Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310000, Zhejiang, China.
School of Medicine, Zhejiang University, Hangzhou, 310000, Zhejiang, China.
Biol Trace Elem Res. 2022 Dec;200(12):4988-5002. doi: 10.1007/s12011-022-03105-w. Epub 2022 Jan 8.
The contamination of dental unit waterlines (DUWLs) is a major health concern since it can pose cross-infection risks among dental professionals and their patients. Silver is one of the widely used metals in medical fields due to its superior antimicrobial properties. Silver-based agents have been commercially available for the decontamination of dental unit water currently. This systematic review aims to examine the evidence supporting efficacy and safety of application of silver to decontaminate DUWLs. We performed a search of the peer-review literature of studies in six electronic databases using corresponding search terms. Eligibility was restricted to English-language studies exploring the application of silver to decontaminate dental unit water, e.g., silver-based disinfectants and silver-coated dental waterlines tubing. The search identified 148 articles, and 9 articles that met the criteria were synthesized with qualitative narrative analyses. We observed good evidence of antimicrobial efficacy of silver with hydrogen peroxide on diverse microorganism present in DUWLs. Furthermore, there is insufficient evidence on the application of silver nanoparticles (AgNPs) as an efficient material to control the biofilms in DUWLs. Post-treatment data of either the bactericidal and bacteriostatic effects of silver or AgNPs, especially the actual clinical efficacy of long-term application, are scarce. More high-quality research is needed to resolve the gap on the optimal dosage and treatment options required to control bacterial and biofilm in DUWLs with silver-containing materials.
牙科器械用水管路（DUWLs）的污染是一个主要的健康问题，因为它可能会在牙科专业人员及其患者之间造成交叉感染的风险。银是医学领域中广泛使用的金属之一，因为它具有卓越的抗菌性能。目前，已有商业化的含银制剂可用于牙科器械用水的消毒。本系统评价旨在研究支持应用银来消毒 DUWLs 的疗效和安全性的证据。我们使用相应的检索词在六个电子数据库中对同行评审文献进行了检索。入选标准仅限于探索应用银来消毒牙科器械用水的英语语言研究，例如，含银消毒剂和银涂覆的牙科用水管路。该检索共确定了 148 篇文章，其中有 9 篇符合标准，采用定性叙事分析进行综合。我们观察到银与过氧化氢联合对 DUWLs 中存在的各种微生物具有良好的抗菌效果。此外，关于银纳米粒子（AgNPs）作为控制 DUWLs 中生物膜的有效材料的应用，证据不足。关于银或 AgNPs 的杀菌和抑菌作用的治疗后数据，特别是长期应用的实际临床疗效，非常缺乏。需要更多高质量的研究来解决在使用含银材料控制 DUWLs 中的细菌和生物膜时所需的最佳剂量和治疗方案方面的差距。
