Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (4): 284-288.doi: 10.12016/j.issn.2096-1456.2021.04.011

• Review Articles • Previous Articles    

Research progress on the application of antibacterial titanium alloys in stomatology

FAN Dongyang1,2,3(),WANG Qiang4,ZHOU Yijun2,LI Siwen1,2,3,FENG Xu5,LIU Chunran2,CUI Jiasen2,SUN Hongchen2()   

  1. 1. Department of General Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
    2. Department of Oral Pathology, School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
    3. Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
    4. Department of Dental Materials, School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
    5. Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
  • Received:2020-07-08 Revised:2020-10-17 Online:2021-04-20 Published:2021-02-26
  • Contact: Hongchen SUN;
  • Supported by:
    National Key Research and Development Program of China(2016YFC1102800);Science and Technology Project of Liaoning Province(2018225059)


Currently, titanium alloys are widely used in the field of stomatology; however, owing to long-term exposure to a complex microbial environment, dental plaques easily form on the surface of the materials, affecting the use efficiency and the service life of the materials. The antibacterial titanium alloy is a new kind of titanium alloy with antimicrobials added through surface modification or overall modification. Based on the location of antibacterial agents in titanium 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 duration of antibacterial agents is relatively short. Passive antibacterial titanium alloys exhibit an antibacterial effect by contact 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 implant, orthodontic treatment and oral and maxillofacial surgery. However, most of the current studies on antibacterial titanium alloys are in vitro experiments, and their long-term clinical effects and antibacterial mechanisms are still unclear and need further study.

Key words: titanium alloy, biofilm, adhesion, antibacterial property, antibacterial modification, antimicrobial, controlled release, alloy, coating, hydroxyapatite, chitosan, copper ions, anionic

CLC Number: 

  • R78
[1] Campoccia D, Montnaro L, Arciola CR. The significance of infection related to orthopedic devices and issues of antibiotic resistance[J]. Biomaterials, 2006,27(11):2331-2339. doi: 10.1016/j.biomaterials.2005.11.044.
doi: 10.1016/j.biomaterials.2005.11.044
[2] Li M, Ma Z, Zhu Y, et al. Toward a molecular understanding of the antibacterial mechanism of copper-bearing titanium alloys against staphylococcus aureus[J]. Adv Healthc Mater, 2016,5(5):557-566. doi: 10.1002/adhm.201500712.
pmid: 26692564
[3] Shi A, Zhu C, Fu S, et al. What controls the antibacterial activity of Ti-Ag alloy, Ag ion or Ti2 Ag particles?[J]. Mater Sci Eng C Mater Biol Appl, 2020,109:110548. doi: 10.1016/j.msec.2019. 110548.
doi: 10.1016/j.msec.2019.110548 pmid: 32228943
[4] Tran MQ, Nakata K, Serpone N, et al. Microwave-/UV-assisted enhancement of the wettability of photoactive TiO2 substrates coated on an inactive Ti/i-TiO2 base[J]. Journal Oleo Sci, 2019,68(10):967-975. doi: 10.5650/jos.ess19115.
doi: 10.5650/jos.ess19115
[5] Wang X, Liu L, Zhou X, et al. Casein phosphopeptide combined with fluoride enhances the inhibitory effect on initial adhesion of Streptococcus mutans to the saliva-coated hydroxyapatite disc[J]. BMC Oral Health, 2020,20(1):169. doi: 10.1186/s12903-020-01158-8.
doi: 10.1186/s12903-020-01158-8 pmid: 32532263
[6] Liu BY, Liu J, Zhang D, et al. Effect of silver diammine fluoride on micro-ecology of plaque from extensive caries of deciduous teeth--in vitro study[J]. BMC Oral Health, 2020,20(1):1-18. doi: 10.1186/s12903-020-01141-3.
doi: 10.1186/s12903-019-0991-2 pmid: 31892323
[7] Del Curto B, Brunella MF, Giordano C, et al. Decreased bacterial adhesion to surface-treated titanium[J]. Int J Artif Organs, 2005,28(7):718-730. doi: 10.1177/039139880502800711.
doi: 10.1177/039139880502800711 pmid: 16049906
[8] Wang Z, Deng X, Ding J, et al. Mechanisms of drug release in pH-sensitive micelles for tumour targeted drug delivery system: a review[J]. Int J Pharm, 2018,535(1-2).doi: 10.1016/j.ijpharm.2017. 11.003.
pmid: 29129572
[9] Lan SF, Kehinde T, Zhang X, et al. Controlled release of metronidazole from composite poly-ε-caprolactone/alginate (PCL/alginate) rings for dental implants[J]. Dent Mater. 2013,29(6):656-665.doi: 10.1016/
doi: 10.1016/
[10] Kido R, Hiroshima Y, Kido J, et al. Advanced glycation end-products increase lipocalin 2 expression in human oral epithelial cells[J]. J Periodont Res, 2020,55(4):539-550. doi: 10.1111/jre.12741.
doi: 10.1111/jre.v55.4
[11] Venugopal A, Muthuchamy N, Tejani H, et al. Incorporation of silver nanoparticles on the surface of orthodontic microimplants to achieve antimicrobial properties[J]. Korean J Orthod, 2017,47(1):3-10. doi: 10.4041/kjod.2017.47.1.3.
doi: 10.4041/kjod.2017.47.1.3 pmid: 28127534
[12] Aranya AK, Pushalkar S, Zhao M, et al. Antibacterial and bioactive coatings on titanium implant surfaces[J]. J Biomed Mater Res A, 2017,105(8):2218-2227. doi: 10.1002/jbm.a.36081.
doi: 10.1002/jbm.a.36081 pmid: 28380669
[13] Zhang XM, Li Y, Gu YX, et al. Ta-coated titanium surface with superior bacteriostasis and osseointegration[J]. Int J Nanomedicine, 2019,14:8693-8706. doi: 10.2147/IJN.S218640.
pmid: 31806965
[14] 王强, 季洋, 徐大可. 医用金属材料腐蚀疲劳性能研究进展[J]. 表面技术, 2019,48(7):193-199, 210. doi: 10.16490/j.cnki.issn.1001-3660.2019.07.021.
Wang Q, Ji Y, Xu DK. Research progress on the corrosion fatigue of biomedical metallic alloys[J]. Surf Technol, 2019,48(7):193-199, 210. doi: 10.16490/j.cnki.issn.1001-3660.2019.07.021.
[15] Wang X, Dong OH, Liu J, et al. In vivo antibacterial property of Ti-Cu sintered alloy implant[J]. Mater Sci Eng C Mater Biol Appl, 2019,100:38-47. doi: 10.1016/j.msec.2019.02.084.
pmid: 30948074
[16] Zhang E, Wang X, Chen M, et al. Effect of the existing form of Cu element on the mechanical properties, bio-corrosion and antibacterial properties of Ti-Cu alloys for biomedical application[J]. Mater Sci Eng C Mater Biol Appl, 2016,69:1210-1221. doi: 10.1016/j.msec.2016.08.033.
doi: 10.1016/j.msec.2016.08.033 pmid: 27612819
[17] Morita Y, Imai S, Hanyuda A, et al. Effect of silver ion coating of fixed orthodontic retainers on the growth of oral pathogenic bacteria[J]. Dent Mater J, 2014,33(2):268-274. doi: 10.4012/dmj.2013-216.
doi: 10.4012/dmj.2013-216
[18] Mhaske AR, Shetty PC, Bhat NS, et al. Antiadherent and antibacterial properties of stainless steel and NiTi orthodontic wires coated with silver against Lactobacillus acidophilus--an in vitro study[J]. Prog Orthod, 2015,16:40. doi: 10.1186/s40510-015-0110-0.
pmid: 26576557
[19] Venkatesan K, Kailasam V, Padmanabhan S. Evaluation of titanium dioxide coating on surface roughness of nickel-titanium archwires and its influence on Streptococcus mutans adhesion and enamel mineralization: a prospective clinical study[J]. Am J Orthod Dentofacial Orthop, 2020,158(2):199-208. doi: 10.1016/j.ajodo.2019.07.019.
doi: 10.1016/j.ajodo.2019.07.019 pmid: 32576426
[20] Yoshinari M, Oda Y, Kato T, et al. Influence of surface modifications to titanium on antibacterial activity in vitro[J]. Biomaterials, 2001,22(14):2043-2048. doi: 10.1016/S0142-9612(00)00392-6.
pmid: 11426884
[21] Li HF, Qiu KJ, Zhou FY, et al. Design and development of novel antibacterial Ti-Ni-Cu shape memory alloys for biomedical application[J]. Sci Rep, 2016,6(1):37475. doi: 10.1038/srep37475.
doi: 10.1038/srep37475
[22] Zheng YF, Zhang BB, Wang BL, et al. Introduction of antibacterial function into biomedical TiNi shape memory alloy by the addition of element Ag[J]. Acta Biomater, 2011,7(6):2758-2767. doi: 10.1016/j.actbio.2011.02.010.
doi: 10.1016/j.actbio.2011.02.010 pmid: 21316493
[23] Li B, Xia X, Guo M, et al. Biological and antibacterial properties of the micro-nanostructured hyd- roxyapatite/chitosan coating on titanium[J]. Sci Rep, 2019,9(1):140-152. doi: 10.1038/s41598-019-49941-0.
doi: 10.1038/s41598-018-36594-8
[24] Li Q, Li L, Zhao M, et al. Biological actions of Cu/Zn coimplanted TiN on Ti-6Al-4V alloy[J]. Biointerphases, 2019,14(5):051008. doi: 10.1116/1.5116640.
doi: 10.1116/1.5116640 pmid: 31615215
[25] Liu R, Tang Y, Zeng L, et al. In vitro and in vivo studies of anti-bacterial copper-bearing titanium alloy for dental application[J]. Dent Mater, 2018,34(8):1112-1126. doi: 10.1016/
pmid: 29709241
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[4] CHEN Xi, SUN Qin-zhou. The study of colorimetric board of porcelain fused to metal restoration for moderate to severe dental fluorosis[J]. journal1, 2016, 24(1): 33 -36 .
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[7] LIU Fang. Clinical assessment of two fissure sealant techniques in children’s dental caries prevention[J]. journal1, 2016, 24(1): 44 -45 .
[8] . [J]. journal1, 2016, 24(1): 49 -52 .
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