Antibacterial abilities and biocompatibilities of Ti-Ag alloys with nanotubular coatings.

Purpose: To endow implants with both short- and long-term antibacterial activities without impairing their biocompatibility, novel Ti-Ag alloy substrates with different proportions of Ag (1, 2, and 4 wt% Ag) were generated with nanotubular coverings (TiAg-NT). Methods: Unlike commercial pure Ti and titania nanotube, the TiAg-NT samples exhibited short-term antibacterial activity against Staphylococcus aureus (S. aureus), as confirmed by scanning electron microscopy and double staining with SYTO 9 and propidium iodide. A film applicator coating assay and a zone of inhibition assay were performed to investigate the long-term antibacterial activities of the samples. The cellular viability and cytotoxicity were evaluated through a Cell Counting Kit-8 assay. Annexin V-FITC/propidium iodide double staining was used to assess the level of MG63 cell apoptosis on each sample. Results: All of the TiAg-NT samples, particularly the nanotube-coated Ti-Ag alloy with 2 wt% Ag (Ti2% Ag-NT), could effectively inhibit bacterial adhesion and kill the majority of adhered S. aureus on the first day of culture. Additionally, the excellent antibacterial abilities exhibited by the TiAg-NT samples were sustained for at least 30 days. Although Ti2% Ag-NT had less biocompatibility than titania nanotube, its performance was satisfactory, as demonstrated by the higher cellular viability and lower cell apoptosis rate obtained with it compared with those achieved with commercial pure Ti. The Ti1% Ag-NT and Ti4% Ag-NT samples did not yield good cell viability. Conclusion: This study indicates that the TiAg-NT samples can prevent biofilm formation and maintain their antibacterial ability for at least 1 month. Ti2% Ag-NT exhibited better antibacterial ability and biocompatibility than commercial pure Ti, which could be attributed to the synergistic effect of the presence of Ag (2 wt%) and the morphology of the nanotubes. Ti2% Ag-NT may offer a potential implant material that is capable of preventing implant-related infection.