title: Emerging antibacterial biomaterial strategies for the prevention of peri-implant inflammatory diseases.
abstract: OBJECTIVE
  Peri-implantitis is an inflammatory disease due to bacteria and plaque formation on implant surfaces which can lead to bone resorption and loss of osseointegration. Biomaterial strategies to prevent or eliminate initial bacterial attachment, in favor of host tissue attachment may have a positive effect on decreasing peri-implantitis, particularly for at risk patient groups. This study provides a brief overview of some of the experimental biomaterial strategies aimed at suppressing or inhibiting bacterial colonization of implant surfaces in favor or host cells and tissues.
  
  
  METHODS
  These biomaterial strategies have different mechanisms of action from interfering with bacterial adhesion by modifying surface energies, immobilizing antimicrobials on implant surfaces, creating photocatalytic surfaces, as well as modifying surfaces to deliver antimicrobial agents either prophylactically or in response to bacterial challenge. This is not a comprehensive review, rather a review of studies that serve to illustrate many of the different approaches being investigated.
  
  
  RESULTS
  While many of these strategies have demonstrated the potential to significantly reduce bacterial attachment on implant surfaces in vitro, it is unclear if these same reductions will be adequate clinically since even a few adhering bacteria may over time develop into inflammatory inducing biofilms or plaque. Also, data on the ability of the antibacterial modified biomaterials to support osseointegration and permuosal seal formation is still needed.
  
  
  CONCLUSIONS
  Given the complex and multivariate causes of peri-implant disease, it is likely that combinations of these strategies (eg, antimicrobial surfaces and or delivery mechanisms coupled with methods to favor stable osseointegration and permucosal seal) will be most effective in developing implants resistant to peri-implant disease.
authors.affiliation: University of Memphis, TN, USA. jbmgrdnr@memphis.edu
authors.forename: Joel D
authors.initials: JD
authors.lastname: Bumgardner
authors.forename: Pradeep
authors.initials: P
authors.lastname: Adatrow
authors.forename: Warren O
authors.initials: WO
authors.lastname: Haggard
authors.forename: P Andrew
authors.initials: PA
authors.lastname: Norowski
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control*; D001672:Biocompatible Materials / Q000737:chemistry* / Q000627:therapeutic use; D020099:Coated Materials, Biocompatible / Q000737:chemistry / Q000627:therapeutic use; D015921:Dental Implants / Q000009:adverse effects* / Q000382:microbiology; D004337:Drug Carriers / Q000737:chemistry; D006801:Humans; D057873:Peri-Implantitis / Q000188:drug therapy / Q000517:prevention & control*; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D020099:Coated Materials, Biocompatible; D015921:Dental Implants; D004337:Drug Carriers