Electrical potential approaches to inhibit biofilm adhesion on titanium implants

The main aim of this study was to perform a scoping review on the titanium electric stimuli approach to inhibit biofilm accumulation. An electronic search was conducted using key terms related to the incorporation of metal particles on the titanium surface for antibacterial purposes. The search identified 163 studies, of which 37 were considered relevant to this study. Previous studies reported the Ag-based modification of titanium surfaces to inhibit the bacterial adhesion considering that the Ag element has been used as an antimicrobial agent. Other metals such as Au, Zn, Cu, or Mg have been incorporated to titanium implant surfaces for antibiofilm proposal. Those metals are entrapped on the titanium surface and can speed up the exchanging of electrons within an increased electrical current flow. Reactive oxygen species or electron-depleted regions can arise from those interactions and disturb the normal regulation of bacterial functions. The proposed surface modifications showed some degree of antibacterial effect on Gram-positive and Gram-negative bacteria although further studies are required to access a potential cytotoxicity of the metal debris and ions.