Host response to bacterially contaminated titanium and titanium alloy surfaces

Biomaterial-implants are frequently used to restore the function and form of human anatomy. However, the presence of implanted biomaterials dramatically elevates infection risk. Their use will increase due to an increasing life expectancy of an ever growing population world-wide. The occurrence of biomaterials-associated infection depends on an interplay between bacterial contamination, host healing, host immune responses and biomaterial characteristics. In this thesis, we investigated photocatalytically activated, anodized titanium and titanium alloy as possible antimicrobial and osseointegrative biomaterials. Furthermore bacteria and host cell interactions, including the relationship between healing and immune cells, on titanium alloy and photocatalytically activated, anodized surfaces were studied. We concluded that photocatalytically activated, anodized titanium and titanium alloy surfaces constitute a potential prophylactic antibacterial hardware. Moreover, we demonstrated in this thesis that the importance of considering interactions between different biological key-players in the evaluation of novel biomaterials. Multi-functional biomaterial surfaces which were able to resist bacterial infection and promote tissue integration whilst preventing undesirable immune responses should be the general guide for the design of infection-resistant biomaterials. By combining the in vitro approaches used in this thesis it may be possible to more accurately predict the behavior of biomaterials in vivo. This will subsequently aid the translation of potential anti-infective materials to the clinic.