Abstract
Protruding nanostructured surfaces have gained increasing interest due to their unique wetting behaviours and more recently their antimicrobial and osteogenic properties. Rapid development in nanofabrication techniques that offer high throughput and versatility on titanium substrate open up the possibility for better orthopaedic and dental implants that deter bacterial colonisation while promoting osteointegration. In this review we present a brief overview of current problems associated with bacterial infection of titanium implants and of efforts to fabricate titanium implants that have both bactericidal and osteogenic properties. All of the proposed mechano-bactericidal mechanisms of protruding nanostructured surfaces are then considered so as to explore the potential advantages and disadvantages of adopting such novel technologies for use in future implant applications. Different nanofabrication methods that can be utilised to fabricate such nanostructured surfaces on titanium substrate are briefly discussed.
Highlights
Medical implants are devices that are placed inside or on the surface of the body to replace or restore the function of damaged or degenerated tissues or organs
This study proposed the importance of adhesion energy and deformation energy to the bactericidal activity of nanostructured surfaces, indicating that stretching of the bacterial cell wall was significantly enhanced by nanopillars of 40 nm in diameter and a spacing of 100 nm (Figure 2C)
Due to interaction forces, the membrane stretches and eventually ruptures; A (e–h) show bactericidal mechanisms proposed for dragonfly wing-like surfaces, which consist of non-uniform high aspect ratio nanopillars, meaning that initial contact points are expected to be fewer than for the cicada wing
Summary
Medical implants are devices that are placed inside or on the surface of the body to replace or restore the function of damaged or degenerated tissues or organs. Current dental practices to reduce post-operative complications include evaluation of systemic or syndromic diseases, immune disorder [12] and accurate examination of the bone crest for proper implant fitting [13] Factors such as the dental implant properties (i.e., surface roughness, anatomic site and implant fit) and patient oral hygiene (i.e., periodontitis, bone quality, vascular integrity, soft tissue viability) will influence the risk of implant failure [11]. Orthopaedic implants can cause bone-tissue conditions such as osteomyelitis and septic arthritis, which involve inflammatory destruction of joint and bone [14] Staphylococci such as Staphylococcus aureus and Staphylococcus epidermidis account for most implant-related infections, being identified from two out of every three cases (Table 1) [14]. Gram-positive cocci (e.g., Streptococcus), Gram-negative anaerobic oral bacteria
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