Leonardi de Oliveira Rigotti Renan, Dias Corpa Tardelli Juliana, Cândido Dos Reis Andréa
Department of Dental Materials and Prosthesis; School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
Heliyon. 2023 Feb 16;9(3):e13693. doi: 10.1016/j.heliyon.2023.e13693. eCollection 2023 Mar.
There is no consensus in the literature about the best non-cytotoxic antibacterial surface treatment for dental implants. Critically evaluate the existing literature and answer the question: "which surface treatment for dental implants made of titanium and its alloys has the greatest non-cytotoxic antibacterial activity for osteoblastic cells?" This systematic review was registered in the Open Science Framework (osf.io/8fq6p) and followed the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. The search strategy was applied to four databases. Articles were selected that evaluated in both studies the properties of 1) antibacterial activity and 2) cytotoxicity on osteoblastic cells of titanium and their alloy dental implants when treated superficially. Systematic reviews, book chapters, observational studies, case reports, articles that studied non-dental implants, and articles that evaluated only the development of surface treatment were excluded. The Joanna Briggs Institute, a quasi-experimental study assessment tool, was adapted to assess the risk of bias. The search strategy found 1178 articles in the databases after removing duplicates in EndNote Web, resulting in 1011 articles to be evaluated by title and abstract, of which 21 were selected for full reading, of which 12 were included by eligibility criteria, and nine were excluded. Quantitative synthesis could not be performed due to the heterogeneity of the data (surface treatment, antibacterial assay, bacteria strain, cell viability assay, and cell type). Risk of bias assessment showed that ten studies were classified as low risk and two studies as moderate risk. The evaluated literature allowed us to conclude that: 1) The literature surveyed did not allow answering the question due to the heterogeneity of the studies; 2) Ten of the 12 studies evaluated presented surface treatments with non-cytotoxic antibacterial activity; 3) Adding nanomaterials, QPEI, BG, and CS, reduce the chances of bacterial resistance by controlling their adhesion by electrical forces.
关于牙科植入物最佳的非细胞毒性抗菌表面处理方法，文献中尚无共识。批判性地评估现有文献并回答问题：“对于由钛及其合金制成的牙科植入物，哪种表面处理方法对成骨细胞具有最大的非细胞毒性抗菌活性？” 本系统评价在开放科学框架（osf.io/8fq6p）中注册，并遵循系统评价和Meta分析方案的首选报告项目。检索策略应用于四个数据库。选取了在两项研究中均评估了1）抗菌活性以及2）钛及其合金牙科植入物表面处理后对成骨细胞的细胞毒性的文章。排除了系统评价、书籍章节、观察性研究、病例报告、研究非牙科植入物的文章以及仅评估表面处理发展情况的文章。采用了一种准实验研究评估工具——乔安娜·布里格斯研究所工具来评估偏倚风险。检索策略在EndNote Web中去除重复项后在数据库中找到1178篇文章，从而有1011篇文章需通过标题和摘要进行评估，其中21篇被选作全文阅读，其中12篇符合纳入标准被纳入，9篇被排除。由于数据的异质性（表面处理、抗菌检测、细菌菌株、细胞活力检测和细胞类型），无法进行定量综合分析。偏倚风险评估表明，十项研究被归类为低风险，两项研究为中度风险。评估的文献使我们能够得出以下结论：1）由于研究的异质性，所调查的文献无法回答该问题；2）在评估的12项研究中，有10项呈现出具有非细胞毒性抗菌活性的表面处理方法；3）添加纳米材料、季铵化聚乙烯亚胺、生物玻璃和壳聚糖，通过电力控制细菌粘附，可降低细菌耐药的几率。
