Antibacterial Strategies for Titanium Biomaterials

University dissertation from Uppsala : Acta Universitatis Upsaliensis

Abstract: Titanium and titanium based alloys are widely used in dentistry and orthopedics to replace hard tissue and to mend broken bones. It has become a material of choice due to its low density, high strength, good biocompatibility and its capacity to integrate closely with the bone. Today, modern materials and surgical techniques can enable patients to live longer, and aid in maintaining or regaining mobility for a more fulfilling life. There are, however, instances where implants fail, and one of the primary causes for implant failure is infection.This thesis deals with two possible ways of reducing or eliminating implant associated infections; TiO2 photocatalysis, where a surface can become antibacterial upon irradiation with UV light; and incorporation of silver, where a subsequent release of silver metal ions result in an antibacterial effect.For the TiO2 photocatalysis strategy, a simple and cost effective chemical oxidation technique, using hydrogen peroxide (H2O2) and water, was used to create an active TiO2 surface on titanium substrates. This surface was shown to effectively degrade an organic model substance (rhodamine B) by generating reactive oxygen species (ROS) under UV illumination. However, it was shown that Ti-peroxy radical species remaining in the surface after the H2O2-oxidation process, rather than generation of ROS from a heterogeneous photocatalytic process, was responsible for the effect. This discovery was further exploited in a TiO2/H2O2/UV system, which demonstrated synergy effects in both rhodamine B degradation tests and in antibacterial assays.For the silver ion release strategy, a combinatorial materials science approach was employed. Binary Ag-Ti oxide gradients were co-deposited in a reactive (O2) environment using a custom built physical vapor deposition system, and evaluated for antibacterial properties. The approach enabled synthesis and composition-structure-property evaluation unlikely to have been achieved by traditional means, and the gradient coatings demonstrated antibacterial properties against both S. aureus and S. epidermidis according to silver ion release. The release was shown to depend more on structural features, such as surface area, crystallinity and oxidation state, than on composition.Ag-Ti oxide gradients were also evaluated under UV illumination, as Ag deposits on crystalline TiO2 can enhance photocatalytic properties. In this work, however, the TiO2 was amorphous and UV illumination caused a slight reduction in the antibacterial effect of silver ions. This was attributed to a UV-induced SOS response in the S. epidermidis bacteria.The results of this thesis demonstrate that both TiO2 photocatalysis, or UV induced activation of Ti-peroxy radical species, as well as incorporation of silver are viable antibacterial strategies for titanium biomaterials. However, their clinical applications are still pending risk-benefit analyses of potential adverse host tissue responses.