钙硅基生物材料的抗菌性能及在根管感染控制中的研究进展

Antimicrobial properties of calcium silicate cements and advances in root canal infection control

钙硅基生物材料(calcium silicate cements,CSCs)含有Ca和Si,具有良好的理化性能、生物相容性和诱导骨再生能力,在医学领域具有良好的应用前景。CSCs能释放Ca^2+和Si^4+形成碱性环境,产生抗菌效果。临床常用的CSCs如三氧化物聚合物(mineral trioxide aggregate,MTA)和iRoot的抗菌性能局限,有浓度和时间依赖性,对厌氧菌和兼性厌氧菌的抗菌效果欠佳。新型CSCs如生物玻璃(bioactive glass,BG)、介孔生物玻璃(mesoporous bioactive glass,MBG)及介孔钙硅纳米粒子(mesoporous calcium-silicate nanoparticles,MCSNs)能更好地诱导磷灰石矿化、促进细胞增殖和诱导成骨,但其自身的抗菌能力仍有限。MBG和MCSNs特殊的介孔结构,可负载药物、蛋白和生长因子,既能保持材料良好的理化性能,又能实现对抗菌药物的有效传递和缓释,成为优良的生物载体。该文就代表性CSCs的抗菌性及在根管感染控制中的研究进展进行综述。

Calcium silicate cements(CSCs)with Ca and Si are biomaterials with advantageous physicochemical properties,biocompatibility and bone regeneration ability,which have good prospects in the medical field.CSCs can create an alkaline environment by releasing Ca^2+ and Si^4+ and produce antibacterial effects.The commonly used CSCs in clinic,such as mineral trioxide aggregate(MTA)and iRoot,have limited antibacterial properties which depend on concentration and time and have poor antibacterial effects on anaerobic bacteria and facultative anaerobic bacteria.New CSCs such as bioactive glass(BG),mesoporous bioactive glass(MBG)and mesoporous calcium-silicate nanoparticles(MCSNs)can induce apatite mineralization,promote cell proliferation and induce osteogenesis better,but their antibacterial abilities are still limited.The special mesoporous structure of MBG and MCSNs can be loaded with drugs,proteins and growth factors,which can not only maintain good physical and chemical properties of the materials,but also achieve effective delivery and controlled release of antibacterial drugs.Therefore,they are considered to be excellent biological carriers.This article reviews the antimicrobial properties of representative CSCs and their advances in root canal infection control.