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Antibacterial and anti-biofilm evaluation of bioactive glasses embedding organic and inorganic compounds to enhance peri-implant bone repair- A Systematic Review


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Bioactive glasses(BG) are promising materials for bone healing due to their desirable properties such as osteoconductivity, biodegradability, angiogenic potential, and antibacterial activity. Ionic dissolution products from bioactive glasses increase pH ́s medium reducing surrounding bacteria proliferation. Nevertheless, such antibacterial effect has been reported as restricted due to their insignificant anti-biofilm activity exhibited in previous studies. The aim of this systematic review was to assess the efficacy of antibacterial and anti-biofilm compounds embedded into bioactive glass composition to prevent or treat peri-implant infection during bone repairing applications. The question according to Population, Intervention, Control, Outcomes (PICO) was established as follows: “In bioactive glass particles what is the effect of the embedding of antimicrobials compared to the non-embedding on bacterial and biofilm activity?”. The electronic search was performed including in vitro studies written in English, Portuguese, and Spanish published up to December 3, 2015, in the following databases: PubMed, LILACS, Scopus, Web of Science, and Science Direct. The first phase of the research yielded 525 abstracts. 81 studies exhibiting the incorporation of antibacterial compounds into BG structures were completely examined for inclusion in the final analysis and 49 studies were chosen to be scrutinized for qualitative analysis. The collected data was divided into 3 categories: bioactive glass non-embedding compounds (n:22), metallic ion doped BG ́s (n:23) and organic compounds embedded into bioactive glass (n:4). As follows, this systematic review showed that BG without the incorporation of antibacterial compounds has an important antibacterial activity; however, Ag ions doping BG have the most efficient antibacterial activity among other embedded compounds.The size of BG particles determines its antibacterial activity, nm particles showed a higher antibacterial effect compared to micrometric particles. Surface BG modification converts this biomaterial into a promising antibacterial and antibiofilm delivery system as illustrated in fig 1. Only In vitro studies have been considered in this systematic review, therefore future in vivo studies and clinical trials are warranted to determine the most promising anti-biofilm agent incorporated into bioactive glass to counteract biofilm proliferation, promote bone regeneration, and have none toxic side effects in human tissues being a possible solution to treat and repair peri-implantitis defects.


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All rights reserved.