抗菌钛合金在口腔医学中应用研究进展

Research progress on the application of antibacterial titanium alloys in stomatology

广泛应用于口腔医学领域的钛合金,由于长期处于复杂微生物环境中,材料表面易形成细菌生物膜,影响其使用效率和寿命。抗菌钛合金是一种通过表面改性或整体改性的方法添加了抗菌剂的新型钛合金。根据抗菌剂在钛合金材料中分布的位置,抗菌钛合金分为涂层型和合金型。涂层型抗菌钛合金的抗菌效果良好,但缺点是涂层大多不耐磨;合金型抗菌钛合金的抗菌剂一般为金属元素,可在合金中均匀分布,抗菌性能稳定持久。根据抗菌钛合金能否释放抗菌剂,分为主动抗菌型和被动抗菌型,主动抗菌型钛合金可释放负载的抗菌剂,抗菌效果比较明显,但有些抗菌剂的释放时间较短;被动抗菌型钛合金不释放抗菌剂,通过接触杀菌或抑制细菌黏附的方式产生抗菌作用。抗菌钛合金可抑制材料表面细菌黏附,对延长矫治器、种植体、钛板等在口腔内的使用寿命具有重要意义,且抗菌改性后钛合金的机械性能未受明显影响,羟基磷灰石等抗菌剂的加入还提高了材料的成骨功能,在种植义齿、正畸矫治及口腔颌面外科等口腔医学领域应用前景良好。但是,目前关于抗菌钛合金的研究大多是体外实验,其长期的临床效果及其抗菌机制仍不明确,有待深入研究。

Currently,titanium alloys are widely used in the field of stomatology;however,owing to long⁃term expo⁃sure to a complex microbial environment,dental plaques easily form on the surface of the materials,affecting the use ef⁃ficiency and the service life of the materials.The antibacterial titanium alloy is a new kind of titanium alloy with antimi⁃crobials added through surface modification or overall modification.Based on the location of antibacterial agents in tita⁃nium alloy materials,antibacterial titanium alloys can be divided into coating and alloy types.The antibacterial effect of coated antibacterial titanium alloy is good,but the disadvantage is that most of the coatings are not wear⁃resistant.The widely⁃used antibacterial agent of the alloy type is metal elements,which can be evenly distributed in the alloy,and the antibacterial properties are stable and long⁃lasting.Based on whether antibacterial agents can be released,antibacterial titanium alloys can be further divided into active antibacterial and passive antibacterial types.Active antibacterial type titanium alloys can release loaded antibacterial agents,and the antibacterial effect is more obvious,but the release dura⁃tion of antibacterial agents is relatively short.Passive antibacterial titanium alloys exhibit an antibacterial effect by con⁃tact sterilization or inhibition of bacterial adhesion instead of releasing antibacterial agents.The antibacterial titanium alloy can inhibit the adhesion of bacteria on the surface of the material and prolong the service life of oral orthodontic appliances,implants and titanium plates.Moreover,the mechanical properties of the titanium alloy after antibacterial modification are not significantly affected,and the addition of antibacterial agents such as hydroxyapatite can increase the osteogenic function of the material.Therefore,the alloy has good application prospects in the fields of dental im⁃plant,orthodontic treatment and oral and maxillofacial surgery.However,most of the current studies on antibacterial ti⁃tanium alloys are in vitro experiments,and their long⁃term clinical effects and antibacterial mechanisms are still unclear and need further study.