Increasing the quantity of silver in zinc-based glass polyalkenoate cement: Is there an improvement in antibacterial efficacy?

Bone cements should have the ability to chemically bond to both bone and surgical metals, exhibit no chemical or thermal necrosis, and have no significant shrinkage or exotherm upon setting. Taking these properties into consideration, glass polyalkenoate cements (GPCs) have potential as bone cements. GPCs are formed by the reaction between an ion-leachable glass and an aqueous solution of polyacrylic acid (PAA) [1] and have proven antibacterial and cariostatic properties [2], which are related to their ability to release beneficial amounts of ions over time [3, 4]. The GPCs can be formulated to release ions that can have a therapeutic benefit in a chosen application such as fluoride release in dental applications [5], which assists in the prevention of secondary caries [6]. Recently, GPCs have been formulated with zinc (Zn) replacing Al; a more biologically acceptable ion [7]. The authors have previously shown that GPCs based on a glass phase containing both Zn and silver (Ag) have the ability to release ions which are antibacterial against both Staphylococcus aureus (Oxford strain) [8] and Pseudomonas aeruginosa (a clinical isolate) [9, 10] in vitro and methicillin-resistant S. aureus (MRSA) both in vitro and in vivo [11]. The authors have also shown that their cements have the ability to inhibit proliferation of a biofilm of P. aeruginosa (PA01) [9]. The objective of the study reported herein is to build on the authors previous publications in order to determine if increases in Ag content of the glass phase of these cements will result in a concomitant increase in antibacterial efficacy of the resultant Ag-Zn GPCs formulated from them.