Influence of the electrostatic condition of the titanium surface on bacterial adhesion: A systematic review

Abstract

Statement of ProblemInfection of a dental implant is undesirable and decreases the success rate of the dental prosthesis; however, systematic reviews on the issue are lacking. PurposeThe purpose of this systematic review was to evaluate studies that dealt with inherent factors or those applied to the titanium surface or alloys to provide an antimicrobial action. Material and methodsSCOPUS, PubMed/Medline, Web of Science, EMBASE, and Science Direct databases were searched and manual searches made between June and July 2019 using the keywords “titanium,” “surface,” “implants,” “photoelectron spectroscopy,” and “fourier transform infrared spectroscopy.” The criteria included in vitro studies evaluating the titanium surface and describing hydrophobicity, surface crystalline phase, nanotopography, surface charges, and their relationship with bacteria and/or osseointegration. ResultsA comprehensive search identified 767 articles that were selected by the title and/or abstract as per the inclusion criteria. Of the 58 studies selected for full reading, 7 were used for this systematic review. Another 6 studies were added by further research, resulting in 13 articles, all in vitro studies. As the selected studies had a high heterogeneity that precluded any statistical analysis of the data, a descriptive analysis of these topics was performed: hydrophilicity, surface crystalline phase, nanotopography, and surface charges. ConclusionsThe articles analyzed in this systematic review suggest that hydrophilicity, crystalline phase, surface topography, and surface titanium charge, when altered, may provide an antimicrobial surface. However, the strategy used resulted in heterogeneous articles, making it impossible to demonstrate the unique effect of the electrostatic surface of titanium or titanium alloy used for implants and its effect on bacterial control.