a Department of Otolaryngology and Ophtalmology , Prof. Stanislaw Popowski Voivoid Children Hospital Department of Head and Neck Surgery - Maxillofacial Surgery , Zołnierska , Olsztyn , Poland.
b Private Dental Practice , Poland.
Drug Deliv. 2018 Nov;25(1):1504-1515. doi: 10.1080/10717544.2018.1477855.
Along with the development of nanotechnological strategies for biomaterials associated with the prevention of infections, a myriad of clinically unproven techniques have been described to date. In this work, the aim was to perform a critical analysis of the literature available concerning antibacterial biomaterials for oral implantology and to provide a practical derivation for such a purpose. As anti-adhesive strategies may affect osseointegration, they should no longer be recommended for inclusion in this class of biomaterials, despite promising results in biomedical engineering for other, non-bone load bearing organs. Targeted, antibacterial drug delivery is most likely desirable in the case of intraosseous implants. Interfering factors such as the oral cavity environment, saliva, the bacterial microbiome, as well as, the characteristics of the alveolar mucosa and peri-implant space must be taken into account when calculating the local pharmacokinetics for antibacterial coatings. Effective release is crucial for tailoring antibacterial implant longevity providing minimal inhibitory concentration (MIC) for the desired amount of time, which for oral implants, should be at least the cumulative time for the osseointegration period and functional loading period within the tissues. These parameters may differ between the implant type and its anatomical site. Also, the functional drug concentration in the peri-implant space should be calculated as the amount of the drug released from the implant surface including the concentration of the drug inactivated by biological fluids of the peri-implant space or saliva flow throughout the effective release time.
随着与预防感染相关的生物材料的纳米技术策略的发展，迄今为止已经描述了无数尚未在临床上得到证实的技术。在这项工作中，目的是对口腔种植学抗菌生物材料的现有文献进行批判性分析，并为此提供实用的推导。由于抗附着策略可能会影响骨整合，因此尽管在其他非承重骨骼的器官的生物医学工程中取得了有希望的结果，但不应再建议将其纳入此类生物材料。在骨内植入物的情况下，靶向抗菌药物递送很可能是可取的。在计算抗菌涂层的局部药代动力学时，必须考虑到口腔环境、唾液、细菌微生物组以及牙槽黏膜和种植体周围空间的特征等干扰因素。有效的释放对于定制抗菌植入物的寿命至关重要，为所需的时间提供最小抑菌浓度 (MIC)，对于口腔植入物，至少应为骨整合期和组织内功能加载期的累积时间。这些参数可能因植入物类型及其解剖部位而异。此外，还应计算种植体周围空间的功能药物浓度，即将从植入物表面释放的药物量加上种植体周围空间或唾液流中的生物体液失活的药物浓度，整个有效释放时间。
