University of Memphis, TN, USA.
Int J Oral Maxillofac Implants. 2011 May-Jun;26(3):553-60.
Peri-implantitis is an inflammatory disease due to bacteria and plaque formation on implant surfaces which can lead to bone resorption and loss of osseointegration. Biomaterial strategies to prevent or eliminate initial bacterial attachment, in favor of host tissue attachment may have a positive effect on decreasing peri-implantitis, particularly for at risk patient groups. This study provides a brief overview of some of the experimental biomaterial strategies aimed at suppressing or inhibiting bacterial colonization of implant surfaces in favor or host cells and tissues.
These biomaterial strategies have different mechanisms of action from interfering with bacterial adhesion by modifying surface energies, immobilizing antimicrobials on implant surfaces, creating photocatalytic surfaces, as well as modifying surfaces to deliver antimicrobial agents either prophylactically or in response to bacterial challenge. This is not a comprehensive review, rather a review of studies that serve to illustrate many of the different approaches being investigated.
While many of these strategies have demonstrated the potential to significantly reduce bacterial attachment on implant surfaces in vitro, it is unclear if these same reductions will be adequate clinically since even a few adhering bacteria may over time develop into inflammatory inducing biofilms or plaque. Also, data on the ability of the antibacterial modified biomaterials to support osseointegration and permuosal seal formation is still needed.
Given the complex and multivariate causes of peri-implant disease, it is likely that combinations of these strategies (eg, antimicrobial surfaces and or delivery mechanisms coupled with methods to favor stable osseointegration and permucosal seal) will be most effective in developing implants resistant to peri-implant disease.
种植体周围炎是一种由细菌和牙菌斑在种植体表面形成的炎症性疾病，可导致骨质吸收和丧失骨整合。生物材料策略可以预防或消除初始细菌附着，有利于宿主组织附着，可能对减少种植体周围炎有积极作用，特别是对于高危患者群体。本研究简要概述了一些旨在抑制或抑制种植体表面细菌定植以有利于宿主细胞和组织的实验性生物材料策略。
这些生物材料策略通过改变表面能、在种植体表面固定抗菌剂、制造光催化表面以及修饰表面以预防性或响应细菌挑战来输送抗菌剂，从而具有不同的作用机制，以干扰细菌的粘附。这不是一个全面的综述，而是对许多正在研究的不同方法进行的综述。
虽然许多这些策略已经证明了在体外显著减少种植体表面细菌附着的潜力，但尚不清楚这些相同的减少是否在临床上足够，因为即使只有少数附着的细菌也可能随着时间的推移发展成炎症诱导的生物膜或菌斑。此外，还需要有关具有抗菌功能的改性生物材料支持骨整合和黏膜密封形成能力的数据。
鉴于种植体周围病的复杂和多变量原因，这些策略的组合（例如，抗菌表面和/或输送机制与有利于稳定骨整合和黏膜密封的方法相结合）可能是开发对种植体周围病具有抗性的植入物最有效的方法。
