Multivalent network modifier upregulates bioactivity of multispecies biofilm-resistant polyalkenoate cement.

Abstract

Polyalkenoate cement (PAC) is a promising material for regenerative hard tissue therapy. The ionically rich glass component of PAC encourages bioactive interaction <i>via</i>. the release of essential ions. However, PAC bioactivity is restricted owing to (i) structurally inherent cationic network formers and (ii) surface bacterial biofilm formation. These two factors cause a deficiency in ion release, further complicated by secondary infections and premature therapeutic failure. Here, a multivalent zwitterionic network modifier (<i>m</i>ZM) is presented for upregulation of ionic exchange and bioactivity enhancement. By introducing a non-zero charged <i>m</i>ZM into PACs, an increase in the proportion of non-bridging oxygen occurs. The network modification promotes ion channel formation, causing a multiple-fold increase in ion release and surface deposition of hydroxy-carbonate apatite (<i>ca</i>. 74%). Experiments <i>ex vivo</i> and animal models also demonstrate the efficient remineralization ability of the <i>m</i>ZM. Furthermore, divalent cationic interaction results in bacterial biofilm reduction (<i>ca</i>. 68%) while also influencing a shift in the biofilm species composition, which favors commensal growth. Therefore, PAC modification with <i>m</i>ZM offers a promising solution for upregulation of bioactivity, even aiding in customization by targeting site-specific regenerative therapy in future applications.