Mechanical Biocompatibility, Osteogenic Activity, and Antibacterial Efficacy of Calcium Silicate-Zirconia Biocomposites.

Zirconia ceramics with high mechanical properties have been used as a load-bearing implant in the dental and orthopedic surgery. However, poor bone bonding properties and high elastic modulus remain a challenge. Calcium silicate (CaSi)-based ceramic can foster osteoblast adhesion, growth, and differentiation and facilitate bone ingrowth. This study was to prepare CaSi-ZrO(2) composites and evaluate their mechanical properties, long-term stability, in vitro osteogenic activity, and antibacterial ability. The Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria and human mesenchymal stem cells (hMSCs) were used to evaluate the antibacterial and osteogenic activities of implants in vitro, respectively. Results indicated that the three-point bending strength of ZrO(2) was 486 MPa and Young's modulus was 128 GPa, which were much higher than those of the cortical bone. In contrast, the bending strength and modulus of 20% (201 MPa and 48 GPa, respectively) and 30% CaSi (126 MPa and 20 GPa, respectively) composites were close to the reported strength and modulus of the cortical bone. As expected, higher CaSi content implants significantly enhanced cell growth, differentiation, and mineralization of hMSCs. It is interesting to note the induction ability of CaSi in osteogenic differentiation of hMSCs even when cultured in the absence of an osteogenic differentiation medium. The composite with the higher CaSi contents exhibited the greater bacteriostatic effect against E. coli and S. aureus. In conclusion, the addition of 20 wt % CaSi can effectively improve the mechanical biocompatibility, osteogenesis, and antibacterial activity of ZrO(2) ceramics, which may be a potential choice for load-bearing applications.