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Title: [Progress in antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants].
Author: Liu P, Fan B, Zou L, Lü L, Gao Q.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2023 Oct 15; 37(10):1300-1313. PubMed ID: 37848328.
Abstract:
OBJECTIVE: To review antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants, so as to provide reference for subsequent research. METHODS: The related research literature on antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants in recent years was reviewed, and the research progress was summarized based on different kinds of antibacterial substances and osteogenic active substances. RESULTS: At present, the antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants includes: ① Combined coating strategy of antibiotics and osteogenic active substances. It is characterized in that antibiotics can be directly released around titanium-based implants, which can improve the bioavailability of drugs and reduce systemic toxicity. ② Combined coating strategy of antimicrobial peptides and osteogenic active substances. The antibacterial peptides have a wide antibacterial spectrum, and bacteria are not easy to produce drug resistance to them. ③ Combined coating strategy of inorganic antibacterial agent and osteogenic active substances. Metal ions or metal nanoparticles antibacterial agents have broad-spectrum antibacterial properties and various antibacterial mechanisms, but their high-dose application usually has cytotoxicity, so they are often combined with substances that osteogenic activity to reduce or eliminate cytotoxicity. In addition, inorganic coatings such as silicon nitride, calcium silicate, and graphene also have good antibacterial and osteogenic properties. ④ Combined coating strategy of metal organic frameworks/osteogenic active substances. The high specific surface area and porosity of metal organic frameworks can effectively package and transport antibacterial substances and bioactive molecules. ⑤ Combined coating strategy of organic substances/osteogenic active substancecs. Quaternary ammonium compounds, polyethylene glycol, N-haloamine, and other organic compounds have good antibacterial properties, and are often combined with hydroxyapatite and other substances that osteogenic activity. CONCLUSION: The factors that affect the antibacterial and osteogenesis properties of titanium-based implants mainly include the structure and types of antibacterial substances, the structure and types of osteogenesis substances, and the coating process. At present, there is a lack of clinical verification of various strategies for antibacterial/osteogenesis dual-functional surface modification of titanium-based implants. The optimal combination, ratio, dose-effect mechanism, and corresponding coating preparation process of antibacterial substances and bone-active substances are needed to be constantly studied and improved. 目的: 对钛基植入物的抗菌/促成骨双功能表面改性策略进行综述，为后续研究提供参考。. 方法: 查阅近年来钛基植入物抗菌和促成骨双功能表面改性方法的相关研究文献，就不同种类的抗菌物质和促成骨活性物质进行分类总结。. 结果: 目前钛基植入物抗菌/促成骨双功能表面改性策略包括：① 抗生素/促成骨活性物质复合涂层策略。特点是抗生素可以直接在钛基植入物周围释放，在提高药物生物利用率的同时降低全身毒性。② 抗菌肽/促成骨活性物质复合涂层策略。特点是抗菌肽具有广泛抗菌谱，细菌不易对其产生耐药性。③ 无机抗菌剂/促成骨活性物质复合涂层策略。金属离子或金属纳米颗粒抗菌剂具有广谱抗菌性和多种抗菌机制，但其高剂量应用通常具有细胞毒性，因此常将其与促成骨活性物质联合应用以减少或消除细胞毒性。另外，氮化硅、硅酸钙、石墨烯等无机物涂层也具有良好的抗菌与促成骨性能。④ 有机金属骨架/促成骨活性物质复合涂层策略。有机金属骨架的高比表面积和大孔隙率可实现抗菌物质和生物活性分子等物质的有效封装和传输。⑤ 有机物/促成骨活性物质复合涂层策略。季铵化合物、聚乙二醇、N-卤胺等有机物具有良好的抗菌性能，常与羟基磷灰石等促成骨活性物质联合涂层。. 结论: 影响钛基植入物表面抗菌与促成骨性能的因素主要包括抗菌物质、促成骨活性物质的结构与种类以及涂层工艺。目前对于钛基植入物抗菌/促成骨双功能表面改性的多种策略均缺乏临床验证，抗菌物质与促成骨活性物质的最佳组合、配比、量效机制、以及相应的涂层制备工艺均有待进一步研究。.

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