Emerging Antibacterial Coated Dental Implants: A Preventive Measure for Peri-implantitis

Abstract

Dental implants are the modern marvel and are widely accepted as a reconstructive treatment modality for tooth replacement. In recent times, there has been a marked progress in the clinical success rates of dental implants, but implant failures as a result of infections are continuing at an alarming rate of 8% per year, translating into 1 million failures worldwide. Perimucositis and peri-implantitis are the chief complications reported postimplant surgery that effects its short- and long-term success. Peri-implantitis is characterized by clinical and radiological bone loss around the implant accompanied with an inflammatory reaction of the peri-implant mucosa and is an irreversible condition, whereas perimucositis is a reversible inflammatory change. Implant surfaces provide an ideal substrate for bacterial adhesion forming a biofilm. Biofilm performs vast functions ranging from physical defensive barrier against phagocytic predation to working as a selective permeable barrier. This limits the diffusion of systemic antimicrobial agents that are capable of damaging the bacterial complexes. These rapidly growing bacteria give rise to a chronic infection which is difficult to eradicate by conventional antibiotic therapy. To inhibit peri-implant infections, various functional modifications in the implant surfaces have been suggested. The coatings on the titanium implant are incorporated with disinfectants, antibiotics as well as antimicrobial peptides AMPs. This paper is an attempt to review all the antibiotic coatings available for a titanium implant and discuss their prospective future to prevent peri-implant infections. How to cite this article Yarramaneni V, Aparna IN, Sachdeva A, Balakrishnan D, Prabhu N. Emerging Antibacterial Coated Dental Implants: A Preventive Measure for Peri-implantitis. World J Dent 2016;7(4):195-198.

Customized Therapeutic Surface Coatings for Dental Implants

“…Infections associated with dental implants are often very complex, multifactorial, and challenging to manage. The most common bacterial infections related to dental implants are Gram-positive bacteria, i.e., Staphylococcus epidermidis, Staphylococcus aureus, and Enterococcus spp., and Gram-negative bacteria, for example, Pseudomonas aeruginosa [191,228,229]. The implant surface provides a medium for bacterial adhesion by forming a physical defensive biofilm and diminishes the systemic antibiotic diffusion, resulting in relatively limited drug availability at the infection site [230].…”

“…A number of studies [58,228,231,[234][235][236] have investigated the incorporation of antimicrobial agents to the implants' coating using dip or spray coating methods. However, it is very challenging to meet the desired requirements during production of implant coatings.…”

Current state‐of‐the‐art and future perspectives of the three main modern implant‐dentistry concerns: Aesthetic requirements, mechanical properties, and peri‐implantitis prevention

“…Finally, the third approach consists of treating the implant surface with a coating containing cytotoxic compounds that induce the death of nearby bacteria or adhered bacteria. Various functional modifications of implant surfaces have been suggested, for example, coatings loaded with antibiotics, organic nonantibiotic antimicrobial coatings, and inorganic nonantibiotic antimicrobial coatings. Most of these studies have been carried out with titanium implants/surfaces, considered to be the gold standard in oral implantology.…”

In vitro response of THP-1 derived macrophages to antimicrobially effective PHMB-coated Ti6Al4V alloy implant material with and without contamination with S. epidermidis and P. aeruginosa

“…Another possibility is coating the implant material with antimicrobial agents [ 11 ]. Existing coatings use biocides that are released from the surface, as antibiotics, antimicrobial peptides [ 12 ], antiseptics or metal ions [ 13 – 16 ]. However, the release of antibiotics and some antiseptics as e.g.…”