaging. Nanostructured (Rq ≤ 40 nm) surfaces significantly reduced early bacterial attachment compared to polished nanoflat controls. In parallel, osteoblast‐like SaOs‐2 cells showed stable adhesion and spreading, confirmed by phalloidin/DAPI staining and LDH cytotoxicity assay. Together, these results demonstrate that NaOH‐etched Ti–6Al–4V surfaces can impair early microbial adhesion based on physical action and preserve osteoblast compatibility. By integrating advanced materials characterization with microbiological and cell biological assays, we provide a framework for topography‐driven surface design toward infection‐resistant orthopedic implants that support favorable early osteoblast–surface interactions.
Sadaf Khalatbarizamanpoor, Adrian G. Nowotnick, Stephanie Lippmann et al.· Small Science· 0 citations
Dental implants rely on a stable and functional interface between the implant surface, surrounding tissues, and the oral microbial environment. While titanium remains the clinical gold standard due to its mechanical properties and capacity for osseointegration, peri-implant inflammation and biofilm-associated infection continue to compromise long-term outcomes. Consequently, there is growing interest in multifunctional implant surfaces capable of simultaneously regulating microbial colonisation, immune responses and peri-implant tissue integration. Advances in surface engineering and biomaterials science have revealed that implant surface chemistry and micro- and nanoscale topography strongly influence protein adsorption, immune activation, cellular behaviour, and bacterial attachment at the host-implant interface. Inspired by naturally antimicrobial and self-cleaning biological surfaces, biomimetic approaches have led to the development of mechano-bactericidal nanostructured titanium interfaces capable of physically inactivating bacteria while maintaining cytocompatibility and enhancing osteogenesis. This review examines the mechanobiological principles governing host-implant interactions and examines current strategies for engineering multifunctional antimicrobial, immunomodulatory, and regenerative implant surfaces. The translational challenges limiting clinical implementation, including mechanical durability, biological masking of engineered surfaces and long-term functional stability, are also discussed, together with emerging interest in alternative implant materials such as zirconia. Collectively, biomimetic multifunctional implant surfaces represent a promising strategy for improving long-term implant integration and peri-implant tissue health, although further translational and clinical validation remains necessary before widespread clinical adoption.
R. S. Pessoa, Lauren E Steele, Mehvish Mumtaz et al.· Journal of Periodontal Resea...· 0 citations
Periprosthetic joint infection (PJI) is sustained by implant-associated biofilms, ineffective immune activation, oxidative stress, and impaired osseointegration, and therefore requires more than local bacterial killing alone. Hydrogel-based therapies have attracted growing attention, but their biological effects are often attributed indiscriminately to the hydrogel even when they are primarily produced by incorporated antibiotics, antimicrobial peptides, enzymes, nanoparticles, growth factors, or cells. This narrative review develops a material-centered framework that distinguishes three sources of therapeutic activity: matrix-intrinsic functions, payload-derived biological effects, and hydrogel-enabled effects. We summarize the interface-specific pathophysiology of PJI and analyze the hydrogel properties most relevant to peri-implant treatment, including local retention, injectability, conformability to irregular dead space, wet-surface and implant-interface adaptation, tunable degradation, controlled or stimuli-responsive release, and extracellular matrix-like support. Representative antibacterial, antibiofilm, redox-regulating, immunomodulatory, angiogenic, and osteogenic systems are assessed according to their material composition, payload, release mechanism, experimental model, and direct relevance to true PJI. Hydrogels are also compared with polymethylmethacrylate cement, calcium sulfate carriers, nanoparticles or microspheres, electrospun scaffolds, and conventional implant coatings to clarify their scenario-specific advantages and limitations. The available evidence indicates that hydrogels are most valuable when they improve spatial retention, temporal sequencing, interface contact, or compatibility with labile therapeutics; they are not universally superior when mechanical support, established surgical familiarity, or long-term structural stability is required. Translation will depend on clinically representative implant-associated models, standardized reporting, sterilization and storage compatibility, reproducible manufacturing, surgical usability, and proportionate regulatory complexity. This hydrogel-enabled perspective supports indication-driven design and more rigorous evaluation of local biomaterial strategies for PJI.
Chao Zhang, Rui Zhang, Yuwen Yang et al.· Frontiers in Cell and Develo...· 0 citations