Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry—A Comprehensive Review
Abstract
:1. Introduction
2. Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry
2.1. Study Characteristics
2.2. Available Strategies to Reduce Biofilm Formation on PEEK Materials
- (a)
- PEEK sulfonation process, which can be employed either to produce a 3D network on polymer surface [39], or to embed therapeutic compounds (e.g., lactams [45,46], mouse beta-defensin [59]). Further surface treatments were also employed after the sulfonation process, such as chlorogenic acid/grafting peptide [43], graphene oxide coating [61] and hydrothermal treatment [48].
- (b)
- Incorporation of therapeutic and/or bioactive agents in the PEEK matrix or on the PEEK surface, such as simvastatin-PLLA [39]; Ag and Zn ions [37,39,40,58], dexamethasone plus minocycline-loaded liposomes [57], bioactive titanium dioxide (TiO2) [52], 2-methacryloyloxyethyl phosphorylcholine [51] and titanium plasma [56].
- (c)
- (d)
2.3. Microbiological Analysis
2.4. Physicochemical and Topographical Characterization
3. Discussion
4. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Reference | Materials (Roughness and Contact Angle Values) b | Microorganisms | Microbiologic Assay | Biologic Response |
---|---|---|---|---|
1. Barton et al. [30] |
|
|
| Bacterial adhesion was higher on PEEK than on biodegradable polymers; |
2. Bock et al. [31] |
|
|
| For both bacteria and at both experimental times biofilm growth was greater on PEEK; |
3. Bressan et al. 2017 [32] |
|
|
| No significant differences between groups were identified; |
4. Gorth et al. [33] |
|
|
| Exponential growth of biofilm was noted on PEEK when exposed to S. epidermidis, S. aureus, P. aeruginosa and E. coli. With the exception of Enterococcus, biofilm formation was lower on titanium compared to PEEK for time periods >48 h. PEEK showed the highest biofilm affinity; |
5. Hahnel et al. 2015 [34] |
|
|
| The lowest quantity of adherent viable biomass was identified on the surface of PEEK compared to other groups. After 44 h, biofilms on zirconia yielded the highest value of dead microorganisms and PMMA yielded the lowest value; |
6. Webster et al. [35] |
|
|
| Live bacteria were identified around PEEK (88%) and Ti (21%) implants, while none were observed adjacent to Si3N4; |
Reference | PEEK Modification Strategy | Materials (Roughness and Contact Angle Values) | Microorganisms | Microbiologic Assay | Biologic Response |
---|---|---|---|---|---|
1. Barkarmo et al. [36] | PEEK blasting; |
|
|
| Bacteria showed increased biofilm formation on blasted PEEK (exception: E. faecalis—higher on cp-Ti compared with other materials). |
2. Deng et al. [37] | Novel Ag-decorated 3D printed PEEK via catecholamine chemistry; |
|
|
| PEEK scaffold pDA-coated and UV-treated had significant contact and release killing capacities. Biofilms were reduced in the presence of silver; |
3. Deng et al. [38] | Hierarchically micro/nanoscale produced on PEEK and a simvastatin-PLLA film-tobramycin microspheres delivery system was fabricated; |
|
|
| Few bacteria were detected on the NSP/SIM (1 mm)-TOB group, while other groups had plenty of bacteria adhered. PEEK and NSPEEK showed uncontrolled biofilm proliferation, while no biofilm was observed on NSP/SIM (1 mm)-TOB group; |
4. Deng et al. [39] | Dual therapy implant coating developed on the 3D micro-/nanoporous sulfonated PEEK via layer-by-layer self-assembly of Ag ions and Zn ions; |
|
|
| Ag–SPEEK substrate was superior regarding antibacterial properties against E. coli, while absence of obvious antibacterial effects against S. aureus was observed; |
5. Díez-Pascual et al. [40] | Production of nanocomposites via melt-blending, by addition of a carboxylated polymer derivative covalently grafted onto the surface of hydroxyl-terminated ZnO nanoparticles; |
|
|
| Nanocomposites with polymer-grafted nanoparticles exhibited superior antibacterial activity against both studied bacteria. This effect increased upon raising nanoparticle content and was stronger on E. coli; |
6. Díez-Pascual et al. [41] | Production of biocompatible ternary nanocomposites based on poly PEEK/poly(ether-imide) (PEI) blends reinforced with bioactive titanium dioxide (TiO2) nanoparticles via ultrasonication followed by melt-blending; |
|
|
| The nanoparticles conferred antibacterial action versus tested bacteria in the presence and in the absence of UV light. The highest inhibition was attained at 4.0 wt % nanoparticle concentration; |
7. Gan et al. [42] | Nitrogen plasma immersion ion implantation (PIII) on PEEK; |
|
|
| The number of colonies adherents on the PEEK-L and PEEK-H was lower than that on PEEK-C and PEEK-I. Nitrogen PIII using high pulse or low pulse inhibited S. aureus early adhesion on PEEK, which exhibited antibacterial property; |
8. He et al. [43] | Drug-loaded (chlorogenic acid, CGA)/grafted peptide (BFP) hydrogel system supported on a sulfonated PEEK (SPEEK) surface, using sodium alginate (SA); |
|
|
| SPEEK and SPEEK@SA did not inhibit E. coli growth. SPEEK@SA(CGA) and SPEEK@SA(CGA)BFP scaffolds had a noticeable antibacterial effect on both tested bacteria; |
9. Lu et al. [44] | Dual zinc and oxygen plasma immersion ion implantation (Zn/O-PIII) applied to modify carbon fiber reinforced PEEK (CFRPEEK); |
|
|
| S. aureus, MRSA and S. epidermidis reduction on Zn/O-PIII-CFRPEEK is over 95% at 24 h. This group showed no antibacterial effect on S. epidermidis (biofilm-negative strain), E. coli and P. aeruginosa; |
10. Montero et al. [45] | PEEK sulfonation treatment to functionalize and embed therapeutical substances (lactam); |
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| Planktonic growth showed no significant difference between groups, while biofilm inhibition was found comparing SPEEK with lactams. S. mutans biofilm grew widely separately as agglomerates on SPEEK without lactams, while it could not be detected on SPEEK with lactams; |
11. Montero et al. [46] | PEEK sulfonation (SPEEK) on various degrees (SD);62%, G2 68%, G3 90%, G4 75% and G5 69% |
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| SPEEK heated for 3 h was the group with lowest values of planktonic growth;CFU from S. mutans biofilm showed a significant decrease on SPEEK sulfonated for 2, 2.5 and 3 h. E. faecalis showed this reduction only on groups sulfonated for 2.5 and 3 h; |
12. Ouyang et al. [47] | Preparation of graphene oxide (GO) modified SPEEK (GO-SPEEK) through dip-coating method; |
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| 0.5 GO-SPEEK and 1 GO-SPEEK groups exhibit proper antibacterial properties against E. coli, but poor against S. aureus; |
13. Ouyang et al. [48] | PEEK was sulfonated by concentrated sulfuric acid to fabricate a three-dimensional (3D) network with hydrothermal treatment subsequently; |
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| Amounts of E.coli were reduced to o 100%, 100%, and 24% on SPEEK, SPW25 and SPW120, respectively. On the same groups S. aureus was reduced by nearly 100%. |
14. Rochford et al. [49] | Injection moulded (PO) or machined (PA) PEEK exposed to an oxygen gas plasma in a plasma cleaner; |
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| Surface modification of PEEK did not lead to a significant change in bacterial adhesion in the preoperative contamination model. In the postoperative contamination model, S. aureus adhesion was increased on the modified surfaces. S. epidermidis adhesion to modified PEEK was lower than to nonmodified PEEK in the postoperative model; |
15. Rochford et al. [50] | PEEK films were oxygen plasma treated to increase surface free energy; |
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| There was no significant difference in bacterial adhesion between treated and untreated surfaces; |
16. Tateishi et al. [51] | Modified PEEK surface by photoinduced and self-initiated graft polymerization with 2methacryloyloxyethyl phosphorylcholine, under radiation UV; |
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| SEM revealed adhered bacteria on PEEK, whereas no bacterium was observed on the PMPC-grafted PEEK; |
17. Tran et al. [52] | Production of a hybrid coating of titanium dioxide and polydimethylsiloxane (PDMS) to regulate silver releasing; |
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| Higher Ag loadings resulted in a significant increase in the diameter of the bacteria inhibition zone. On PEEK, a thick and dense biofilm was formed. On H50-38.4, H75-38.4 and H95-38.4 smaller colonies of S. aureus were found, while in H50-384, H75-384 and H95-384 no bacterial colonies were found; |
18. Ur Rehman et al. [53] | Chitosan/bioactive glass (BG)/lawsone coatings were deposited by electrophoretic deposition (EPD) on polyetheretherketone (PEEK)/BG layers (previously deposited by EPD on 316-L stainless steel); |
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| Chitosan/BG/lawsone and the stainless steel chitosan/BG/lawsone PEEK/BG coated induced inhibition halo against S. carnosus. Halo zone was wider for the multilayered group (10 mm vs 4 mm); |
19. Wang et al. [54] | Development of a PEEK/nano-fluorohydroxyapatite (PEEK/nano-FHA) biocomposite; |
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| PEEK/nano-FHA biocomposite inhibited bacterial adhesion and proliferation, which did not occur with PEEK; |
20. Wang et al. [55] | PEEK coated with red and gray selenium nanoparticles through a quick precipitation method; |
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| Red and gray selenium-coated PEEK significantly inhibited the growth of P. aeruginosa compared with uncoated PEEK at all experimental times. |
21. Wang et al. [56] | Titanium plasma immersion ion implantation (PIII) technique was applied to modify the carbon-fiber-reinforced polyetheretherketone (CFRPEEK) surface, constructing a unique multilevel TiO2 nanostructure; |
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| The TiPIII modified surface can reduced S. mutans, F. nucleatum and P. gingivalis adhesion and growth, directly implicating on death of adhesive bacterial; |
22. Xu et al. [57] | PEEK modified surface using dexamethasone plus minocycline-loaded liposomes (Dex/Mino liposomes) bonded by a mussel-inspired polydopamine coating (pDA); |
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| Minor releasing from PEEK blank lipossomes surfaces effectively prevented bacterial adhesion and proliferation. The antibacterial efficiency of PEEK blank lipossomes was about 97.4% against S. mutans; |
23. Yan et al. [58] | A mussel inspired self-polymerized polydopamine (PDA) with silver nanoparticles (AgNPs) incorporated and silk fibroin (SF)/ gentamicin sulfate (GS) coating was constructed upon porous PEEK surface; |
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| SP-PDA-Ag/GS-Silk showed reliable antibacterial capacity against S. aureus and E. coli. It was observed smoothly adhered, proliferated and aggregated bacteria on PEEK, SPEEK and SP-PDA groups; |
24. Yuan et al. [59] | Mouse beta-defensin-14 (MBD-14) was immobilized on the PEEK surface with 3D porous structure through sulfonation process; |
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| SP-MBD with different MBD-14 solutions could effectively kill S. aureus and P. aeruginosa;PEEK with MBD-14 exercised durable and broad-spectrum antibacterial activity; |
25. Zhang et al. [60] | Macro–microporous bone implants of nano-bioglass (nBG) and polyetheretherketone (PK) composite (mBPC) were fabricated; |
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| Thiol (HK) loaded in mBPC (dmBPC) inhibited S. aureus growth and no viable bacteria were found. The presence of higher bacteria number on macro–microporous nBG/PK composites indicated stimulation of bacterial growth/ adhesion; |
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Brum, R.S.; Labes, L.G.; Volpato, C.Â.M.; Benfatti, C.A.M.; Pimenta, A.d.L. Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry—A Comprehensive Review. Antibiotics 2020, 9, 609. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9090609
Brum RS, Labes LG, Volpato CÂM, Benfatti CAM, Pimenta AdL. Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry—A Comprehensive Review. Antibiotics. 2020; 9(9):609. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9090609
Chicago/Turabian StyleBrum, Renata Scheeren, Luiza Gomes Labes, Cláudia Ângela Maziero Volpato, César Augusto Magalhães Benfatti, and Andrea de Lima Pimenta. 2020. "Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry—A Comprehensive Review" Antibiotics 9, no. 9: 609. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9090609