Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants—A Narrative Review

Abstract

Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Therefore, there is a need to create porous implants and other medical devices that will allow a multiple drug delivery at a controlled dose and release profile without traumatic treatment. Due to the growing demand for the use of biologically active agents to support dental implant treatment at its various stages (implant placement, long-term use of dental superstructures, treatment of the peri-implant conditions) and due to the proven effectiveness of the topical application of pharmacological biologically active agents to the implant area, the authors would like to present a review and show the methods and devices that can be used by clinicians for local drug administration to facilitate dental implant treatment. Our review concludes that there is a need for research in the field of inventions such as new medical devices or implants with gradient solid–porous structures. These devices, in the future, will enable to perform repeatable, controllable, atraumatic, and repeatable injections of active factors that may affect the improvement of osteointegration and the longer survival of implants, as well as the treatment of peri-implantitis.

Construction of Local Drug Delivery System on Titanium-Based Implants to Improve Osseointegration

“…The system could mitigate the effects of the above factors and achieve ideal osseointegration by releasing different drugs around Ti implants. For example, the release of anti-bone resorption drugs could transform bone metabolism into bone deposition by inhibiting the absorptive activity of osteoclasts [ 190 , 191 ]. Additionally, with the release of anti-inflammatory drugs, the system could solve aseptic loosening by mitigating local inflammatory responses [ 192 ].…”

Preparation and Characterization of Vancomycin Hydrochloride-Loaded Mesoporous Silica Composite Hydrogels

“…The pore size of the manufactured Van/SBA-15/CS-GP-SA was larger than the other two groups (Figure 5). This indicates that the addition of Van/SBA-15 to CS-GP-SA has a significant influence on the surface structure (Jaidev and Chatterjee, 2019;Ouyang et al, 2019;Metwally et al, 2020;Wychowański et al, 2021).…”

“…Therefore, antimicrobial drug carriers, a topical strategy, have become an adjunct to the prevention and treatment of infections in jaw defects ( Alazzawi et al, 2021 ; Han et al, 2021 ). Topical administration at or near the site of infection diminishes the toxic effects of antibacterial agents, reduces the required dose of antibiotics, and enhances the bioavailability and safety of the drug ( Wychowański et al, 2021 ; Zheng et al, 2021 ).…”

Carbon Nanomaterials Modified Biomimetic Dental Implants for Diabetic Patients

“…Systemic antibiotic applications have drawbacks such as systemic toxicity [75], low bioavailability, and antibiotic resistance [74,76,77], making local antibiotic treatment a preferred method of drug administration [76]. Studies have shown many potential benefits from localized drug delivery for peri-implantitis [77][78][79].…”

“…Apart from their potential to serve as efficient drug delivery platforms, CNMs are also established antibacterial agents, most commonly via contact-mediated biocidal action [76]. The bacterial cell wall permeability is altered by the nanoparticles that are positively charged, which electrostatically attract the negatively charged bacterial cell membrane, resulting in its rupture, followed by leakage of intracellular organelles.…”