目的:纳米技术在牙科科学中不断进步,推进旨在改善牙科植入物的几个功能。牙科植入物表面处理的替代方法是电化学阳极氧化,这可以产生具有抗菌潜力和骨诱导特征的纳米管表面(TiO2纳米管)。本系统综述和荟萃分析旨在阐明与未经处理的钛表面相比,所讨论的表面可能具有抗菌性能。
方法:为此,在PubMed基地进行了系统的搜索,丁香花,Embase,网络科学,Cinahl,和CochraneCentral,还有,手动搜索和灰色文献。
方法:搜索产生了742篇文章,其中156个如下全文阅读。然后,37例纳入系统评价,8例纳入荟萃分析。
结果:15项研究揭示了使用TiO2纳米管表面的显著抗菌保护,而15项研究发现对照和纳米纹理表面之间没有统计学差异。体外研究的荟萃分析表明,仅在6小时内研究金黄色葡萄球菌的研究中,相关的细菌减少。体内研究的荟萃分析显示,在TiO2纳米管表面上的细菌粘附和增殖降低了三倍。
结论:在临床前研究中,TiO2纳米管作为牙科植入物的表面与抗菌性能呈正相关。然而,诸如阳极氧化协议等因素,细菌菌株,应考虑单培养方法,因此,需要进一步的研究来促进临床可翻译性。
OBJECTIVE: Nanotechnology is constantly advancing in dental science, progressing several features aimed at improving dental implants. An alternative for surface treatment of dental implants is electrochemical anodization, which may generate a nanotubular surface (TiO2 nanotubes) with antibacterial potential and osteoinductive features. This systematic review and meta-analysis aims to elucidate the possible antibacterial properties of the surface in question compared to the untreated titanium surface.
METHODS: For that purpose, was performed a systematic search on the bases PubMed, Lilacs, Embase, Web Of Science, Cinahl, and Cochrane Central, as well as, manual searches and gray literature.
METHODS: The searches resulted in 742 articles, of which 156 followed for full-text reading. Then, 37 were included in the systematic review and 8 were included in meta-analysis.
RESULTS: Fifteen studies revealed significant antibacterial protection using TiO2 nanotube surfaces, while 15 studies found no statistical difference between control and nanotextured surfaces. Meta-analysis of in vitro studies demonstrated relevant bacterial reduction only for studies investigating Staphylococcus aureus in a period of 6 h. Meta-analysis of in vivo studies revealed three times lower bacterial adhesion and proliferation on TiO2 nanotube surfaces.
CONCLUSIONS: TiO2 nanotube topography as a surface for dental implants in preclinical research has demonstrated a positive relationship with antibacterial properties, nevertheless, factors such as anodization protocols, bacteria strains, and mono-culture methods should be taken into consideration, consequently, further studies are necessary to promote clinical translatability.