UV photocatalytic activity of titanium dioxide (TiO2) surface contaminated with bacterial biofilm: Implications for photo-restoration of osteoconductivity

Abstract

Ultraviolet (UV) light-mediated activation of titanium dioxide (TiO2) cleans the surface microenvironment through photocatalysis, but it is unknown whether this occurs when TiO2 surfaces is contaminated with bacterial biofilms. We therefore formed bacterial biofilms on TiO2 surfaces through culture with oral microorganisms from rats, which were subsequently exposed to high-intensity broadband UV light for 12 min. Osteoblast attachment, proliferation, and phenotypes were significantly compromised on biofilm-contaminated TiO2 surfaces, but UV treatment restored these biological activities to native baselines of TiO2 surfaces. The strength of bone-implant integration was 18.3 N for original implants, 1.5 N for biofilm-contaminated implants, and 30.5 N for biofilm-contaminated/UV-treated implants in a rat femur model after two weeks of healing. Histologically, there was limited, fragmented bone formation around biofilm-contaminated implants separated by thick fibrous tissue, while biofilm-contaminated/UV-treated implants induced robust bone formation with extensive direct bone-implant contact. Lipopolysaccharide (LPS) deposited on biofilm-contaminated TiO2 surfaces which was decomposed and removed by UV treatment. Notably, biofilm-contaminated TiO2 surfaces became superhydrophilic after UV treatment despite the persistence of carbon and nitrogen compounds, and UV treatment significantly restored the surface morphology of the innate titanium on the biofilm-contaminated TiO2 surfaces. In summary, bacterial biofilm severely compromised titanium osteoconductivity, but treatment of contaminated titanium with UV light significantly restored osteoconductivity through substantially decreased accumulation of carbon, nitrogen, and LPS; the re-emergence of micro-topography; and the induction of superhydrophilicity, paving the way for photoenergy-mediated debridement of TiO2 surface for clinical benefit.