Biomaterials with Antibacterial and Osteoinductive Properties to Repair Infected Bone Defects

Abstract

The repair of infected bone defects is still challenging in the fields of orthopedics, oral implantology and maxillofacial surgery. In these cases, the self-healing capacity of bone tissue can be significantly compromised by the large size of bone defects and the potential/active bacterial activity. Infected bone defects are conventionally treated by a systemic/local administration of antibiotics to control infection and a subsequent implantation of bone grafts, such as autografts and allografts. However, these treatment options are time-consuming and usually yield less optimal efficacy. To approach these problems, novel biomaterials with both antibacterial and osteoinductive properties have been developed. The antibacterial property can be conferred by antibiotics and other novel antibacterial biomaterials, such as silver nanoparticles. Bone morphogenetic proteins are used to functionalize the biomaterials with a potent osteoinductive property. By manipulating the carrying modes and release kinetics, these biomaterials are optimized to maximize their antibacterial and osteoinductive functions with minimized cytotoxicity. The findings, in the past decade, have shown a very promising application potential of the novel biomaterials with the dual functions in treating infected bone defects. In this review, we will summarize the current knowledge of novel biomaterials with both antibacterial and osteoinductive properties.

Induced pluripotent stem cells (iPSCs) as a new source of bone in reconstructive surgery: A systematic review and meta-analysis of preclinical studies

“…However, this mechanism is not satisfactory when the size is greater than the well‐known intrinsic healing capacity of bone tissues. Large bone defects caused by injury, disease, tumour ablation, or congenital malformations possess a tremendous challenge for orthopaedic or maxillofacial surgeons because the injury impairs blood supply and results in ischaemia, osteonecrosis, bone loss, or ultimately non‐union (Dimitriou, Jones, McGonagle, & Giannoudis, ; Jeon et al, ; Lu et al, ; Lu, Chang, Lin, Li, & Hu, ; van Rijt & Habibovic, ).…”

“…However, this mechanism is not satisfactory when the size is greater than the well-known intrinsic healing capacity of bone tissues. Large bone defects caused by injury, disease, tumour ablation, or congenital malformations possess a tremendous challenge for orthopaedic or maxillofacial surgeons because the injury impairs blood supply and results in ischaemia, osteonecrosis, bone loss, or ultimately non-union (Dimitriou, Jones, McGonagle, & Giannoudis, 2011;Jeon et al, 2016;Lu et al, 2016;Lu, Chang, Lin, Li, & Hu, 2013;van Rijt & Habibovic, 2017 (Khaled, Saleh, Hindocha, Griffin, & Khan, 2011;Kimelman Bleich et al, 2012). However, it seems that using gene therapy for bone regeneration (Fliefel, Kuhnisch, Ehrenfeld, & Otto, 2017) is in the adulthood phase compared with iPSCs, which is still in the childhood phase as concluded from our systematic review.…”

Collagen-Nanoparticles Composites for Wound Healing and Infection Control

“…Chemical reduction is the most commonly used method due to its large-scale production of nano-suspension free from aggregation (dimension and morphology variable) with low preparation costs. In addition, it was reported that the reduction of Ag NPs using hydrazine hydrate (HH) helps the large scale production of Ag NPs that could be more interesting in biomedical applications [50,51].…”

“…It seems that CuO NPs incorporated into polymers produce a release of Cu 2+ ions, which may be required for optimum killing [50]. At this time, this issue is not very well developed; there are only a few studies on the incorporation of the copper NPs at the surface of polymers.…”

“…In addition, the functionalized scaffold shows lower minimum inhibitory concentration (MIC) with both in vitro and in vivo studies, suggesting that it can be used as a wound dressing material for clinical applications [69]. It seems that CuO NPs incorporated into polymers produce a release of Cu 2+ ions, which may be required for optimum killing [50]. At this time, this issue is not very well developed; there are only a few studies on the incorporation of the copper NPs at the surface of polymers.…”