Novel antibacterial titanium implant healing abutment with dimethylaminohexadecyl methacrylate to combat implant-related infections

• Published in: Dental materials Vol. 40; no. 2; pp. 244 - 253
• Main Authors: Zhou, Wen, Liang, Jingou, Huang, Xiaoyu, Weir, Michael D., Masri, Radi, Oates, Thomas W., Xu, Hockin H.K., Cheng, Lei
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.02.2024
• Subjects: Anti-Bacterial Agents - pharmacology; Antibacterial titanium healing abutment; Biofilms; Dental Implants; Dimethylaminohexadecyl methacrylate; Humans; Hydroxyapatite; Implant infections; Methacrylates - pharmacology; Methylamines; Polydopamine; Staphylococcus aureus; Titanium - pharmacology; Polydopamine; Antibacterial titanium healing abutment; Dimethylaminohexadecyl methacrylate; Hydroxyapatite; Biofilms; Implant infections
• ISSN: 0109-5641; 1879-0097
• DOI: 10.1016/j.dental.2023.11.011

Implant-related infections from the adhesion and proliferation of dental plaque are a major challenge for dental implants. The objectives of this study were to: (1) develop novel antibacterial titanium (Ti) healing abutment; (2) investigate the inhibition of implant infection-related pathogenic bacteria and saliva-derived biofilm, and evaluate the biocompatibility of the new material for the first time. Dimethylaminohexadecyl methacrylate (DMAHDM) and hydroxyapatite (HAP) were polymerized via polydopamine (PDA) on Ti. Staphylococcus aureus (S. aureus), Streptococcus sanguinis (S. sanguinis) and human saliva-derived biofilms were tested. After 4 weeks of DMAHDM release, the antibacterial efficacy of the DMAHDM remaining on Ti surface and the DMADHM in medium was tested. Biocompatibility was determined using human gingival fibroblasts (HGFs) and periodontal ligament stem cells (PDLSCs). The DMAHDM-loaded coating filled into the nano-voids in Ti surfaces. The modified Ti showed potent antibacterial activity, reducing the CFU of S. aureus, S. sanguinis and saliva-derived biofilms by 8, 7 and 4 log, respectively (P < 0.05). After 4 weeks of release, the modified Ti was still able to reduce S. aureus and S. sanguinis biofilm CFU by 1–3 log (P < 0.05). This provided strong antibacterial function for more than 4 weeks, which were the high-risk period for implant infections. The new material showed excellent biocompatibility when compared to control (P > 0.05). Novel DMAHDM-loaded Ti healing abutment had strong antibacterial effects, reducing biofilm CFUs by orders of magnitude, and lasting for over four weeks to cover the high-risk period for implant infections. The novel antibacterial Ti is promising to combat implant-related infections in dental, craniofacial and orthopedic applications. •The DMAHDM-loaded Ti effectively inhibit biofilms on the surface in the high-risk period of peri-implant inflammation.•The released DMAHDM inhibited the surrounding planktonic S. aureus and S. sanguinis.•After 4 weeks, the modified Ti was still able to show antibacterial effects on S. aureus and S. sanguinis biofilm.•The DMAHDM-loaded Ti is biocompatible, with no cytotoxicity to soft tissue seal and osseointegration related cells.