Emerging antibacterial coated dental implants: A preventive measure for peri-implantitis

Dental implants are the modern marvel and are widely accepted as a reconstructive treatment modality for tooth replacement. In recent times,there has been a marked progress in the clinical success rates of dental implants,but implant failures as a result of infections are continuing at an alarming rate of 8% per year,translating into 1 million failures worldwide. Perimucositis and peri-implantitis are the chief complications reported postimplant surgery that effects its short- and long-term success. Peri-implantitis is characterized by clinical and radiological bone loss around the implant accompanied with an inflammatory reaction of the peri-implant mucosa and is an irreversible condition,whereas perimucositis is a reversible inflammatory change. Implant surfaces provide an ideal substrate for bacterial adhesion forming a biofilm. Biofilm performs vast functions ranging from physical defensive barrier against phagocytic predation to working as a selective permeable barrier. This limits the diffusion of systemic antimicrobial agents that are capable of damaging the bacterial complexes. These rapidly growing bacteria give rise to a chronic infection which is difficult to eradicate by conventional antibiotic therapy. To inhibit peri-implant infections,various functional modifications in the implant surfaces have been suggested. The coatings on the titanium implant are incorporated with disinfectants,antibiotics as well as antimicrobial peptides AMPs. This paper is an attempt to review all the antibiotic coatings available for a titanium implant and discuss their prospective future to prevent peri-implant infections.