Could the newly-discovered antibacterial effect of a bio-ceramic be used to curb the periodontitis epidemic in America? According to new research from the Centers for Disease Control, (CDC) more than 47 percent of the US population over 30 suffers from periodontitis. Emerging research suggests that periodontal disease may contribute to a variety of other health risks including heart disease, glaucoma and diabetes.
In addition to promoting increased awareness of oral hygiene and diet, efforts to curb the growth of periodontitis have focused on identifying new bacteriocidal agents and techniques to arrest the growth of harmful bacteria in the oral cavity. Researchers are working on incorporating new materials with bacteriostatic properties into prosthetic devices to take up the slack where hygiene alone is not enough. Additionally, work continues towards developing new treatments that help patients get a deeper clean in and out of the dental office.
Recently, researchers working at the Kyoto Institute of Technology documented an antibacterial effect of silicon nitride – a hard, biocompatible ceramic – on P. gingivalis, a bacterial species implicated in periodontal disease. These bacteria contribute to an increase in virulence among other oral pathogens leading to more robust bacterial biofilms. Cultures of P. gingivalis applied to a polished silicon nitride plate underwent lysis, as what researchers describe as "peculiar surface chemistry" caused the bacterial membranes and DNA to spontaneously break down. The formation of peroxynitrite, a highly reactive free radical, was observed to be catalyzed upon contact with the surface, damaging the cell walls and DNA of the microbes.
Usually, silicon nitride is used for industrial applications such as bearings and high-temperature-resistant propulsion components, including the US Space Shuttle program. Previous medical use has primarily been in orthopedics for its excellent osseointegration results. Previously a very expensive material, the price of silicon nitride parts has decreased significantly due to manufacturing advances. If incorporated into restorations and prosthetic material, it could help arrest or delay the onset of periodontal disease and peri-implantitis.
There are still a few drawbacks to the material, which continues to present challenges in manufacturing. Silicon nitride is an incredibly hard material only two points behind diamond on the Mohs hardness scale. It is difficult to machine due to this hardness, and cannot easily be cast since it decomposes into silicon and nitrogen at a temperature below its melting point. Therefore, special techniques must be used to shape it into the desired application.
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Image source: https://en.wikipedia.org/wiki/Silicon_nitride#/media/File:Si3N4bearings.jpg
Pezzotti, G., Bock, R. M., Mcentire, B. J., Jones, E., Boffelli, M., Zhu, W., . . . Bal, B. S. (2016). Silicon Nitride Bioceramics Induce Chemically Driven Lysis in Porphyromonas gingivalis. Langmuir, 32(12), 3024-3035. doi:10.1021/acs.langmuir.6b00393
Pezzotti, G., Enomoto, Y., Zhu, W., Boffelli, M., Marin, E., & Mcentire, B. J. (2016). Surface toughness of silicon nitride bioceramics: I, Raman spectroscopy-assisted micromechanics. Journal of the Mechanical Behavior of Biomedical Materials, 54, 328-345. doi:10.1016/j.jmbbm.2015.09.036
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