Structure Protects Function: A Multilevel Engineered Surface Modification Renders the Surface of Titanium Dental Implants Resistant to Bacterial Colonization

ACS Applied Materials & Interfaces, vol. 17, pp. 7498–7509

Abstract

The global dental implant market is projected to reach $9.5 billion by 2032, growing at a 6.5% compound annual growth rate due to the rising prevalence of dental diseases. Importantly, this growth raises concerns about postoperative infections, which present significant challenges within our healthcare system and lead to a two-thirds failure rate for infected implants. In this study, we present an innovative multilevel coating system that makes the surface of dental titanium implants resistant to bacterial colonization, thereby minimizing the risk of infection development. This multilevel coating features a nanometer-thick biohybrid coating layer combined with a microgroove surface microstructuring, creating physical barriers that enhance the stability of the biohybrids against mechanical abrasion. Our coating demonstrates excellent biocompatibility and strong antifouling properties against undiluted blood plasma proteins. Furthermore, the combination of surface microstructuring and the biohybrid coating remains stable under prolonged mechanical stress simulation and effectively repels clinically relevant bacteria, achieving a 99% reduction in bacterial colonization on the implant. These findings underscore the potential of this approach to prevent implant-associated infections and highlight the critical role of surface engineering in ensuring long-term implant performance.

Authors 12

1. Manuela Garay‐Sarmiento Aachen Chair of Biotechnology DWI-Leibniz-Institute for Interactive Materials e.V

   DWI – Leibniz Institute for Interactive Materials · RWTH Aachen University

   Affiliation as printed

   Chair of Biotechnology, RWTH Aachen University, Worringerweg 3, Aachen 52074, Germany

   DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

2. Abdulkadir Yayci Aachen Chair of Biotechnology DWI-Leibniz-Institute for Interactive Materials e.V

   DWI – Leibniz Institute for Interactive Materials · RWTH Aachen University

   Affiliation as printed

   Chair of Biotechnology, RWTH Aachen University, Worringerweg 3, Aachen 52074, Germany

   DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

3. Yannik Rutsch Aachen DWI-Leibniz-Institute for Interactive Materials e.V

   DWI – Leibniz Institute for Interactive Materials

   Affiliation as printed

   DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

4. Hakim El Kadaoui Aachen Manufacturing Technology Institute MTI

   RWTH Aachen University

   Affiliation as printed

   Manufacturing Technology Institute MTI, RWTH Aachen University, Campus-Boulevard 30, Aachen 52074, Germany

5. Sebastian Apelt Aachen Manufacturing Technology Institute MTI

   RWTH Aachen University

   Affiliation as printed

   Manufacturing Technology Institute MTI, RWTH Aachen University, Campus-Boulevard 30, Aachen 52074, Germany

6. Jenny Englert Aachen Chair of Biotechnology DWI-Leibniz-Institute for Interactive Materials e.V

   DWI – Leibniz Institute for Interactive Materials · RWTH Aachen University

   Affiliation as printed

   Chair of Biotechnology, RWTH Aachen University, Worringerweg 3, Aachen 52074, Germany

   DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

7. Alexander Boes Aachen DWI-Leibniz-Institute for Interactive Materials e.V

   DWI – Leibniz Institute for Interactive Materials

   Affiliation as printed

   DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

8. Martin Kohse Aachen Fraunhofer Institute for Production Technology IPT

   Fraunhofer Institute for Production Technology IPT

   Affiliation as printed

   Fraunhofer Institute for Production Technology IPT, Steinbachstr. 17, Aachen 52074, Germany

9. Felix Jakob Aachen DWI-Leibniz-Institute for Interactive Materials e.V

   DWI – Leibniz Institute for Interactive Materials

   Affiliation as printed

   DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

10. Thomas Bergs Aachen Fraunhofer Institute for Production Technology IPT Manufacturing Technology Institute MTI

    Fraunhofer Institute for Production Technology IPT · RWTH Aachen University

    Affiliation as printed

    Fraunhofer Institute for Production Technology IPT, Steinbachstr. 17, Aachen 52074, Germany

    Manufacturing Technology Institute MTI, RWTH Aachen University, Campus-Boulevard 30, Aachen 52074, Germany

11. Ulrich Schwaneberg corresponding Aachen Chair of Biotechnology DWI-Leibniz-Institute for Interactive Materials e.V

    DWI – Leibniz Institute for Interactive Materials · RWTH Aachen University

    Affiliation as printed

    Chair of Biotechnology, RWTH Aachen University, Worringerweg 3, Aachen 52074, Germany

    DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

12. César Rodriguez‐Emmenegger corresponding Aachen DWI-Leibniz-Institute for Interactive Materials e.V

    Institució Catalana de Recerca i Estudis Avançats · Instituto de Salud Carlos III · DWI – Leibniz Institute for Interactive Materials · Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine · Institute for Bioengineering of Catalonia

    Affiliation as printed

    Biomedical Research Networking, Center in Bioengineering, Biomaterials and Nanomedicine

    DWI─Leibniz Institute for Interactive Materials e.V., Forckenbeckstraße 50, Aachen 52074, Germany

    Institució Catalana de Recerca i Estudis Avançats (ICREA), Passeig Lluís Companys 23, Barcelona 08010, Spain

    Institute for Bioengineering of Catalonia (IBEC), Carrer de Baldiri Reixac, 10, 12, Barcelona 08028, Spain

    The Institute of Health Carlos III

    Biomedical Research Networking, Center in Bioengineering, Biomaterials and Nanomedicine, The Institute of Health Carlos III, Madrid 28029, Spain