The paradigm shift for drug delivery systems for oral and maxillofacial implants.
The paradigm shift for drug delivery systems for oral and maxillofacial implants.
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DOI：
10.1080/10717544.2018.1477855
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发表时间：
2018-11
期刊：
影响因子：
6
通讯作者：
Pokrowiecki R
中科院分区：
文献类型：
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作者：
Pokrowiecki R
沿着与预防感染相关的生物材料的纳米技术策略的发展，迄今为止已经描述了无数临床上未经证实的技术。在这项工作中，目的是执行一个关键的分析文献有关抗菌生物材料的口腔种植，并提供一个实用的推导这样一个目的。由于抗粘连策略可能会影响骨整合，因此不应再推荐将其纳入此类生物材料中，尽管在生物医学工程中对其他非骨承重器官的结果很有希望。在骨内植入物的情况下，靶向的抗菌药物递送最有可能是期望的。在计算抗菌涂层的局部药代动力学时，必须考虑口腔环境、唾液、细菌微生物组以及牙槽粘膜和种植体周围空间的特征等干扰因素。有效释放对于定制抗菌植入物寿命至关重要，提供所需时间量的最小抑菌浓度（MIC），对于口腔植入物，其应至少是组织内骨整合期和功能负荷期的累积时间。这些参数可能因植入物类型及其解剖部位而异。此外，植入物周围空间中的功能药物浓度应计算为从植入物表面释放的药物的量，包括在整个有效释放时间内被植入物周围空间的生物流体或唾液流灭活的药物的浓度。
Along with the development of nanotechnological strategies for biomaterials associated with the prevention of infections, a myriad of clinically unproven techniques have been described to date. In this work, the aim was to perform a critical analysis of the literature available concerning antibacterial biomaterials for oral implantology and to provide a practical derivation for such a purpose. As anti-adhesive strategies may affect osseointegration, they should no longer be recommended for inclusion in this class of biomaterials, despite promising results in biomedical engineering for other, non-bone load bearing organs. Targeted, antibacterial drug delivery is most likely desirable in the case of intraosseous implants. Interfering factors such as the oral cavity environment, saliva, the bacterial microbiome, as well as, the characteristics of the alveolar mucosa and peri-implant space must be taken into account when calculating the local pharmacokinetics for antibacterial coatings. Effective release is crucial for tailoring antibacterial implant longevity providing minimal inhibitory concentration (MIC) for the desired amount of time, which for oral implants, should be at least the cumulative time for the osseointegration period and functional loading period within the tissues. These parameters may differ between the implant type and its anatomical site. Also, the functional drug concentration in the peri-implant space should be calculated as the amount of the drug released from the implant surface including the concentration of the drug inactivated by biological fluids of the peri-implant space or saliva flow throughout the effective release time.