In Vivo Antibacterial Efficacy of Nanopatterns on Titanium Implant Surface: A Systematic Review of the Literature

Abstract

Background: Bionic surface nanopatterns of titanium (Ti) materials have excellent antibacterial effects in vitro for infection prevention. To date, there is a lack of knowledge about the in vivo bactericidal outcomes of the nanostructures on the Ti implant surfaces. Methods: A systematic review was performed using the PubMed, Embase, and Cochrane databases to better understand surface nanoscale patterns’ in vivo antibacterial efficacy. The inclusion criteria were preclinical studies (in vivo) reporting the antibacterial activity of nanopatterns on Ti implant surface. Ex vivo studies, studies not evaluating the antibacterial activity of nanopatterns or surfaces not modified with nanopatterns were excluded. Results: A total of five peer-reviewed articles met the inclusion criteria. The included studies suggest that the in vivo antibacterial efficacy of the nanopatterns on Ti implants’ surfaces seems poor. Conclusions: Given the small number of literature results, the variability in experimental designs, and the lack of reporting across studies, concluding the in vivo antibacterial effectiveness of nanopatterns on Ti substrates’ surfaces remains a big challenge. Surface coatings using metallic or antibiotic elements are still practical approaches for this purpose. High-quality preclinical data are still needed to investigate the in vivo antibacterial effects of the nanopatterns on the implant surface.

TiO2/HA and Titanate/HA Double-Layer Coatings on Ti6Al4V Surface and Their Influence on In Vitro Cell Growth and Osteogenic Potential

“…Infections can be the cause of implant removal or prolonged patient recovery. The important point is that systems with an antimicrobial coating do not impede tissue integration into the implant [90][91][92][93]. In our study, the produced systems with a hydroxyapatite layer (T5/HA, T-S/HA, TNF6C/HA) did not show antimicrobial properties.…”

“…It should be noted that the antibacterial ability of coatings will gradually weaken over time, and the release of metal ions from their surface may affect the osseointegration efficiency of titanium implants and have a significant impact on their cytotoxicity. So far, the problem of emerging infections is solved with appropriately selected antibiotics [92,93,109].…”

Recent Advances in Antibacterial Coatings to Combat Orthopedic Implant-Associated Infections

“…Such nano-patterned surfaces can be combined with soft materials to obtain more effective and long-lasting antibacterial coatings, and they may be used as innovative nanocatalytic therapies. These therapies are based on supporting these coatings with catalytic components, leading to a significant increase in the local oxidative stress on bacteria [ 148 , 149 ].…”