Title:
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Chlorhexidine-based antimicrobial coatings for titanium dental implants
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Dental implants are a popular solution to missing teeth; they are predominantly
formed from titanium due to its biocompatibility, corrosion resistance and high rate of
osseointegration. While micro-roughening of the surfaces has been shown to increase
osteoblast adhesion and proliferation, it has also been shown to increase the adhesion
of bacteria and therefore the likelihood of implant infection and implant failure.
Chlorhexidine is a broad spectrum antimicrobial agent used extensively in healthcare,
particularly in oral care products such as mouthwash. It has previously been shown to
adhere to titanium, forming a saturated surface layer within 60 s; these surfaces
exhibited an antimicrobial efficacy against the oral bacterium Streptococcus gordonii.
However, this effect was shown to be short-lived as the coated surfaces released their
entire chlorhexidine payload within c.a. 2 days' immersion in water.
The development of two surface coatings, based on nanoparticle and coacervate
technology, is described in this thesis. The aim was to increase the surface retention of
chlorhexidine on a titanium surface to provide antimicrobial functionality.
An antimicrobial nanoparticle has been developed by combining chlorhexidine with
hexametaphosphate. These particles form micron-sized surface aggregates on titanium
substrates upon exposure to the nanoparticle suspension. The nanoparticle-coated
titanium substrates elute soluble chlorhexidine for 230 days and exhibit an effective
antimicrobial action against the oral primary coloniser S. gordonii and oral pathogen
Porphyromonas gingivalis.
An antimicrobial coacervate has been created through the combination of
chlorhexidine and carboxymethyl dextran. When this suspension was drop-cast onto a
titanium surface, a confluent film was formed; these film-coated surfaces exhibited an
antimicrobial efficacy against S. gordonii. The film was released from the surface after
immersion in water for 1 hour.
Finally, by applying both coatings, a dual-action antimicrobial surface has been
developed
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