The treatment of infectious or potentially infective bone defects remains a major problem in clinical practice. Silver has the ability to potentiate antibiotics against resistant bacterial strains. In order to reduce the risk of long-term infections, it is necessary for the biomaterial scaffold to release Ag+ in a controlled manner during the entire healing process. In this study, given the antimicrobial characteristics of nanosized Ag (NSAg), we synthesized β-tricalcium phosphate (β-TCP) doped with 5 and 10 wt% NSAg (5 wt% NSAgTCP and 10 wt% NSAgTCP, respectively). The NSAgTCP composites exhibited similar macroporous structures to pure β-TCP. The NSAgTCP samples were examined by scanning electron microscopy at 10,000-times magnification, which revealed that silver was still present at the nanometer scale. X-ray diffraction revealed that silver does not change the crystalline properties of β-TCP. In addition, we observed that the mechanical strength of NSAgTCP increased with increasing amounts of added Ag. The antibacterial, physical, and chemical properties of NSAgTCP were investigated in vitro. We found that NSAgTCP is effective at inhibiting the growth of Staphylococcus aureus and Escherichia coli and is not cytotoxic to human bone marrow mesenchymal stem cells. Moreover, it does not hinder liver or kidney function when tested in vivo. As the bioceramic degrades, Ag ions are slowly released and new bone is formed. No significant cytotoxic effects were observed even when 10 wt% NSAgTCP was used. NSAgTCP has the ability to simultaneously repair bone defects and act as an anti-infective agent; hence, we expect that this material, with its good bone-repairing and anti-infective properties, will find wide spread use as a novel bone substitute.
Keywords: Cytotoxicity; Nanosized silver; Osteoconductivity; Silver release; β-Tricalcium phosphate.
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