Prosthesis implantation and bone integration under bacterial infection are arduous challenges in clinical practice. It is well known that the reactive oxygen species (ROS) produced by bacterial infection around the bone defects will further hinder bone healing. To solve this problem, we prepared a ROS-scavenging hydrogel by cross-linking polyvinyl alcohol and a ROS-responsive linker, N¹-(4-boronobenzyl)-N³-(4-boronophenyl)-N¹, N¹, N³, N³-tetramethylpropane-1, 3-diaminium, to modify the microporous titanium alloy implant. The prepared hydrogel was used as an advanced ROS-scavenging tool to promote bone healing by inhibiting the ROS levels around the implant. Bifunctional hydrogel serving as a drug delivery system can release therapeutic molecules, including vancomycin, to kill bacteria and bone morphogenetic protein-2 to induce bone regeneration and integration. This multifunctional implant system that combines mechanical support and disease microenvironment targeting provides a novel strategy for bone regeneration and integration of implants in infected bone defects.

The primary goal of peri-implantitis treatments remains the decontamination of implant surfaces exposed to polymicrobial biofilms and renders biocompatibility. In this study, we reported a synergistic strategy for the debridement and re-osteogenesis of contaminated titanium by using erythritol air abrasion (AA) coupled with an as-synthesized pH-responsive antimicrobial agent. Here, the anionic antibacterial peptide Maximin H5 C-terminally deaminated isoform (MH5C) was introduced into the Zeolitic Imidazolate Frameworks (ZIF-8) via a one-pot synthesis process. The formed MH5C@ZIF-8 nanoparticles (NPs) not only possessed suitable stability, but also guarantee the slow-release effect of MH5C. Antibacterial experiments revealed that MH5C@ZIF-8 NPs exhibited excellent antimicrobial abilities toward pathogenic bacteria of peri-implantitis, confirming ZIF-8 NPs as efficient nanoplatforms for delivering antibacterial peptide. To evaluate the comprehensive debridement efficiency, single-species as well as mixed-species biofilms were successively established on commercially used titanium surfaces and decontaminated with different methods: removed only by erythritol air abrasion, treated merely with MH5C@ZIF-8 NPs, or received both managements. The results demonstrated that only erythritol air abrasion accompanied with MH5C@ZIF-8 NPs at high concentrations eliminated almost all retained bacteria and impeded biofilm rehabilitation, while neither erythritol air abrasion nor MH5C@ZIF-8 NPs alone could achieve this. Subsequently, we evaluated the re-osteogenesis on previously contaminated surfaces which were treated with different debridement methods afterwards. We found that cell growth and osteogenic differentiation of bone marrow–derived mesenchymal stem cells (BMSCs) in the group received both treatments (AA + MH5C@ZIF-8) were higher than those in other groups. Our work emphasized the great potential of the synergistic therapy as a credible alternative for removing microorganisms and rendering re-osseointegration on contaminated implant surfaces, boding well for the comprehensive applications in peri-implantitis treatments.

Dental implants have become the leading choice for patients who lose teeth; however, dental implantation is challenged by peri-implant infections. Here, calcium-doped titanium was fabricated by the combinational use of thermal evaporation and electron beam evaporation in a vacuum; then, the material was immersed in a calcium-free phosphate-buffered saline solution containing human plasma fibrinogen and incubated at 37 °C for 1 h, creating calcium- and protein-conditioned titanium. The titanium contained 12.8 ± 1.8 at.% of calcium, which made the material more hydrophilic. Calcium release by the material during protein conditioning was able to change the conformation of the adsorbed fibrinogen, which acted against the colonization of peri-implantitis-associated pathogens (Streptococcus mutans, UA 159, and Porphyromonas gingivalis, ATCC 33277), while supporting the adhesion and growth of human gingival fibroblasts (hGFs). The present study confirms that the combination of calcium-doping and fibrinogen-conditioning is a promising pathway to meeting the clinical demand for suppressing peri-implantitis.

Introduction: Alveolar cleft (AC) is a common congenital defect in people with cleft lip and palate (CLP). Alveolar bone grafting (ABG) is typically performed during adolescence, resulting in the fissure remaining in the mouth for a longer length of time. Patients with AC have a greater rate of oral diseases such as dental caries than the normal population, and the precise characteristics of the bacterial alterations caused by AC are unknown.Methods: We recruited a total of 87 subjects and collected dental plaque samples from AC adolescents (AAP), post-operative ABG adolescents (PAP), healthy control adolescents (CAP), AC young adults (AYP), post-operative ABG young adults (PYP), and healthy control young adults (CYP). The sequencing of 16S rRNA genes was performed.Results: The microbial composition of plaque from alveolar cleft patients differed significantly from age-matched healthy controls. Linear discriminant analysis effect size (LEfSe) analysis revealed that AAP was enriched for Neisseria, Haemophilus, Fusobacterium, Rhodococcus, Aggregatibacter, Gemella, and Porphyromonas, whereas AYP was enriched for Capnocytophaga, Rhodococcus, and Actinomyces-f0332. There were phenotypic differences in facultatively anaerobic, Gram-negative, Gram-positive, and oxidative stress tolerance between the AYP group with longer alveolar cleft and the healthy control group according to Bugbase phenotypic predictions. Alveolar bone grafting did not alter the functional phenotype of alveolar cleft patients but reduced the number of differential genera between alveolar cleft patients and healthy controls at both ages.Conclusions: Our study systematically characterized the supragingival plaque microbiota of alveolar cleft patients, post-alveolar bone grafting patients, and matched healthy controls in two ages to gain a better understanding of plaque ecology and microbiology associated with alveolar clefts.