Journal of Functional Biomaterials

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5 pages, 179 KiB

Open AccessEditorial

State-of-the-Art Functional Biomaterials in China

by Yuqin Qiao and Huiliang Cao

J. Funct. Biomater. 2024, 15(1), 23; https://doi.org/10.3390/jfb15010023 - 15 Jan 2024

Viewed by 1969

Abstract

In recent years, rapid advancements in multidisciplinary fields (materials, biology, chemical physics, etc [...] Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

Research

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14 pages, 3382 KiB

Open AccessEditor’s ChoiceArticle

Cell Responses to Calcium- and Protein-Conditioned Titanium: An In Vitro Study

by Qiang Zhi, Yuehua Zhang, Jianxu Wei, Xiaolei Lv, Shichong Qiao and Hongchang Lai

J. Funct. Biomater. 2023, 14(5), 253; https://doi.org/10.3390/jfb14050253 - 1 May 2023

Cited by 1 | Viewed by 1932

Abstract

Dental implants have become the leading choice for patients who lose teeth; however, dental implantation is challenged by peri-implant infections. Here, calcium-doped titanium was fabricated by the combinational use of thermal evaporation and electron beam evaporation in a vacuum; then, the material was [...] Read more.

Dental implants have become the leading choice for patients who lose teeth; however, dental implantation is challenged by peri-implant infections. Here, calcium-doped titanium was fabricated by the combinational use of thermal evaporation and electron beam evaporation in a vacuum; then, the material was immersed in a calcium-free phosphate-buffered saline solution containing human plasma fibrinogen and incubated at 37 °C for 1 h, creating calcium- and protein-conditioned titanium. The titanium contained 12.8 ± 1.8 at.% of calcium, which made the material more hydrophilic. Calcium release by the material during protein conditioning was able to change the conformation of the adsorbed fibrinogen, which acted against the colonization of peri-implantitis-associated pathogens (Streptococcus mutans, UA 159, and Porphyromonas gingivalis, ATCC 33277), while supporting the adhesion and growth of human gingival fibroblasts (hGFs). The present study confirms that the combination of calcium-doping and fibrinogen-conditioning is a promising pathway to meeting the clinical demand for suppressing peri-implantitis. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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21 pages, 4431 KiB

Open AccessEditor’s ChoiceArticle

Submicron-Grooved Films Modulate the Directional Alignment and Biological Function of Schwann Cells

by Zhen Zhang, Yuanliang Lv, Javad Harati, Jianan Song, Ping Du, Peiyan Ou, Jiaqi Liang, Huaiyu Wang and Peng-Yuan Wang

J. Funct. Biomater. 2023, 14(5), 238; https://doi.org/10.3390/jfb14050238 - 23 Apr 2023

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Abstract

Topographical cues on material surfaces are crucial for guiding the behavior of nerve cells and facilitating the repair of peripheral nerve defects. Previously, micron-grooved surfaces have shown great potential in controlling nerve cell alignment for studying the behavior and functions of those cells [...] Read more.

Topographical cues on material surfaces are crucial for guiding the behavior of nerve cells and facilitating the repair of peripheral nerve defects. Previously, micron-grooved surfaces have shown great potential in controlling nerve cell alignment for studying the behavior and functions of those cells and peripheral nerve regeneration. However, the effects of smaller-sized topographical cues, such as those in the submicron- and nano-scales, on Schwann cell behavior remain poorly understood. In this study, four different submicron-grooved polystyrene films (800/400, 800/100, 400/400, and 400/100) were fabricated to study the behavior, gene expression, and membrane potential of Schwann cells. The results showed that all submicron-grooved films could guide the cell alignment and cytoskeleton in a groove depth-dependent manner. Cell proliferation and cell cycle assays revealed that there was no significant difference between the submicron groove samples and the flat control. However, the submicron grooves can direct the migration of cells and upregulate the expression of critical genes in axon regeneration and myelination (e.g., MBP and Smad6). Finally, the membrane potential of the Schwann cells was significantly altered on the grooved sample. In conclusion, this study sheds light on the role of submicron-grooved patterns in regulating the behavior and function of Schwann cells, which provides unique insights for the development of implants for peripheral nerve regeneration. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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15 pages, 5667 KiB

Open AccessArticle

Enhanced Antibacterial Effect on Zirconia Implant Abutment by Silver Linear-Beam Ion Implantation

by Yang Yang, Mingyue Liu, Zhen Yang, Wei-Shao Lin, Li Chen and Jianguo Tan

J. Funct. Biomater. 2023, 14(1), 46; https://doi.org/10.3390/jfb14010046 - 13 Jan 2023

Cited by 7 | Viewed by 2462

Abstract

Peri-implant lesions, such as peri-implant mucositis and peri-implantitis, are bacterial-derived diseases that happen around dental implants, compromising the long-term stability and esthetics of implant restoration. Here, we report a surface-modification method on zirconia implant abutment using silver linear-beam ion implantation to reduce the [...] Read more.

Peri-implant lesions, such as peri-implant mucositis and peri-implantitis, are bacterial-derived diseases that happen around dental implants, compromising the long-term stability and esthetics of implant restoration. Here, we report a surface-modification method on zirconia implant abutment using silver linear-beam ion implantation to reduce the bacterial growth around the implant site, thereby decreasing the prevalence of peri-implant lesions. The surface characteristics of zirconia after ion implantation was evaluated using energy dispersive spectroscopy, X-ray photoelectron spectroscopy, and a contact-angle device. The antibacterial properties of implanted zirconia were evaluated using Streptococcus mutans and Porphyromonas gingivalis. The biocompatibility of the material surface was evaluated using human gingival fibroblasts. Our study shows that the zirconia surface was successfully modified with silver nanoparticles by using the ion-implantation method. The surface modification remained stable, and the silver-ion elution was below 1 ppm after one-month of storage. The modified surface can effectively eliminate bacterial growth, while the normal gingiva’s cell growth is not interfered with. The results of the study demonstrate that a silver-ion-implanted zirconia surface possesses good antibacterial properties and good biocompatibility. The surface modification using silver-ion implantation is a promising method for future usage. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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16 pages, 4845 KiB

Open AccessArticle

Why Is Tantalum Less Susceptible to Bacterial Infection?

by Xin Chen, Yikang Bi, Moran Huang, Huiliang Cao and Hui Qin

J. Funct. Biomater. 2022, 13(4), 264; https://doi.org/10.3390/jfb13040264 - 22 Nov 2022

Cited by 6 | Viewed by 1959

Abstract

Periprosthetic infection is one of the trickiest clinical problems, which often leads to disastrous consequences. The emergence of tantalum and its derivatives provides novel ideas and effective methods to solve this problem and has attracted great attention. However, tantalum was reported to have [...] Read more.

Periprosthetic infection is one of the trickiest clinical problems, which often leads to disastrous consequences. The emergence of tantalum and its derivatives provides novel ideas and effective methods to solve this problem and has attracted great attention. However, tantalum was reported to have different anti-infective effects in vivo and in vitro, and the inherent antibacterial capability of tantalum is still controversial, which may restrict its development as an antibacterial material to some extent. In this study, the polished tantalum was selected as the experimental object, the implant-related tibia osteomyelitis model was first established to observe whether it has an anti-infective effect in vivo compared to titanium, and the early studies found that the tantalum had a lower infectious state in the implant-related tibia osteomyelitis model in vivo than titanium. However, further in vitro studies found that the polished tantalum was not superior to the titanium against bacterial adhesion and antibacterial efficacy. In addition, we focus on the state of interaction between cells, bacteria and materials to restore the internal environment as realistically as possible. We found that the adhesion of fibroblasts to tantalum was faster and better than that of titanium. Moreover, what is more, interesting is that, in the early period, bacteria were more likely to adhere to cells that had already attached to the surface of tantalum than to the bare surface of it, and over time, the cells eventually fell off the biomaterials and took away more bacteria in tantalum, making it possible for tantalum to reduce the probability of infection in the body through this mechanism. Moreover, these results also explained the phenomenon of the “race for the surface” from a completely different perspective. This study provides a new idea for further exploring the relationship between bacteria and host tissue cells on the implant surface and a meaningful clue for optimizing the preparation of antibacterial implants in the future. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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16 pages, 16099 KiB

Open AccessEditor’s ChoiceArticle

AMPK/mTOR Pathway Is Involved in Autophagy Induced by Magnesium-Incorporated TiO₂ Surface to Promote BMSC Osteogenic Differentiation

by Guifang Wang, Jiaxin Luo, Yuqin Qiao, Dongdong Zhang, Yulan Liu, Wenjie Zhang, Xuanyong Liu and Xinquan Jiang

J. Funct. Biomater. 2022, 13(4), 221; https://doi.org/10.3390/jfb13040221 - 5 Nov 2022

Cited by 6 | Viewed by 2276

Abstract

Magnesium has been extensively utilized to modify titanium implant surfaces based on its important function in promoting osteogenic differentiation. Autophagy has been proven to play a vital role in bone metabolism. Whether there is an association between autophagy and magnesium in promoting osteogenic [...] Read more.

Magnesium has been extensively utilized to modify titanium implant surfaces based on its important function in promoting osteogenic differentiation. Autophagy has been proven to play a vital role in bone metabolism. Whether there is an association between autophagy and magnesium in promoting osteogenic differentiation remains unclear. In the present study, we focused on investigating the role of magnesium ions in early osteogenic activity and the underlying mechanism related to autophagy. Different concentrations of magnesium were embedded in micro-structured titanium surface layers using the micro-arc oxidation (MAO) technique. The incorporation of magnesium benefited cell adhesion, spreading, and viability; attenuated intracellular ATP concentrations and p-mTOR levels; and upregulated p-AMPK levels. This indicates the vital role of the ATP-related AMPK/mTOR signaling pathway in the autophagy process associated with osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) induced by magnesium modification on titanium surfaces. The enhanced osteogenic differentiation and improved cellular autophagy activity of BMSCs in their extraction medium further confirmed the function of magnesium ions. The results of the present study advance our understanding of the mechanism by which magnesium regulates BMSC osteogenic differentiation through autophagy regulation. Moreover, endowing implants with the ability to activate autophagy may be a promising strategy for enhancing osseointegration in the translational medicine field in the future. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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12 pages, 4040 KiB

Open AccessArticle

Oxyhydroxide-Coated PEO–Treated Mg Alloy for Enhanced Corrosion Resistance and Bone Regeneration

by Juning Xie, Shi Cheng, Guoqing Zhong, Ruixiang Zhou, Chi Zhang, Yue He, Feng Peng and Yu Zhang

J. Funct. Biomater. 2022, 13(2), 50; https://doi.org/10.3390/jfb13020050 - 1 May 2022

Cited by 7 | Viewed by 3096

Abstract

Plasma electrolytic oxidation (PEO) is widely used as a surface modification method to enhance the corrosion resistance of Mg alloy, the most likely applied biodegradable material used in orthopedic implants. However, the pores and cracks easily formed on the PEO surface are unfavorable [...] Read more.

Plasma electrolytic oxidation (PEO) is widely used as a surface modification method to enhance the corrosion resistance of Mg alloy, the most likely applied biodegradable material used in orthopedic implants. However, the pores and cracks easily formed on the PEO surface are unfavorable for long-term corrosion resistance. In this study, to solve this problem, we used simple immersion processes to construct Mn and Fe oxyhydroxide duplex layers on the PEO-treated AZ31 (PEO–Mn/Fe). As control groups, single Mn and Fe oxyhydroxide layers were also fabricated on PEO (denoted as PEO–Mn and PEO–Fe, respectively). PEO–Mn showed a similar porous morphology to the PEO sample. However, the PEO–Fe and PEO–Mn/Fe films completely sealed the pores on the PEO surfaces, and no cracks were observed even after the samples were immersed in water for 7 days. Compared with PEO, PEO–Mn, and PEO–Fe, PEO–Mn/Fe exhibited a significantly lower self-corrosion current, suggesting better corrosion resistance. In vitro C3H10T1/2 cell culture showed that PEO–Fe/Mn promoted the best cell growth, alkaline phosphatase activity, and bone-related gene expression. Furthermore, the rat femur implantation experiment showed that PEO–Fe/Mn–coated Mg showed the best bone regeneration and osteointegration abilities. Owing to enhanced corrosion resistance and osteogenesis, the PEO–Fe/Mn film on Mg alloy is promising for orthopedic applications. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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16 pages, 4402 KiB

Open AccessEditor’s ChoiceArticle

Synergistic Antibacterial Effect of Zinc Oxide Nanoparticles and Polymorphonuclear Neutrophils

by Kai Ye, Moran Huang, Xiaojian He, Zhiquan An and Hui Qin

J. Funct. Biomater. 2022, 13(2), 35; https://doi.org/10.3390/jfb13020035 - 23 Mar 2022

Cited by 5 | Viewed by 3539

Abstract

Zinc oxide nanoparticles (ZnONPs) are inorganic nano-biomaterials with excellent antimicrobial properties. However, their effects on the anti-infection ability of the innate immune system remains poorly understood. The aim of the present study was to explore the potential immunomodulatory effects of ZnONPs on the [...] Read more.

Zinc oxide nanoparticles (ZnONPs) are inorganic nano-biomaterials with excellent antimicrobial properties. However, their effects on the anti-infection ability of the innate immune system remains poorly understood. The aim of the present study was to explore the potential immunomodulatory effects of ZnONPs on the innate immune system, represented by polymorphonuclear leukocytes (PMNs), and determine whether they can act synergistically to resist pathogen infections. In vitro experiment showed that ZnONPs not only exhibit obvious antibacterial activity at biocompatible concentrations but also enhance the antibacterial property of PMNs. In vivo experiments demonstrated the antibacterial effect of ZnONPs, accompanied by more infiltration of subcutaneous immune cells. Further ex vivo and in vitro experiments revealed that ZnONPs enhanced the migration of PMNs, promoted their bacterial phagocytosis efficiency, proinflammatory cytokine (TNF-α, IL-1β, and IL-6) expression, and reactive oxygen species (ROS) production. In summary, this study revealed potential synergistic effects of ZnONPs on PMNs to resist pathogen infection and the underlying mechanisms. The findings suggest that attempts should be made to fabricate and apply biomaterials in order to maximize their synergy with the innate immune system, thus promoting the host’s resistance to pathogen invasion. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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17 pages, 4891 KiB

Open AccessEditor’s ChoiceArticle

Multi-Stimulus Responsive Multilayer Coating for Treatment of Device-Associated Infections

by Wenlong Li, Guanping Hua, Jingfeng Cai, Yaming Zhou, Xi Zhou, Miao Wang, Xiumin Wang, Baoqing Fu and Lei Ren

J. Funct. Biomater. 2022, 13(1), 24; https://doi.org/10.3390/jfb13010024 - 28 Feb 2022

Cited by 16 | Viewed by 4930

Abstract

Antibacterial coating with antibiotics is highly effective in avoiding device-associated infections (DAIs) which is an unsolved healthcare problem that causes significant morbidity and mortality rates. However, bacterial drug resistance caused by uncontrolled release of antibiotics seriously restricts clinical efficacy of antibacterial coating. Hence, [...] Read more.

Antibacterial coating with antibiotics is highly effective in avoiding device-associated infections (DAIs) which is an unsolved healthcare problem that causes significant morbidity and mortality rates. However, bacterial drug resistance caused by uncontrolled release of antibiotics seriously restricts clinical efficacy of antibacterial coating. Hence, a local and controlled-release system which can release antibiotics in response to bacterial infected signals is necessary in antibacterial coating. Herein, a multi-stimulus responsive multilayer antibacterial coating was prepared through layer-by-layer (LbL) self-assembly of montmorillonite (MMT), chlorhexidine acetate (CHA) and Poly(protocatechuic acid-polyethylene glycol 1000-bis(phenylboronic acid carbamoyl) cystamine) (PPPB). The coating can be covered on various substrates such as cellulose acetate membrane, polyacrylonitrile membrane, polyvinyl chloride membrane, and polyurethane membrane, proving it is a versatile coating. Under the stimulation of acids, glucose or dithiothreitol, this coating was able to achieve controlled release of CHA and kill more than 99% of Staphylococcus aureus and Escherichia coli (4 × 10⁸ CFU/mL) within 4 h. In the mouse infection model, CHA releasing of the coating was triggered by infected microenvironment to completely kill bacteria, achieving wounds healing within 14 days. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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Review

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25 pages, 9475 KiB

Open AccessEditor’s ChoiceReview

Antibacterial-Based Hydrogel Coatings and Their Application in the Biomedical Field—A Review

by Tai Peng, Qi Shi, Manlong Chen, Wenyi Yu and Tingting Yang

J. Funct. Biomater. 2023, 14(5), 243; https://doi.org/10.3390/jfb14050243 - 25 Apr 2023

Cited by 12 | Viewed by 4097

Abstract

Hydrogels exhibit excellent moldability, biodegradability, biocompatibility, and extracellular matrix-like properties, which make them widely used in biomedical fields. Because of their unique three-dimensional crosslinked hydrophilic networks, hydrogels can encapsulate various materials, such as small molecules, polymers, and particles; this has become a hot [...] Read more.

Hydrogels exhibit excellent moldability, biodegradability, biocompatibility, and extracellular matrix-like properties, which make them widely used in biomedical fields. Because of their unique three-dimensional crosslinked hydrophilic networks, hydrogels can encapsulate various materials, such as small molecules, polymers, and particles; this has become a hot research topic in the antibacterial field. The surface modification of biomaterials by using antibacterial hydrogels as coatings contributes to the biomaterial activity and offers wide prospects for development. A variety of surface chemical strategies have been developed to bind hydrogels to the substrate surface stably. We first introduce the preparation method for antibacterial coatings in this review, which includes surface-initiated graft crosslinking polymerization, anchoring the hydrogel coating to the substrate surface, and the LbL self-assembly technique to coat crosslinked hydrogels. Then, we summarize the applications of hydrogel coating in the biomedical antibacterial field. Hydrogel itself has certain antibacterial properties, but the antibacterial effect is not sufficient. In recent research, in order to optimize its antibacterial performance, the following three antibacterial strategies are mainly adopted: bacterial repellent and inhibition, contact surface killing of bacteria, and release of antibacterial agents. We systematically introduce the antibacterial mechanism of each strategy. The review aims to provide reference for the further development and application of hydrogel coatings. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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33 pages, 6028 KiB

Open AccessEditor’s ChoiceReview

MOFs and MOF-Derived Materials for Antibacterial Application

by Xin Zhang, Feng Peng and Donghui Wang

J. Funct. Biomater. 2022, 13(4), 215; https://doi.org/10.3390/jfb13040215 - 3 Nov 2022

Cited by 60 | Viewed by 6568

Abstract

Bacterial infections pose a serious threat to people’s health. Efforts are being made to develop antibacterial agents that can inhibit bacterial growth, prevent biofilm formation, and kill bacteria. In recent years, materials based on metal organic frameworks (MOFs) have attracted significant attention for [...] Read more.

Bacterial infections pose a serious threat to people’s health. Efforts are being made to develop antibacterial agents that can inhibit bacterial growth, prevent biofilm formation, and kill bacteria. In recent years, materials based on metal organic frameworks (MOFs) have attracted significant attention for various antibacterial applications due to their high specific surface area, high enzyme-like activity, and continuous release of metal ions. This paper reviews the recent progress of MOFs as antibacterial agents, focusing on preparation methods, fundamental antibacterial mechanisms, and strategies to enhance their antibacterial effects. Finally, several prospects related to MOFs for antibacterial application are proposed, aiming to provide possible research directions in this field. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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21 pages, 2401 KiB

Open AccessFeature PaperReview

Smart Bacteria-Responsive Drug Delivery Systems in Medical Implants

by Yijie Yang, Xue Jiang, Hongchang Lai and Xiaomeng Zhang

J. Funct. Biomater. 2022, 13(4), 173; https://doi.org/10.3390/jfb13040173 - 1 Oct 2022

Cited by 17 | Viewed by 3842

Abstract

With the rapid development of implantable biomaterials, the rising risk of bacterial infections has drawn widespread concern. Due to the high recurrence rate of bacterial infections and the issue of antibiotic resistance, the common treatments of peri-implant infections cannot meet the demand. In [...] Read more.

With the rapid development of implantable biomaterials, the rising risk of bacterial infections has drawn widespread concern. Due to the high recurrence rate of bacterial infections and the issue of antibiotic resistance, the common treatments of peri-implant infections cannot meet the demand. In this context, stimuli-responsive biomaterials have attracted attention because of their great potential to spontaneously modulate the drug releasing rate. Numerous smart bacteria-responsive drug delivery systems (DDSs) have, therefore, been designed to temporally and spatially release antibacterial agents from the implants in an autonomous manner at the infected sites. In this review, we summarized recent advances in bacteria-responsive DDSs used for combating bacterial infections, mainly according to the different trigger modes, including physical stimuli-responsive, virulence-factor-responsive, host-immune-response responsive and their combinations. It is believed that the smart bacteria-responsive DDSs will become the next generation of mainstream antibacterial therapies. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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23 pages, 1444 KiB

Open AccessReview

Immunomodulation Effect of Biomaterials on Bone Formation

by Tong Zhao, Zhuangzhuang Chu, Jun Ma and Liping Ouyang

J. Funct. Biomater. 2022, 13(3), 103; https://doi.org/10.3390/jfb13030103 - 25 Jul 2022

Cited by 26 | Viewed by 4825

Abstract

Traditional bone replacement materials have been developed with the goal of directing the osteogenesis of osteoblastic cell lines toward differentiation and therefore achieving biomaterial-mediated osteogenesis, but the osteogenic effect has been disappointing. With advances in bone biology, it has been revealed that the [...] Read more.

Traditional bone replacement materials have been developed with the goal of directing the osteogenesis of osteoblastic cell lines toward differentiation and therefore achieving biomaterial-mediated osteogenesis, but the osteogenic effect has been disappointing. With advances in bone biology, it has been revealed that the local immune microenvironment has an important role in regulating the bone formation process. According to the bone immunology hypothesis, the immune system and the skeletal system are inextricably linked, with many cytokines and regulatory factors in common, and immune cells play an essential role in bone-related physiopathological processes. This review combines advances in bone immunology with biomaterial immunomodulatory properties to provide an overview of biomaterials-mediated immune responses to regulate bone regeneration, as well as methods to assess the bone immunomodulatory properties of bone biomaterials and how these strategies can be used for future bone tissue engineering applications. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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35 pages, 3655 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Antibacterial Designs for Implantable Medical Devices: Evolutions and Challenges

by Huiliang Cao, Shichong Qiao, Hui Qin and Klaus D. Jandt

J. Funct. Biomater. 2022, 13(3), 86; https://doi.org/10.3390/jfb13030086 - 21 Jun 2022

Cited by 23 | Viewed by 4426

Abstract

The uses of implantable medical devices are safer and more common since sterilization methods and techniques were established a century ago; however, device-associated infections (DAIs) are still frequent and becoming a leading complication as the number of medical device implantations keeps increasing. This [...] Read more.

The uses of implantable medical devices are safer and more common since sterilization methods and techniques were established a century ago; however, device-associated infections (DAIs) are still frequent and becoming a leading complication as the number of medical device implantations keeps increasing. This urges the world to develop instructive prevention and treatment strategies for DAIs, boosting the studies on the design of antibacterial surfaces. Every year, studies associated with DAIs yield thousands of publications, which here are categorized into four groups, i.e., antibacterial surfaces with long-term efficacy, cell-selective capability, tailored responsiveness, and immune-instructive actions. These innovations are promising in advancing the solution to DAIs; whereas most of these are normally quite preliminary “proof of concept” studies lacking exact clinical scopes. To help identify the flaws of our current antibacterial designs, clinical features of DAIs are highlighted. These include unpredictable onset, site-specific incidence, and possibly involving multiple and resistant pathogenic strains. The key point we delivered is antibacterial designs should meet the specific requirements of the primary functions defined by the “intended use” of an implantable medical device. This review intends to help comprehend the complex relationship between the device, pathogens, and the host, and figure out future directions for improving the quality of antibacterial designs and promoting clinical translations. Full article

(This article belongs to the Special Issue State-of-the-Art Functional Biomaterials in China)

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