Abstract：
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.
摘要：
牙科单元水线（DUWL）的污染是一个主要的健康问题，因为它可能在牙科专业人员及其患者之间造成交叉感染风险。银因其优越的抗菌性能而成为医疗领域中广泛使用的金属之一。目前,银基试剂已经在商业上可用于牙科单元水的净化。本系统综述旨在研究支持银对DUWL进行净化的有效性和安全性的证据。我们使用相应的搜索词在六个电子数据库中搜索了同行评审的研究文献。资格仅限于英语研究，探索应用银来净化牙科单位水，例如，银基消毒剂和镀银牙科水线管。搜索确定了148篇文章，并对9篇符合标准的文章进行了定性叙事分析。我们观察到银与过氧化氢对DUWL中存在的多种微生物的抗微生物功效的良好证据。此外，没有足够的证据表明银纳米颗粒（AgNPs）作为有效的材料来控制DUWL中的生物膜。银或AgNPs的杀菌和抑菌效果的后处理数据，特别是长期应用的实际临床疗效,是稀缺的。需要更多高质量的研究来解决在使用含银材料控制DUWL中的细菌和生物膜所需的最佳剂量和治疗选择方面的差距。
