Alenezi Ali, Chrcanovic Bruno
Department of Prosthodontics, College of Dentistry, Qassim University, Saudi Arabia.
Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
Jpn Dent Sci Rev. 2020 Nov;56(1):177-183. doi: 10.1016/j.jdsr.2020.09.003. Epub 2020 Nov 25.
This review aimed to evaluate the effects of the local delivery of antibiotics incorporated in implant surfaces on some quantitative parameters of bone formation.
An electronic search was undertaken in three databases (PubMed, Scopus, Embase) in addition to hand searching. The search was limited to animal experiments using endosseous implants combined with localized antibiotics release. Meta-analyses were performed for the percentages of bone volume (BV) and bone-to-implant contact (BIC).
Nine studies met the inclusion criteria. Several methods were identified for local delivery of antibiotics at the bone-implant interface, but the most commonly used method was by coating (incorporating the implant surface with the antibiotic agents). Different antibiotic agents were used, namely bacitracin, doxycycline, enoxacin, gentamicin, minocycline, tobramycin, and vancomycin. There was no statistically significant difference in the percentage of BIC between implants with or without localized antibiotic release ( = 0.59). The meta-analysis revealed higher BV around implants coated with antibiotics compared to control groups (without antibiotics) ( < 0.01).
It is suggested that the local administration of antibiotics around implants did not adversely affect the percentage of direct bone contact around implants, with a tendency for a slightly better bone formation around implants when combined with local administration of antibiotics. It is a matter of debate whether these in vivo results will have the same effect in the clinical setting. However, the risk of bias of these studies may, to some extent, question the validity of these results.
本综述旨在评估植入物表面所含抗生素的局部递送对骨形成的一些定量参数的影响。
除手工检索外，还在三个数据库（PubMed、Scopus、Embase）中进行了电子检索。检索限于使用骨内植入物并结合局部抗生素释放的动物实验。对骨体积（BV）百分比和骨与植入物接触（BIC）进行了荟萃分析。
九项研究符合纳入标准。确定了几种在骨 - 植入物界面局部递送抗生素的方法，但最常用的方法是涂层（将抗生素制剂与植入物表面结合）。使用了不同的抗生素制剂，即杆菌肽、强力霉素、依诺沙星、庆大霉素、米诺环素、妥布霉素和万古霉素。有或没有局部抗生素释放的植入物之间BIC百分比无统计学显著差异（P = 0.59）。荟萃分析显示，与对照组（无抗生素）相比，涂有抗生素的植入物周围的BV更高（P < 0.01）。
建议植入物周围局部使用抗生素不会对植入物周围直接骨接触的百分比产生不利影响，与局部使用抗生素联合时，植入物周围骨形成有稍好一些的趋势。这些体内结果在临床环境中是否会有相同效果尚有争议。然而，这些研究的偏倚风险可能在一定程度上质疑这些结果的有效性。
