Evaluating the critical strain energy release rate of bioactive glass coatings on Ti6Al4V substrates after degradation.

It has been reported that the adhesion of bioactive glass coatings to Ti6Al4V reduces after degradation, however, this effect has not been quantified. This paper uses bilayer double cantilever (DCB) specimens to determine GIC and GIIC, the critical mode I and mode II strain energy release rates, respectively, of bioactive coating/Ti6Al4V substrate systems degraded to different extents. Three borate-based bioactive glass coatings with increasing amounts of incorporated SrO (0, 15 and 25mol%) were enamelled onto Ti6Al4V substrates and then immersed in de-ionized water for 2, 6 and 24h. The weight loss of each glass composition was measured and it was found that the dissolution rate significantly decreased with increasing SrO content. The extent of dissolution was consistent with the hypothesis that the compressive residual stress tends to reduce the dissolution rate of bioactive glasses. After drying, the bilayer DCB specimens were created and subjected to nearly mode I and mode II fracture tests. The toughest coating/substrate system (one composed of the glass containing 25mol% SrO) lost 80% and 85% of its GIC and GIIC, respectively, in less than 24h of degradation. The drop in GIC and GIIC occurred even more rapidly for other coating/substrate systems. Therefore, degradation of borate bioactive glass coatings is inversely related to their fracture toughness when coated onto Ti6A4V substrates. Finally, roughening the substrate was found to be inconsequential in increasing the toughness of the system as the fracture toughness was limited by the cohesive toughness of the glass itself.

Quantifying the mode II critical strain energy release rate of borate bioactive glass coatings on Ti6Al4V substrates.

Bioactive glasses have been used as coatings for biomedical implants because they can be formulated to promote osseointegration, antibacterial behavior, bone formation, and tissue healing through the incorporation and subsequent release of certain ions. However, shear loading on coated implants has been reported to cause the delamination and loosening of such coatings. This work uses a recently developed fracture mechanics testing methodology to quantify the critical strain energy release rate under nearly pure mode II conditions, GIIC, of a series of borate-based glass coating/Ti6Al4V alloy substrate systems. Incorporating increasing amounts of SrCO3 in the glass composition was found to increase the GIIC almost twofold, from 25.3 to 46.9J/m2. The magnitude and distribution of residual stresses in the coating were quantified, and it was found that the residual stresses in all cases distributed uniformly over the cross section of the coating. The crack was driven towards, but not into, the glass/Ti6Al4V substrate interface due to the shear loading. This implied that the interface had a higher fracture toughness than the coating itself.

Comparison of a SiO2-CaO-ZnO-SrO glass polyalkenoate cement to commercial dental materials: ion release, biocompatibility and antibacterial properties.

Ion Release and biocompatibility of a CaO-SrO-ZnO-SiO2 (BT 101) based glass polyalkenoate cement (GPC) was compared against commercial GPCs, Fuji IX and Ketac Molar. The radiopacity (R) was similar for each material, 2.0-2.8. Ion release was evaluated on each material over 1, 7, 30 and 90 days. BT 101 release included Ca (23 mg/L), Sr (23 mg/L) Zn (13 mg/L), Si (203 mg/L). Fuji IX release includes Ca (0.7 mg/L), Al (3 mg/L) Si (26 mg/L), Na (60 mg/L) and P (0.5 mg/L) while Ketac Molar release includes Ca (1 mg/L), Al (0.6 mg/L) Si (23 mg/L), Na (76 mg/L) and P (0.7 mg/L). Simulated body fluid trials revealed CaP surface precipitation on BT 101. No evidence of precipitation was found on Fuji IX or Ketac Molar. Cytotoxicity testing found similar cell viability values for each material (~60 %, P = 1.000). Antibacterial testing determined a reduced CFU count with BT 101 (2.5 × 10³) when compared to the control bacteria (2.4 × 104), Fuji IX (1.5 × 104) and Ketac Molar (1.2 × 104).

Aluminium-free glass polyalkenoate cements: ion release and in vitro antibacterial efficacy.

Glass polyalkenoate cements (GPCs) have exhibited potential as bone cements. This study investigates the effect of substituting TiO2 for SiO2 in the glass phase and the subsequent effect on cement rheology, mechanical properties, ion release and antibacterial properties. Glass characterization revealed a reduction in glass transition temperature (T(g)) from 685 to 669 °C with the addition of 6 mol % TiO2 (AT-2). Magic angle spinning nuclear magnetic resonance (MAS-NMR) revealed a shift from -81 ppm to -76 pmm when comparing a Control glass to AT-2, indicating de-polymerization of the Si network. The incorporation of TiO2 also increased the working time (T(w)) from 19 to 61 s and setting time (T(s)) from 70 to 427 s. The maximum compressive strength (σ(c)) increased from 64 to 85 MPa. Ion release studies determined that the addition of Ti to the glass reduced the release of zinc, calcium and strontium ions, with low concentrations of titanium being released. Antibacterial testing in E. coli resulted in greater bactericidal effects when tested in aqueous broth for both titanium containing cements.

Does elevating silver content in zinc-based glass polyalkenoate cements increase their antibacterial efficacy against two common bacteria using the agar gel diffusion method?

The authors have previously shown that it is possible to incorporate silver into a soda-zinc-silicate glass and subsequently form a glass polyalkenoate cement from it. The objective of the research described herein is to determine if incremental increases in the silver content of these glass polyalkenoate cements will increase their antibacterial efficacy against gram-positive and gram-negative bacteria using the accepted spread plate method. Four glass polyalkenoate cements were formulated; three contained increasing amounts of silver incorporated into them (cements A, B, and C, containing 0.33 mol%, 0.66 mol%, and 0.99 mol% silver, respectively) and a fourth contained no silver, which acted as a control (control cement). The handling properties of the glass polyalkenoate cements were evaluated, where working times were around 2 min and setting times ranged from 1 h 17 min to 2 h 41 min. Inductively coupled plasma atomic emission spectroscopy was employed to determine silver ion release with cement maturation for up to 14 days. The majority of silver ions were released within the first 24 h, with up to 2 mg/L cumulative ion release recorded up to 14 days. The antibacterial properties of the coatings were evaluated against Staphylococcus aureus and Pseudomonas aeruginosa bacteria. The silver-glass polyalkenoate cements exhibited antibacterial effect against both bacterial strains. The maximum inhibition zones recorded against S. aureus was 14.8 mm (SD ± 1.11) and against P. aeruginosa was 20.6 mm (SD ± 0.81). Cement B had a greater antibacterial effect compared to cement A, however, cements B and C had comparable antibacterial effects after 14 days even though cement C contained 0.33 mol% more silver than B. This indicates that by increasing the silver content in these cements, the antibacterial efficacy increases to a point, but there is a threshold where further silver ion release does not increase the antibacterial effect.

Comparison of a SiO(2)-CaO-ZnO-SrO glass polyalkenoate cement to commercial dental materials: glass structure and physical properties.

Glass polyalkenoate cements (GPCs) have previously been considered for orthopedic applications. A Zn-GPC (BT 101) was compared to commercial GPCs (Fuji IX and Ketac Molar) which have a setting chemistry analogous to BT 101. Handling properties (working, T (w) and setting, T (s) times) for BT 101 were shorter than the commercial GPCs. BT 101 also had a higher setting exotherm (S (x) -34 °C) than the commercial GPCs (29 °C). The maximum strengths for BT 101, Fuji IX, and Ketac Molar were 75, 238, and 216 MPa (compressive, σ (c)), and 34, 54, and 62 MPa (biaxial flexural strengths, σ (f)), respectively. The strengths of BT 101 are more suitable for spinal applications than commercial GPCs.

Fabrication of CaO-NaO-SiO(2)/TiO (2) scaffolds for surgical applications.

A series of titanium (Ti) based glasses were formulated (0.62 SiO(2)-0.14 Na(2)O-0.24 CaO, with 0.05 mol% TiO(2) substitutions for SiO(2)) to develop glass/ceramic scaffolds for bone augmentation. Glasses were initially characterised using X-ray diffraction (XRD) and particle size analysis, where the starting materials were amorphous with 4.5 µm particles. Hot stage microscopy and high temperature XRD were used to determine the sintering temperature (~700 °C) and any crystalline phases present in this region (Na(2)Ca(3)Si(6)O(16), combeite and quartz). Hardness testing revealed that the Ti-free control (ScC-2.4 GPa) had a significantly lower hardness than the Ti-containing materials (Sc1 and Sc2 ~6.6 GPa). Optical microscopy determined pore sizes ranging from 544 to 955 µm. X-ray microtomography calculated porosity from 87 to 93 % and surface area measurements ranging from 2.5 to 3.3 SA/mm(3). Cytotoxicity testing (using mesenchymal stem cells) revealed that all materials encouraged cell proliferation, particularly the higher Ti-containing scaffolds over 24-72 h.

Gallium containing glass polyalkenoate anti-cancerous bone cements: glass characterization and physical properties.

A gallium (Ga) glass series (0.48SiO(2)-0.40ZnO-0.12CaO, with 0.08 mol% substitution for ZnO) was developed to formulate a Ga-containing Glass Polyalkenoate Cement (GPC) series. Network connectivity (NC) and X-ray Photoelectron Spectroscopy (XPS) was employed to investigate the role of Ga(3+) in the glass, where it is assumed to act as a network modifier. Ga-GPC series was formulated with E9 and E11 polyacrylic acid (PAA) at 50, 55 and 60 wt% additions. E11 working times (T(w)) ranged from 68 to 96 s (Lcon.) and 106 s for the Ga-GPCs (LGa-1 and LGa-2). Setting times (T(s)) ranged from 104 to 226 s (Lcon.) and 211 s for LGa-1 and LGa-2. Compression (σc) and biaxial flexural (σf) testing were conducted where Lcon. increased from 62 to 68 MPa, LGa-1 from 14 to 42 MPa and LGa-2 from 20 to 47 MPa in σc over 1-30 days. σf testing revealed that Lcon. increased from 29 to 42 MPa, LGa-1 from 7 to 32 MPa and LGa-2 from 12 to 36 MPa over 1-30 days.

Silver coated bioactive glass particles for wound healing applications.

Bioactive glass particles (0.42SiO(2)-0.15CaO-0.23Na(2)O-0.20ZnO) of varying size (<90 µm and 425-850 µm) were synthesized and coated with silver (Ag) to produce Ag coated particles (PAg). These were compared against the uncoated analogous particles (Pcon.). Surface area analysis determined that Ag coating of the glass particles resulted in increased the surface area from 2.90 to 9.12 m(2)/g (90 µm) and 1.09-7.71 m(2)/g (425-850 µm). Scanning electron microscopy determined that the Ag coating remained at the surface and there was little diffusion through the bulk. Antibacterial (Escherichia coli--13 mm and Staphylococcus epidermidis--12 mm) and antifungal testing (Candida albicans--7.7 mm) determined that small Ag-coated glass particles exhibited the largest inhibition zones compared to uncoated particles. pH analysis determined an overall higher pH consider in the smaller particles, where after 24 h the large uncoated and Ag coated particles were 8.27 and 8.74 respectively, while the smaller uncoated and Ag coated particles attained pH values of 9.63 and 9.35 respectively.

Experimental composite guidance conduits for peripheral nerve repair: an evaluation of ion release.

Poly (lactide-co-glycolide) (PLGA) - Pluronic F127 - glass composites have demonstrated excellent potential, from the perspective of controlled mechanical properties and cytocompatibility, for peripheral nerve regeneration. In addition to controlling the mechanical properties and cytotoxicity for such composite devices, the glass component may mediate specific responses upon implantation via degradation in the physiological environment and release of constituent elements. However, research focused on quantifying the release levels of such therapeutic ions from these experimental medical devices has been limited. To redress the balance, this paper explores the ion release profiles for Si(4+), Ca(2+), Na(+), Zn(2+), and Ce(4+) from experimental composite nerve guidance conduits (CNGC) comprising PLGA (at 12.5, and 20 wt.%), F127 (at 0, 2.5 and 5 wt.%) and various loadings of Si-Ca-Na-Zn-Ce glass (at 20 and 40 wt.%) for incubation periods of up to 28 days. The concentration of each ion, at various time points, was determined using Inductively Coupled Plasma-Atomic Emission Spectrometry (Perkin Elmer Optima 3000). It was observed that the Si(4+), Na(+), Ca(2+), Zn(2+) release from CNGCs in this study ranged from 0.22 to 6.477 ppm, 2.307 to 3.277 ppm, 40 to 119 ppm, and 45 to 51 ppm, respectively. The Ce(4+) concentrations were under the minimum detection limits for the ICP instrument utilized. The results indicate that the ion release levels may be appropriate to mediate therapeutic effects with respect to peripheral nerve regeneration. The data generated in this paper provides requisite evidence to optimize composition for pre-clinical evaluation of the experimental composite.

clinical risk factors for osteoporosis in Ireland and the UK: a comparison of FRAX and QFractureScores.

Recently two algorithms have become available to estimate the 10-year probability of fracture in patients suspected to have osteoporosis on the basis of clinical risk factors: the FRAX algorithm and QFractureScores algorithm (QFracture). The aim of this study was to compare the performance of these algorithms in a study of fracture patients and controls recruited from six centers in the United Kingdom and Ireland. A total of 246 postmenopausal women aged 50-85 years who had recently suffered a low-trauma fracture were enrolled and their characteristics were compared with 338 female controls who had never suffered a fracture. Femoral bone mineral density was measured by dual-energy X-ray absorptiometry, and fracture risk was calculated using the FRAX and QFracture algorithms. The FRAX algorithm yielded higher scores for fracture risk than the QFracture algorithm. Accordingly, the risk of major fracture in the overall study group was 9.5% for QFracture compared with 15.2% for FRAX. For hip fracture risk the values were 2.9% and 4.7%, respectively. The correlation between FRAX and QFracture was R = 0.803 for major fracture and R = 0.857 for hip fracture (P ≤ 0.0001). Both algorithms yielded high specificity but poor sensitivity for prediction of osteoporosis. We conclude that the FRAX and QFracture algorithms yield similar results in the estimation of fracture risk. Both of these tools could be of value in primary care to identify patients in the community at risk of osteoporosis and fragility fractures for further investigation and therapeutic intervention.

The bioactivity and ion release of titanium-containing glass polyalkenoate cements for medical applications.

The ion release profiles and bioactivity of a series of Ti containing glass polyalkenoate cements. Characterization revealed each material to be amorphous with a T(g) in the region of 650-660°C. The network connectivity decreased (1.83-1.35) with the addition of TiO(2) which was also evident with analysis by X-ray photoelectron spectroscopy. Ion release from cements were determined using atomic absorption spectroscopy for zinc (Zn(2+)), calcium (Ca(2+)), strontium (Sr(2+)), Silica (Si(4+)) and titanium (Ti(4+)). Ions such as Zn(2+) (0.1-2.0 mg/l), Ca(2+) (2.0-8.3 mg/l,) Sr(2+) (0.1-3.9 mg/l), and Si(4+) (14-90 mg/l) were tested over 1-30 days. No Ti(4+) release was detected. Simulated body fluid revealed a CaP surface layer on each cement while cell culture testing of cement liquid extracts with TW-Z (5 mol% TiO(2)) produced the highest cell viability (161%) after 30 days. Direct contact testing of discs resulted in a decrease in cell viability of the each cement tested.

The effect of ionic dissolution products of Ca-Sr-Na-Zn-Si bioactive glass on in vitro cytocompatibility.

Many commercial bone grafts cannot regenerate healthy bone in place of diseased bone. Bioactive glasses have received much attention in this regard due to the ability of their ionic dissolution products to promote cell proliferation, cell differentiation and activate gene expression. Through the incorporation of certain ions, bioactive glasses can become therapeutic for specific pathological situations. Calcium-strontium-sodium-zinc-silicate glass bone grafts have been shown to release therapeutic levels of zinc and strontium, however the in vitro compatibility of these materials is yet to be reported. In this study, the in vitro cytocompatibility of three different calcium-strontium-sodium-zinc-silicate glasses was examined as a function of their ion release profiles, using Novabone® bioglass as a commercial comparison. Experimental compositions were shown to release Si(4+) ranging from 1 to 81 ppm over 30 days; comparable or enhanced release in comparison to Novabone. The maximum Ca(2+) release detected for experimental compositions was 9.1 ppm, below that reported to stimulate osteoblasts. Sr(2+) release was within known therapeutic ranges, and Zn(2+) release ranged from 0.5 to 1.4 ppm, below reported cytotoxic levels. All examined glass compositions show equivalent or enhanced in vitro compatibility in comparison to Novabone. Cells exposed to BT112 ionic products showed enhanced cell viabilities indicating cell proliferation was induced. The ion release profiles suggest this effect was due to a synergistic interaction between certain combinations and concentrations of ions. Overall, results indicate that the calcium-strontium-sodium-zinc-silicate glass compositions show equivalent or even enhanced in vitro compatibility compared to Novabone®.

Zinc and silver glass polyalkenoate cements: an evaluation of their antibacterial nature.

A biofilm is an accumulation of micro-organisms and their extracellular products forming a structured community on a surface. Biofilm formation on medical devices has severe health consequences as bacteria growing in this lifestyle are tolerant to both host defence mechanisms and antibiotic therapies. However, silver and zinc ions inhibit the attachment and proliferation of immature biofilms. The objective of this study is to evaluate whether silver and zinc ions eluted from novel glass polyalkenoate cement (GPC) coatings have the ability to inhibit Methicillin-resistant Staphylococcus aureus (MRSA) in vivo. A silver and zinc-containing GPC coating was synthesised, deposited onto Ti6Al4V discs and placed in a specified amount of analytical water for 1, 7 and 30 days. The resulting elutes were collected and Atomic absorption spectroscopy was used to measure ion release. The elutes were injected into Galleria mellonella larvae infected with MRSA and the antibacterial properties of these elutes were evaluated in vivo. The majority of the zinc and silver ions were released within the first 24 h; this corresponded with the greatest degree of protection observed in infected larvae. Results were compared to a conventional in vitro model where identical elutes were incubated with MRSA on nutrient agar. These results were consistent with those observed in the larval model, demonstrating a reduction in bacterial viability when co-cultured with elutes for 2 h. This work confirms the promise of the Galleria mellonella as a model for the assessment of antimicrobial agents and demonstrates the capacity of novel silver and zinc-containing GPCs to retard the colonisation of MRSA.

A spectroscopic investigation into the setting and mechanical properties of titanium containing glass polyalkenoate cements.

Titanium (Ti) implants are extensively used in a number of biomedical and dental applications. This work introduces Ti into the glass phase of a zinc based glass polyalkenoate cement (GPC) and investigates changes in handling and mechanical properties considering two molecular weight polyacrylic acids (PAA), E9 and E11. Considering the handling properties, the working time (T (w)) increased from 50 s(E9), 32 s(E11) (BT 101, Ti-free) to 169 s(E9), 74 s(E11) with TW-Z (highest Ti content), respectively. The setting time (T (s)) increased from 76 s(E9), 47 s(E11) (BT 101) to 303 s(E9), 232 s(E11) with TW-Z, respectively. Ti was also found to have a significant increase on both compressive (sigma (c)) and biaxial flexural strength (sigma (f)), where sigma (c) increased from 36 MPa(E9), 56 MPa(E11) (BT 101) to 56 MPa(E9) and 70 MPa(E11) with TW-Z respectfully. sigma (f) also increased from 11 MPa(E9), 22 MPa(E11) (BT 101) to 22 MPa(E9) and 77 MPa(E11) with TW-Z, respectively. No increase in mechanical properties was evident with respect to maturation. Raman Spectroscopy was employed to investigate changes in glass structure and the setting of the cements with. This revealed increased glass network disruption with increasing TiO(2) content and matured cement setting with TW-Z as compared to the control BT 101. FT-IR was then employed to investigate any additional setting mechanism and changes with time. Spectroscopy determined that Ca(2+)/Sr(2+)PAA complexes are primarily responsible for the setting and mechanical strength with no changes occurring over time.

Strontium-based glass polyalkenoate cements for luting applications in the skeleton.

Glass Polyalkenoate Cements (GPCs) based on strontium calcium zinc silicate (Sr-Ca-Zn-SiO2) glasses and high molecular weight poly(acrylic acid) (PAA) have been shown to exhibit suitable mechanical properties for orthopaedic arthroplasty applications, however for vertebroplasty and other medical luting applications these cements have working and setting times which are unsuitable for such applications. In this study GPCs based on Sr-Ca-Zn-SiO2 glasses and low molecular weight PAA were evaluated for orthopaedic luting applications. GPCs based on four different glasses; BT100 (0.16CaO, 0.36ZnO, 0.48SiO2), BT101 (0.04SrO, 0.12CaO, 0.36ZnO, 0.48SiO2), BT102 (0.08SrO 0.08CaO, 0.36ZnO, 0.48SiO2) and BT103 (0.12SrO 0.04CaO, 0.36ZnO, 0.48SiO2) and two PAAs (MW; 12,700 and 25,700) were examined. These cement formulations exhibited handling properties potentially suitable for luting applications as well as mechanical strengths which were similar to those of trabecular bone. Upon immersion in simulated body fluid, the GPCs showed sustained growth of a calcium phosphate layer on the surface of the cement indicating that these cements were bioactive in nature.

Characterisation and mechanical testing of hydrothermally treated HA/ZrO2 composites.

Hydrothermal treatment is traditionally employed to improve the sinterability of powder compacts by reducing porosity and increasing apparent density. The effect of hydrothermal treatment on green powder compacts has been assessed in order to better understand how treatment may affect the sinterability of the bodies. Laboratory synthesised nano sized hydroxyapatite (HA) and a commercial zirconia (ZrO(2)) powder have been ball milled together to create composite mixtures containing 0-5 wt% ZrO(2) loadings. Disc shaped bodies have been formed using uniaxial and subsequent isostatic pressure. The resultant coherent samples were subjected to hydrothermal treatment at either 120 or 250 degrees C for 10 h in order to assess the effect of this processing technique on the physical, mechanical and microstructural properties of the green composites. ZrO(2) loadings up to 3 wt% increased apparent density from 90 to 92%, whereas increased loading to 5 wt% increased flexural strength, from 6 to 9 MPa. Increasing the hydrothermal treatment temperature increased open porosity, from ~44 to ~48% and reduced biaxial flexural strengths of the treated bodies compared to those of their room temperature isostatically pressed counterparts (~10 to ~6 MPa).

The effect of glass synthesis route on mechanical and physical properties of resultant glass ionomer cements.

Glass ionomer cements (GICs) have potential orthopaedic applications. Solgel processing is reported as having advantages over the traditional melt-quench route for synthesizing the glass phase of GICs, including far lower processing temperatures and higher levels of glass purity and homogeneity. This work investigates a novel glass formulation, BT 101 (0.48 SiO(2)-0.36 ZnO-0.12 CaO-0.04 SrO) produced by both the melt-quench and the solgel route. The glass phase was characterised by X-ray diffraction (XRD) to determine whether the material was amorphous and differential thermal analysis (DTA) to measure the glass transition temperature (T (g)). Particle size analysis (PSA) was used to determine the mean particle size and X-ray photoelectron spectroscopy (XPS) was used to investigate the structure and composition of the glass. Both glasses, the melt-quench BT 101 and the solgel BT 101, were mixed with 50 wt% polyacrylic acid (M (w), 80,800) and water to form a GIC and the working time (T (w)) and the setting time (T (s)) of the resultant cements were then determined. The cement based on the solgel glass had a longer T (w) (78 s) as compared to the cement based on the melt derived glass (19 s). T (s) was also much longer for the cement based on the solgel (1,644 s) glass than for the cement based on the melt-derived glass (25 s). The cements based on the melt derived glass produced higher strengths in both compression (sigma(c)) and biaxial flexure (sigma(f)), where the highest strength was found to be 63 MPa in compression, at both 1 and 7 days. The differences in setting and mechanical properties can be associated to structural differences within the glass as determined by XPS which revealed the absence of Ca in the solgel system and a much greater concentration of bridging oxygens (BO) as compared to the melt-derived system.

Comparison of failure mechanisms for cements used in skeletal luting applications.

Glass Polyalkenoate Cements (GPCs) based on strontium calcium zinc silicate (Sr-Ca-Zn-SiO(2)) glasses and low molecular weight poly(acrylic acid) (PAA) have been shown to exhibit suitable compressive strength (65 MPa) and flexural strength (14 MPa) for orthopaedic luting applications. In this study, two such GPC formulations, alongside two commercial cements (Simplex P and Hydroset) were examined. Fracture toughness and tensile bond strength to sintered hydroxyapatite and a biomedical titanium alloy were examined. Fracture toughness of the commercial Poly(methyl methacrylate) cement, Simplex P, (3.02 MPa m(1/2)) was superior to that of the novel GPC (0.36 MPa m(1/2)) and the commercial calcium phosphate cement, Hydroset, for which no significant fracture toughness was obtained. However, tensile bond strengths of the novel GPCs (0.38 MPa), after a prolonged period (30 days), were observed to be superior to commercial controls (Simplex P: 0.07 MPa, Hydroset: 0.16 MPa).

Antibacterial properties of a tri-sodium citrate modified glass polyalkenoate cement.

Primary deep infection following joint replacement surgery accounts for 7% of all revisions. Glass polyalkenoate cements (GPCs) have previously been shown to exhibit antibacterial properties. The present study had two objectives. The first was to determine if addition of tri-sodium citrate (TSC) to the powder phase of an Al-free GPC (0.04 SrO-0.12 CaO-0.36 ZnO-0.48 SiO2, by mole fraction) enhanced the resultant cement's antibacterial properties against three strains of bacteria that are commonly found in periprosthetic sites following total joint replacements (TJRs); namely, E. coli, B. fragilis, and S. epidermidis. Four cement sets were prepared, which contained 0 wt% TSC (control), 5 wt% TSC, 10 wt% TSC, and 15 wt% TSC. All the TSC-modified cements were found to exhibit large inhibition zones against all the bacterial strains, especially the cement containing 15 wt% TSC against E. coli. The antibacterial properties of the TSC containing GPCs are attributed to the release of Zn and Na ions from the cements and the presence of the TSC. The second objective was to investigate if, when a modified GPC is embedded in a bovine bone model, ionic transfer occurs. It was found that Zn ions migrated from the cement to the surrounding bone, particularly at the cement-bone interface. This is a desirable outcome as Zn ions are known to play a vital role in both bone metabolism and the regeneration of healthy bone. The present results point to the potential clinical benefits of using TSC-modified GPCs in TJRs.