Antimicrobial surface treatment of titanium dental implants: a narrative review between 2011 and 2021

Abstract

Background and Objective: Development of methods to decrease bacterial contamination on oral penetrating devices has been increasing but has not born predictable results. The need for antimicrobial coatings for devices placed inside of the body, particularly penetrating devices that emerge inside the oral cavity is of profound interests to dentistry. Titanium dental implant surfaces, including the abutment-implant junction are associated with a relatively high incidence of chronic infection termed peri-implant disease. In fact, peri-implant disease is the most frequent complication of dental implant treatment. Therefore, a narrative review of the need for technological development to prevent or curtail peri-implant disease is presented. Methods: A review of current English language literature published between 2011 and December 1st, 2021 was done in PubMed using the MeSH subject of anti-bacterial treatment of titanium dental implants. The Search librarian conducted the search at the American Dental Association Library in Chicago, Illinois. A further criterion was searched for sustained in vivo anti-microbial activity. There were no stringent selection criteria, such as removing fluoride treatment from the search, due to the limitation of articles in this nascent field. Key Content and Findings: This narrative review summarizes the lack of publications that fulfill the search criteria with no surface treatment being shown to have a sustained antimicrobial effect. Therefore, there remains a need for extraordinary oral hygiene measures to delay gingival marginal instability, circumferential bone loss, papillary height instability and extension of peri-implant disease around the surface of the implant. Conclusions: Antimicrobial surface treatments or coatings were reviewed, none of which have proven to satisfy present clinical needs including the use of antibiotic, silver or nitride coatings. No surface modification has shown a sustained anti-microbial effect to combat peri-implant disease.