Antibacterial Cement Research Articles

1,3,5-triacryloylhexahydro-1,3,5-triazine improves antibacterial and physicochemical properties of an experimental resin-based cement

Stable antibacterial cement could contribute to reducing the biofilm formation for a healthy marginal sealing in high-risk areas in indirect restorations. This study aimed to incorporate 1,3,5-triacryloylhexahydro-1,3,5-triazine (TAT) on experimental resin-based cements and evaluate its antibacterial and physicochemical properties. An experimental resin-based cement was formulated with 50 wt% Bisphenol A-Glycidyl Methacrylate (BisGMA), 30 wt% Urethane Dimethacrylate (UDMA), 20 wt% Triethylene Glycol Dimethacrylate (TEGDMA), and initiators. Barium silicate glass was used as a filler (45 wt%) and two different groups were tested: C TAT with 15 wt% TAT addition and C CONTROL with no TAT addition. The developed cements were evaluated by their degree of conversion, film thickness, flow, flexural strength, softening solvent, cytotoxicity, and antibacterial activity. Microshear bond strength (μSBS) was evaluated regarding dental tissues, glass-ceramics, and polycrystalline ceramics. C TAT showed a higher degree of conversion, lower cytotoxicity, lower softening solvent, and an increased film thickness when compared to C CONTROL. No statistical difference was found between the groups for flow, flexural strength, planktonic antibacterial analysis, and cytotoxicity. Reduced biofilm formation was observed in the C TAT group. C TAT improved the μSBS values for a polycrystalline ceramic substrate. The addition of 1,3,5-triacryloylhexahydro-1,3,5-triazine showed anti-biofilm activity, increased degree of conversion, decreased cytotoxicity, and increased bond strength for IPS-YTZP substrate tested.

Intra-articular versus systemic vancomycin for the treatment of periprosthetic joint infection after debridement and spacer implantation in a rat model.

AimsTreatment outcomes for methicillin-resistant Staphylococcus aureus (MRSA) periprosthetic joint infection (PJI) using systemic vancomycin and antibacterial cement spacers during two-stage revision arthroplasty remain unsatisfactory. This study explored the efficacy and safety of intra-articular vancomycin injections for PJI control after debridement and cement spacer implantation in a rat model.MethodsTotal knee arthroplasty (TKA), MRSA inoculation, debridement, and vancomycin-spacer implantation were performed successively in rats to mimic first-stage PJI during the two-stage revision arthroplasty procedure. Vancomycin was administered intraperitoneally or intra-articularly for two weeks to control the infection after debridement and spacer implantation.ResultsRats receiving intra-articular vancomycin showed the best outcomes among the four treatment groups, with negative bacterial cultures, increased weight gain, increased capacity for weightbearing activities, increased residual bone volume preservation, and reduced inflammatory reactions in the joint tissues, indicating MRSA eradication in the knee. The vancomycin-spacer and/or systemic vancomycin failed to eliminate the MRSA infections following a two-week antibiotic course. Serum vancomycin levels did not reach nephrotoxic levels in any group. Mild renal histopathological changes, without changes in serum creatinine levels, were observed in the intraperitoneal vancomycin group compared with the intra-articular vancomycin group, but no changes in hepatic structure or serum alanine aminotransferase or aspartate aminotransferase levels were observed. No local complications were observed, such as sinus tract or non-healing surgical incisions.ConclusionIntra-articular vancomycin injection was effective and safe for PJI control following debridement and spacer implantation in a rat model during two-stage revision arthroplasties, with better outcomes than systemic vancomycin administration.Cite this article: Bone Joint Res 2022;11(6):371–385.

Effect of Antibacterial Enoxacin on the Properties of Injectable Nano-hydroxyapatite/Polyurethane Cement for Bone Repairing

Biomaterial-associated infection (BAI) is a kind of serious post-operative complication in orthopaedic surgery. Antibiotic-loaded bone cement shines a light on BAI prevention for convenient manipulation and complex filling. To this aim, we designed an antibacterial bone cement based on Nano-hydroxyapatite/Polyurethane (PUHA) loading with antibiotic Enoxacin (EN). The distinct shear-thinning behavior of the prepolymers was observed, indicating a good injectability. The PUHA bone cement possessed a suitable curing speed, and the addition of EN might slightly expedite the curing process and enhance the mechanical properties. The EN release profile indicated that the EN-loaded bone cement could reach the minimum inhibitory concentration in 2 h, and sustainedly released EN for almost 8 days, exhibiting an antibacterial delivery potential. Antibacterial test further confirmed the antibacterial ability of EN-loaded bone cement is in a dose-dependent manner. However, the osteogenic performance of drug-loaded bone cement with high dosage is not as good as antibacterial activity. When the EN concentration of antibacterial cement was lower than 32 μg⋅mL−1, the proliferation and osteogenic differentiation of rat mesenchymal stem cells could be significantly promoted. Overall, this study verified the potential of the EN-loaded PUHA bone cement in anti-infection and osteogenesis for bone repairing.

Production of antibacterial cement composites containing ZnO/lignin and ZnO–SiO2/lignin hybrid admixtures

Inorganic–organic systems based on ZnO or ZnO–SiO2 and lignin were used for the first time to counteract the biodeterioration of cement composites. The stability of the oxide–lignin and interoxide–lignin combinations was confirmed by Fourier transform infrared spectroscopy, while electrokinetic studies confirmed the stability of the systems in the alkaline environment of the cement matrix. Moreover, lignin-enriched admixtures showed very good water wettability, which enabled their uniform dispersion in the cement matrix. Physical and mechanical tests confirmed the retarding effect of zinc oxide on the hydration of the cement binder in the initial setting period, which was manifested by lower mechanical parameters up to the 7th day of setting. The use of interoxide systems with silica balanced this adverse effect. The designed systems based on ZnO and lignin caused the inactivation of both bacterial and fungal pathogens, the effect being weaker in the case of the systems with silica.

Antibacterial Cement Additive: A Protective Approach Towards Construction

Antibacterial Cement Additive: A Protective Approach Towards Construction

Antimicrobial Activity of Al₂O₃, CuO, Fe₃O₄, and ZnO Nanoparticles in Scope of Their Further Application in Cement-Based Building Materials.

Nanoparticles were proposed as antibacterial cement admixtures for the production of cement-based composites. Nevertheless, the standards for evaluation of such admixtures still do not indicate which model organisms to use, particularly in regard to the further application of material. Apart from the known toxicity of nanomaterials, in the case of cement-based composites there are limitations associated with the mixing and dispersion of nanomaterials. Therefore, four nanooxides (Al2O3, CuO, Fe3O4, and ZnO) and seven microorganisms were tested to initially evaluate the applicability of nanooxides in relation to their further use in cement-based composites. Studies of nanoparticles included chemical analysis, microbial growth kinetics, 4- and 24 h toxicity, and biofilm formation assay. Nanooxides showed toxicity against microorganisms in the used concentration, although the populations were able to re-grow. Furthermore, the effect of action was variable even between strains from the same genus. The effect of nanoparticles on biofilms depended on the used strain. Gathered results show several problems that can occur while studying nanoparticles for specific further application. Proper protocols for nanomaterial dispersion prior the preparation of cement-based composites, as well as a standardized approach for their testing, are the fundamental issues that have to be resolved to produce efficient composites.

Preparation and evaluation of a novel antibacterial glass-ionomer cement

A novel antibacterial glass-ionomer cement has been developed. Compressive strength (CS) and S. mutans viability were used to evaluate the mechanical strength and antibacterial activity of the formed cement. Compressive yield strength (YS), modulus (M), diametral tensile strength (DTS) and flexural strength (FS) were also determined. All the formulated antibacterial cements showed a significant antibacterial activity, accompanying with an initial CS reduction. The effect of the synthesized antibacterial polymer loading was significant. Increasing loading from 1% to 20% significantly decreased the S. mutans viability from 3% to 50% and also reduced the initial CS (325 MPa) of the formed cements from 19% to 75%. The cement with 5% antibacterial polymer loading showed 142 MPa, 6.9 GPa, 224 MPa, 52 MPa, and 62 MPa in YS, M, CS, DTS and FS, respectively, as compared to 170, 7.1, 325, 60 and 87 for the experimental cement without antibacterial polymer addition and 141, 6.9, 236, 42 and 53 for Fuji II LC. It was also found that the chlorine-containing antibacterial cement showed better CS values than the bromine-containing cement, with no significant difference in antibacterial activity. The antibacterial cement also showed a similar antibacterial activity to Streptococcus mutans, lactobacillus, Staphylococcus aureus and Staphylococcus epidermidis. The human saliva did not affect the antibacterial activity of the cement. The thirty-day aging study indicates that the cements may have a long-lasting antibacterial function.

Choice and Doses of Antibacterial Agents for Cement Spacers in Treatment of Prosthetic Joint Infections: Review of Published Studies

Addition of antibacterial drugs to interim antibacterial cement spacers (ACSs) is considered to be standard of care for surgical revision in prosthetic joint infections (PJIs). We reviewed published studies evaluating the choice and doses of antibacterials in spacers. We conducted a PubMed search of all clinical study reports evaluating the use of ACSS in a 2-stage hip or knee arthroplasty for treatment of PJI (1988 through August 2011). The trial design, antibacterials used, and end points studied were analyzed. No randomized trials were found comparing either ACSs with different concentrations of antibacterials or ACSs with or without antibacterials. Most of the studies were uncontrolled and used various time points to evaluate the outcome. Twenty publications that reported doses of antibacterials in spacers and had a follow-up of ≥ 24 months after the second stage were selected for review. Most ACSs included vancomycin and aminoglycosides. The doses of aminoglycosides and vancomycin ranged from 0.25 to 4.8 g and from 1 to 4 g, respectively, per 4 g of cement. No association between reported eradication of the infection and antibacterial load was found. Published data do not allow evaluation of whether antibacterials in temporary cement spacers provide additional benefits in the treatment of PJI, compared with systemic antibacterials, and are not sufficient to support recommendations on dosages. Complications of ACSs have not been consistently analyzed. Prospective randomized trials comparing spacers with and without antibacterials or spacers with different loads of antibacterials are needed to evaluate the safety and efficacy of ACSs.

Repairing Collagen in Dentin Carious Lesions. Influence of Sealing the Material: A Morphometric Study

The aim of the present work was to morphometrically evaluate collagen in carious lesions sealed with calcium hydroxide, adhesive systems, glass ionomer cement, and an antibacterial cement. Samples of infected and affected dentin were stained with Sirius Red (SR). The areas intensively stained with SR were delimited, and the percentage of these areas was measured by blind calibrated examiners. The mean results were subjected to the Kruskal-Wallis test. The affected dentin sealed with Ca(OH)2 showed a better organization of the collagen in relation to the adhesive systems Prime & Bond (p = .0159) and Adhese (p < 0.0001). The affected dentin sealed with Prime & Bond promoted better increase of organized collagen areas in relation to Adhese (p = 0.0004). The infected dentin sealed with glass ionomer cement (p = 0.0018) or antibacterial cement (p = 0.0004) brought a significant increase in the organized collagen areas. Ca(OH)2 is indicated to seal affected dentin and glass ionomer cement and antibacterial cement may be used for treatment of infected dentin. The addition of antibiotics did not influence the restoration of the infected dentin.

Novel Antibacterial Calcium Phosphate Cement

The antibacterial brushite-forming calcium phospahte cements (CPC) were prepared using an equimolar mixture of β-tricalcium phosphate (β-TCP) and monocalcium phosphate monohydrate (MCPM) with chlorine dioxide (ClO2) generating powders (sodium chlorite and mixed acid activator). The effect of ClO2 on cement setting time, compressive strength, and antibacterial property of novel antibacterial CPC was investigated. The use of 0.3M citric acid solutions as liquid phase enabled final setting times of 5~10 min. The setting time of antibacterial cement systems was prolonged with increasing the amount of antibiotic used. Dry compressive strength was found to be in the range between 9~15 MPa and increased with addition of ClO2 generating powders. Wet compressive strength was slightly decreased compared to dry compressive strength after immersion of cement samples in water for 24 h. The antimicrobial potency of the different cement formulations was investigated using the agar diffusion method. The acidic brushite cement itself showed the inhibitory effect for Streptococcus mutans. The inhibition zone was increased with the amount of ClO2 generating powders. These results indicate that our novel antibacterial CPC have the great potential to avoid the development of infections for preventive antibiotic therapy.

Bactericidal eradication from carious lesions of prepared abutments by an antibacterial temporary cement

Purpose. The aim of this study was to observe the antibacterial potential of polycarboxylate temporary cement containing a mixture of metronidazole, ciprofloxacin, and cefaclor on carious lesions of prepared abutments that were designed to leave caries on the abutments. Material and methods. Antibacterial efficacy was estimated in vitro and in vivo by measuring bacterial recovery from the lesions. Bacteria counts ranged from 10 4 to 10 7 both in vitro (nine samples) and in vivo (five samples) in time-zero samples, just before the application of the antibacterial cement. Results. No bacteria were recovered from carious lesions in vitro (six samples) or in vivo (four samples) after the lesions were covered by the antibacterial temporary cement. For the remaining samples, some bacteria (5 to 80 counts per sample) were recovered, with one notable exception in which marginal leakage provided a bacteria count of 10 3. Bacteria counts ranging from 10 3 to 10 5 occurred in carious lesions covered by temporary cement without antibacterial agents, which indicated that temporary cement alone was not a potent disinfectant. Conclusions. The results of this study indicated that the antibacterial temporary cement can be useful for eradicating bacteria from carious lesions of prepared abutments. (J Prosthet Dent 1997;77:348-52.)