Efficacy of electrical stimulation for antimicrobial capacity of titanium materials implants: A systematic review and meta-analysis

Background

Antimicrobial resistance undermines the effectiveness of drugs for treating implant-associated infections. Consequently, there is growing interest in identifying alternative methods to prevent and eliminate infections. The aim of this systematic review was to ascertain whether the electrical stimulation of titanium implants or titanium-based implant materials has antimicrobial properties against bacterial biofilms. The search was conducted in various databases, including PubMed/Medline, Web of Science, EMBASE, SCOPUS, and Google Scholar, in February 2024. In addition, a manual search of the reference lists of the included articles was conducted. The eligibility criteria included in vivo and in vitro studies evaluating the effects of electrical stimulation on titanium implants or titanium-based implant materials in reducing biofilm formation or adhesion as well as eradicating or reducing the viability of bacterial biofilms. The variability between studies was determined using the inverse variance method with random- and fixed-effects models. Heterogeneity was assessed using the I2 and prediction interval statistics. Publication bias was qualitatively evaluated using funnel plots.

Highlights

Different electrical stimulation (ES) parameters (current and voltage) exhibited antibacterial activity, resulting in either bacteriostatic or bactericidal effects.

Conclusions

ES in titanium or titanium-based implant materials confers antimicrobial capacity against bacterial biofilms, and its effectiveness depends on the applied tension. The association between ES and antimicrobials was more robust than with ES administered individually.