Abstract
The current therapeutic strategies for healing bone defects commonly suffer from the occurrence of bacterial contamination on the graft, resulting in nonunion in the segmental bone defects and the requirement for secondary surgery to remove or sterilize the primary graft. A membrane with enhanced anti-bacterial efficacy, mechanical strength and osteoconductivity would represent an improvement in the therapeutic strategy for guided bone regeneration. The present study aims to optimize the content of halloysite nanotubes (HNTs) and TiO2 in the polymer matrix of chitosan (CTS) with a constant amount of nano-hydroxyapatite (5%) with the objective of mimicking the mechanical and biological microenvironment of the natural bone extracellular matrix with enhanced anti-bacterial efficacy. HNTs are a low-cost alternative to MWNCTs for enhancing the mechanical properties and anti-bacterial efficacy of the composite. From the first stage of the study, it was concluded that the membranes possessed enhanced mechanical properties and optimum biological properties at 7.5% (w/w) loading of HNTs in the composite. In the second stage of this investigation, we studied the effect of the addition of TiO2 nanoparticles (NPs) and TiO2 nanotubes (NTs) in small amounts to the CTS/n-HAP/HNT nanocomposite at 7.5% HNT loading, with an aim to augment the anti-bacterial efficacy and osteoconductivity of this mechanically strong membrane. The study revealed a significant enhancement in the anti-bacterial efficacy, osteoblast-like MG-63 cell proliferation and ALP expression with the addition of TiO2 NTs. The CHH-TiT membrane successfully inhibited the S. aureus and E. coli growth within 16 hours and simultaneously assisted the enhanced proliferation of osteoblast-like cells on its surface. The study supports the potential exploitation of CHH-TiT (7.5% HNT & 0.2% TiO2 NT) membranes as a template for guided bone tissue regeneration.