Next Article in Journal
The Current State of 3D-Printed Prostheses Clinical Outcomes: A Systematic Review
Next Article in Special Issue
Influence of Different Biomaterials Extracted from Autologous Blood on the Cell Migration of Stem Cells from Dental Pulp
Previous Article in Journal
Polyethyleneimine-Assisted Fabrication of Poly(Lactic-Co-Glycolic Acid) Nanoparticles Loaded with Tamibarotene (Am80) for Meflin Expression Upregulation
Previous Article in Special Issue
Comparative Evaluation of Shear Bond Strength Between Monolithic Zirconia and Three Different Core Build-Up Materials
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JFB
Volume 16
Issue 10
10.3390/jfb16100369
jfb-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Systematic Review

Effects of Implant Silver Coatings on Bone Formation in Animal Models: A Systematic Review and Meta-Analysis

by
Ali Alenezi
Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Buraydah 51452, Saudi Arabia
J. Funct. Biomater. 2025, 16(10), 369; https://doi.org/10.3390/jfb16100369
Submission received: 1 September 2025 / Revised: 28 September 2025 / Accepted: 29 September 2025 / Published: 1 October 2025
(This article belongs to the Special Issue Biomaterials Applied in Dental Sciences)
Browse Figures
Versions Notes

Abstract

Background/Objective: Clinical statistics show that bacterial infection is a major driver of implant failure. To enhance antibacterial performance, some metallic elements, such as silver (Ag), zinc (Zn), and copper (Cu), are commonly used to modify the titanium surface. Despite the promising antibacterial performance of Ag, concerns persist regarding dose-dependent cytotoxicity, systemic accumulation, and potential effects on local bone metabolism. This review aimed to investigate the effects of incorporating or coating titanium (Ti) implant surfaces with Ag on bone formation around implants. Methods: A search was undertaken using three main databases (PubMed, Web of Science, and Scopus). The search was limited to studies published within the last 20 years that involved animal experiments using endosseous implants coated with or incorporating Ag. Meta-analyses were performed for bone-to-implant contact (BIC), bone formation (BA), and bone volume (BV/TV) around the implant in control and test groups. The compared groups were subjected to similar implant surface treatments aside from the presence of silver in the test group. Results: Sixteen studies met the inclusion criteria in this study and were included. The analysis of BIC values revealed a statistically significant overall effect in favor of silver-coated implants (Z = 2.01, p = 0.04), along with 95% confidence intervals (CIs). The BA analysis found no significant difference between silver-coated and control implants (Z = 1.09, p = 0.28). The BV/TV analysis also showed no statistically significant overall difference (Z = 0.35, p = 0.73). Conclusions: In animal models, silver-coated Ti implants improve bone–implant contact without altering peri-implant bone volume metrics.

1. Introduction

Titanium (Ti) and its alloys are regularly used in implantable medical and dental devices because of their favorable biocompatibility, mechanical strength, and corrosion resistance [1,2]. Ti implants now represent the preferred modality for the restoration of edentulous spaces in dental practice [3,4]. Osseointegration around titanium (Ti) implants is a coordinated cascade of immune, angiogenic, and osteogenic events shaped by surgical protocol, implant surface chemistry/topography, primary stability, functional loading, and host factors [5,6]. However, unlike many other surgical procedures performed under strict aseptic conditions, dFental implants are immediately exposed to the complex oral environment, which is home to diverse microorganisms [7,8].
Peri-implant infections are among the most significant complications related to dental implants, which involve inflammation of peri-implant tissues and continuing marginal bone loss [3,9]. These problems are more pronounced in individuals whose bone healing is compromised by diabetes, older age, or osteoporosis [10,11]. Numerous studies have demonstrated a strong association between peri-implant infections and implant failure, with microbial biofilms playing a pivotal role in disease initiation and progression [6,10]. Once an implant-related infection is established, treatment often requires surgical debridement, implant removal, prolonged antibiotic therapy and, eventually, revision surgery, which imposes substantial clinical and financial burdens on both patients and healthcare systems [10,12].
To reduce such risks, several studies have focused on modifying implant surfaces to enhance osseointegration while minimizing bacterial colonization [13,14]. Nanoscale or microscale roughness could improve the adhesion and proliferation of osteoblasts, accelerating bone healing [13,15]. However, rougher surfaces at exposed regions can also promote bacterial attachment, potentially increasing the risk of infection [16,17]. Coating Ti implants with antimicrobial agents is one strategy to address this issue. Such coatings aim to provide an initial antibacterial effect during the early healing phase, when infection risk is highest, while maintaining compatibility with host tissues [18].
Silver (Ag) is one of the most extensively investigated antimicrobial agents for implant coatings [19,20]. It is active against a wide spectrum of pathogens, including many multidrug-resistant isolates, and its bactericidal properties have been attributed to multiple mechanisms: bacterial membrane disruption, reactive oxygen species generation, and inhibition of essential enzymatic systems [21,22]. Silver nanoparticles (Ag NPs) have enhanced antimicrobial activity compared with bulk Ag, mainly due to their large specific surface area and continuous release of Ag+ ions [20,23].
In vitro and in vivo reports have revealed the ability of Ag-coated Ti surfaces to reduce bacterial adhesion and biofilm formation without significantly impairing osteoblast function when used at controlled concentrations [24,25]. For example, Ti implants modified with Ag NPs have shown significant antibacterial effects against Staphylococcus aureus while maintaining favorable cell viability and alkaline phosphatase activity in osteoblast cultures [26]. Preclinical models have also reported reduced peri-implant infection with Ag-coated Ti implants and bone–implant contact ratios comparable to those of uncoated controls [27,28].
Several methods have been investigated to incorporate Ag into Ti implant surfaces, including plasma-immersion ion implantation, electrochemical deposition, and sol–gel techniques. Each method influences the release kinetics of Ag ions, which is critical for balancing antimicrobial efficacy with cytocompatibility [29,30]. Controlled, low-level Ag release is particularly desirable to minimize cytotoxic effects on host cells, as high local concentrations can impair osteoblast proliferation and differentiation [31,32].
The clinical use of Ag-coated Ti implants in orthopedic applications is more established, with Ag-coated prostheses having been successfully used in tumor surgery to prevent deep infections [33,34]. In dentistry, however, the clinical data remain limited. Early-stage studies have suggested that Ag coatings can reduce early colonization by pathogenic bacteria, but the long-term effects on bone remodeling and implant survival remain unclear [35]. Despite the promising antibacterial performance of Ag, concerns persist regarding its potential cytotoxicity, systemic accumulation, and the possibility of altering local bone metabolism. Some studies have reported delayed bone healing or reduced bone–implant contact at higher Ag concentrations, highlighting the need for precise control over release profiles [36,37]. The cytotoxicity of AgNPs is dose- and time-dependent [38]; however, at appropriately low concentrations, AgNPs can enhance cell proliferation and activity [39].
Given these considerations, this review investigated the effects of incorporating or coating Ti implant surfaces with Ag on bone formation around implants and whether antibacterial benefits can be achieved without compromising osseointegration.

2. Materials and Methods

2.1. PICO Question

This review was performed in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, INPLASY registration number: INPLASY202590035) [40]. Before initiating the systematic literature search, the PICO framework was defined as follows: the Population (p) was defined as animal models; the Intervention (I) was Ti implants modified or coated with silver; the Control (C) was defined as Ti implants without silver modifications or coatings; and the Outcome (O) was bone formation.

2.2. Search Strategies

The literature search was undertaken in May 2025 using three main databases: PubMed, Web of Science, and Scopus. Only studies published within the last 20 years were considered. The search strategies in all the databases included terms related to four primary aspects: bone, implant, silver, and animal studies. The search terms used for the electronic search were (“bone formation” OR “osseointegration” OR “bone growth” OR “bone development” OR “bone remodeling” OR “bone regeneration”) AND (“implants” OR “titanium implants” OR “dental implants” OR “biocompatible coated materials” OR “endosseous dental implantation” OR “bone-implant interface”) AND (“antibacterial” OR “antimicrobial” OR “infection” OR “failure” OR “Coatings” OR “silver” OR “silver nanoparticles” OR “silver coating” OR “Ag”) AND (“in vivo” OR “animals” OR “animal models” OR “animal experimentation”).

2.3. Inclusion and Exclusion Criteria

The eligibility criteria were (1) studies conducted on animals that evaluated the use of silver coatings with endosseous implants. (2) The silver should be incorporated into the substrate or applied as a surface coating for these implants, either prior to or at the time of insertion. (3) Measurements of bone–implant contact (BIC), bone area (BA), or bone volume (BV/TV) should be reported for the control and test groups. (4) The compared groups should have received similar implant surface treatments aside from the presence of silver in the test group. (5) Only articles published in English were included. Clinical studies or in vitro investigations were excluded. Studies that did not report BIC, BA, or BV/TV values and the number of implants used in the evaluated groups were excluded.

2.4. Study Selection

All studies identified in the initial search were screened for eligibility according to the prespecified inclusion criteria. Full-text retrieval was performed for studies that fulfilled these criteria and those whose titles/abstracts lacked sufficient detail to determine their eligibility.

2.5. Data Extraction

When available, the following variables were collected via a standardized extraction form: study title, publication year, coating method, form of silver, animal species, number of animals and implants, duration between implant placement and animal euthanasia, as well as the mean values and standard deviations for BIC, BA, and BV/TV percentages around the implants.

2.6. Quality Assessment

The methodological quality was evaluated using the ARRIVE 2.0 (Animal Research: Reporting of In Vivo Experiments) guidelines [41]. Each of the 21 items was categorized as follows: “reported” (two points) if all subitems were fully addressed, “not reported” (no points) if none were addressed, and “unclear” (one point) if some details were missing. Based on these scores, the quality coefficient was calculated for each study, which was categorized as follows: Poor (<0.5), Average (0.5–0.8), or Excellent (0.8–1).

2.7. Risk of Bias in Individual Studies

The risk of bias was estimated using the SYRCLE (Systematic Review Centre for Laboratory Animal Experimentation) RoB tool [42].

2.8. Data Analysis

The continuous outcomes assessed were BIC, BA, and BV/TV. The weighted mean differences were used to generate forest plots, with the number of implants in each group serving as the statistical unit. Records with insufficiently reported outcomes of interest were excluded from the analysis. Heterogeneity between the studies was quantified using the I2 statistic, which represents the percentage of total variation due to heterogeneity. When statistical heterogeneity reached significance (p < 0.05), a random-effects (inverse-variance) model was used; if not, a fixed-effect model was used. Intervention effects are reported as mean differences (MDs) in percentage, along with 95% confidence intervals (CIs). The meta-analysis was completed using the Review Manager software (version 5.3.3, The Nordic Cochrane Centre, The Cochrane Collaboration).

3. Results

3.1. Literature Search

Figure 1 shows an overview of the study selection process. Following database searching, screening of titles and abstracts, and removal of duplicates, the full-text articles were evaluated for eligibility. In total, 16 animal studies met the eligibility criteria and were included in both the qualitative and quantitative syntheses [28,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57]. PRISMA checklist is shown in Supplementary Materials (Table S1).
The study characteristics of the included articles are shown in Table 1. The investigations were conducted in a range of animal models including Wistar rats, New Zealand White rabbits, Sprague–Dawley rats, Labrador dogs, beagle dogs, pigs, and Merino sheep. A variety of silver modification strategies were reported, including nanotubular structures, plasma immersion ion implantation (PIII), electrodeposition, atomic layer deposition, wet chemical plating, magnetron sputtering, and hybrid coatings. Silver was delivered in several forms, such as nanoparticles, ions, nanolayers, and silver oxide. The outcome assessment methods predominantly employed micro-computed tomography (micro-CT) and histomorphometric analysis.

3.2. Quality Assessment

Quality was assessed using the ARRIVE 2.0 guidelines and the results are presented in Figure 2 and Table 2. The calculated coefficients ranged between 0.71 and 0.93. Eight studies achieved a rating of Excellent [28,44,45,48,50,52,53,56], while the remaining eight were graded as Average. No study was categorized as Poor.

3.3. Risk of Bias

The assessment of the risk of bias based on the SYRCLE guide is displayed in Figure 3. In most studies, the risk of bias was judged to be unclear for both allocation concealment and outcome assessor blinding. Domains related to random sequence generation and selective outcome reporting showed lower levels of concern. Overall, variability in methodological care was observed among the included studies.

3.4. Meta-Analysis of Bone Formation Outcomes

3.4.1. BIC

The pooled analysis of BIC values (Figure 4) revealed a statistically significant overall effect in favor of silver-coated implants (Z = 2.01, p = 0.04). Substantial heterogeneity was observed (Tau2 = 190.60; Chi2 = 555.54, df = 16 (p < 0.001); I2 = 96%).

3.4.2. BA

The pooled analysis of BA (Figure 5) demonstrated no significant difference between silver-coated and control implants (Z = 1.09, p = 0.28). Considerable heterogeneity was observed (Tau2 = 394.55; Chi2 = 3583.07, df = 22 (p < 0.001); I2 = 99%).

3.4.3. BV/TV

The analysis of BV/TV (Figure 6) also showed no statistically significant overall difference (Z = 0.35, p = 0.73). High heterogeneity was detected across studies (Tau2 = 112.23; Chi2 = 2432.44, df = 23 (p < 0.001); I2 = 98%).

4. Discussion

This review evaluated the effect of Ag-coated Ti implants on bone formation around implant in animal models. Sixteen studies were included, and the pooled findings revealed that Ag coatings significantly improved BIC, while no significant differences were found for BA or BV/TV. These results indicate that Ag modifications may facilitate bone integration but do not consistently enhance overall peri-implant bone remodeling.
The integration of Ag into dental implant surfaces has been primarily driven by its antimicrobial potential, as peri-implant infections are among the most prevalent reasons for implant loss. Peri-implantitis is initiated by bacterial colonization and biofilm formation on implant surfaces, leading to a cascade of host immune responses, chronic inflammation, and progressive marginal bone loss [58,59]. Therefore, antibacterial surface modifications are being increasingly explored to prevent early microbial colonization and reduce the incidence of biological complications. Among these modifications, Ag has emerged as a particularly attractive candidate because of its broad-spectrum antibacterial ability and relatively low tendency to develop resistance [19,60].
At the molecular level, Ag ions exert bactericidal effects by binding to bacterial cell membranes, increasing membrane permeability, denaturing enzymes, and interfering with DNA replication [61]. Nanosilver particles also generate reactive oxygen species, further enhancing their antimicrobial efficacy. This potent antibacterial activity has been observed both in vitro and in vivo, with Ag-coated implants showing significantly reduced bacterial adhesion compared with unmodified Ti implants [35,62]. In the orthopedic field, clinical studies have confirmed reduced infection rates with Ag-coated prostheses [63,64] while dental research has focused on whether similar benefits can be achieved in oral implantology. Beyond antibacterial effects, Ti surfaces modified with Ag can promote early macrophage polarization from a pro-inflammatory M1 state to a pro-healing M2 phenotype, thereby moderating inflammation and supporting osteogenesis [54]. In parallel, sustained Ag release is associated with pro-angiogenic signaling, enhanced endothelial tube formation, and an increased microvessel density, collectively strengthening the angiogenesis–osteogenesis coupling required for durable osseointegration [24].
The significant improvement in BIC found in this review suggests that Ag coatings may support early osseointegration, either directly by enhancing osteoblast behavior or indirectly by suppressing bacterial competition at the interface (Figure 4). Several in vivo studies have confirmed this effect. For instance, Cheng et al. [49] demonstrated that Ag NP-modified nanotubular implants promoted greater BIC in rat models, while Xie et al. [52] observed improved osseointegration with Ag–hydroxyapatite hybrid coatings. At the cellular level, Ag has been reported to stimulate osteoblast adhesion and proliferation at low concentrations [35,65]. Furthermore, recent evidence has suggested that Ag coatings may also influence immune modulation, promoting a favorable M2 macrophage phenotype that enhances osteogenesis and angiogenesis [30,66]. This dual antibacterial–immunomodulatory function may explain why Ag coatings improved BIC across diverse experimental conditions.
In contrast, no significant differences were observed in BA or BV/TV, which is a volumetric indicator of peri-implant bone formation (Figure 4 and Figure 5). This discrepancy between interfacial contact and bone volume suggests that the effect of Ag may be localized to the implant–bone interface rather than extending to overall bone remodeling. Several factors may account for this variability. First, the dose-dependent effects of Ag are critical: while low concentrations are osteoconductive, higher concentrations may impair osteoblast proliferation, collagen synthesis, and matrix mineralization [31,38]. Zhao et al. [35] demonstrated that excessive nanosilver exposure reduced osteoblast activity, while Greulich et al. [67] showed cytotoxicity to bone marrow stromal cells at elevated Ag doses. Second, discrepancies in coating techniques (e.g., plasma immersion ion implantation, electrodeposition, magnetron sputtering, and atomic layer deposition) lead to differences in Ag release profiles, which strongly influence biological outcomes [35,50]. Third, most studies used short- or medium-term follow-up, which may not capture the long-term remodeling processes critical for implant survival.
These findings position Ag coatings as dual-function surfaces in implant dentistry: their primary role remains antibacterial, protecting against peri-implant infections, while also appearing to maintain or even enhance interfacial bone contact. More importantly, none of the included studies in this review reported detrimental effects on bone formation, addressing the concerns about the potential cytotoxicity of Ag. This is reassuring for clinical translation, as infection control and bone preservation are interdependent requirements for long-term implant success. Notably, peri-implantitis and marginal bone loss often coexist, particularly in patients at high risk such as those with diabetes, poor oral hygiene, or osteoporosis [10,11,68]. For these populations, Ag-coated implants could offer a valuable adjunctive strategy to reduce complications.
When comparing Ag with other antimicrobial coatings, such as zinc, copper, or chitosan, the evidence suggests that while they all provide antibacterial activity, Ag remains the most extensively studied and exhibits one of the broadest spectrum of antimicrobial efficacy [35,66]. However, other materials may provide additional osteogenic benefits [69]. Zinc (Zn) coatings on titanium implants exhibit favorable bactericidal effects attributable to Zn incorporation [70], and in vivo studies suggest bacteria show limited resistance to Zn2+ [71]. Zn has also been associated with enhanced osteoblastic activity, supporting its use in bone-related applications [72,73]. Copper (Cu) can provide broad-spectrum antimicrobial activity [74]. Furthermore, Cu can be integrated into implant alloys such as Ti-6Al-4V to strengthen antibacterial performance and to enhance angiogenesis [75,76]. However, unlike Ag, elevated Copper ions (Cu2+) release has been linked to cytotoxicity, which necessitate careful control of release kinetics and coating thickness [35,77]. Comparative research is needed to determine whether Ag provides superior clinical benefits or whether combinations of antimicrobial and osteoinductive coatings may represent the optimal approach.
The limitations of the available evidence must be acknowledged. Large discrepancies were observed in all the pooled outcomes, reflecting the differences in animal species, sample sizes, healing times, and methodological approaches (Table 1). The risk of bias was often unclear due to inadequate reporting of allocation concealment and blinding (Figure 3). Moreover, peri-implantitis and marginal bone loss are long-term complications, but the included studies largely reported short-term results (≤6 months). Thus, it remains uncertain whether the antibacterial advantages of Ag coatings translate into sustained improvements in peri-implant bone stability and implant survival.
Future research should prioritize long-term preclinical studies using standardized protocols and large animal models to better approximate clinical conditions. Optimization of Ag concentration, particle size, and release kinetics is necessary to balance antibacterial efficacy with cytocompatibility. Moreover, comparative clinical trials are needed to assess Ag’s effectiveness relative to other antibacterial coatings and to confirm whether the observed improvements in BIC can be translated into reduced risks of peri-implant disease and bone loss in patients.

5. Conclusions

This review demonstrated that Ag-coated Ti implants are associated with a significant improvement in BIC, whereas no consistent effects were observed for BA or BV/TV. These findings suggest that Ag coatings, while primarily applied for their antibacterial properties, may also support interfacial bone healing without compromising peri-implant bone formation. Further preclinical and clinical investigations are warranted to clarify the dose–response relationship, optimize coating strategies, and determine whether the antibacterial advantages of Ag coatings translate into improved peri-implant bone preservation and implant survival in dental practice.

Supplementary Materials

The following supporting information can be downloaded at https://www.mdpi.com/article/10.3390/jfb16100369/s1, Table S1: PRISMA checklist. Reference [78] is cited in the Supplementary Materials.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

No new data were created or analyzed in this study. Data sharing is not applicable to this article.

Acknowledgments

The researcher would like to thank the Deanship of Graduate Studies and Scientific Research at Qassim University for providing financial support (QU-APC-2025).

Conflicts of Interest

The author declares no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
BICbone–implant contact
BAbone area
BV/TVbone volume

References

  1. Quinn, J.; McFadden, R.; Chan, C.W.; Carson, L. Titanium for Orthopedic Applications: An Overview of Surface Modification to Improve Biocompatibility and Prevent Bacterial Biofilm Formation. iScience 2020, 23, 101745. [Google Scholar] [CrossRef]
  2. Marin, E.; Lanzutti, A. Biomedical Applications of Titanium Alloys: A Comprehensive Review. Materials 2023, 17, 114. [Google Scholar] [CrossRef]
  3. Busenlechner, D.; Fürhauser, R.; Haas, R.; Watzek, G.; Mailath, G.; Pommer, B. Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis. J. Periodontal Implant. Sci. 2014, 44, 102–108. [Google Scholar] [CrossRef] [PubMed]
  4. Moraschini, V.; Poubel, L.A.; Ferreira, V.F.; Barboza Edos, S. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: A systematic review. Int. J. Oral Maxillofac. Surg. 2015, 44, 377–388. [Google Scholar] [CrossRef] [PubMed]
  5. Esposito, M.; Grusovin, M.G.; Maghaireh, H.; Worthington, H.V. Interventions for replacing missing teeth: Different times for loading dental implants. Cochrane Database Syst. Rev. 2013, 2013, Cd003878. [Google Scholar] [CrossRef] [PubMed]
  6. Renvert, S.; Quirynen, M. Risk indicators for peri-implantitis. A narrative review. Clin. Oral Implants Res. 2015, 26 (Suppl. 11), 15–44. [Google Scholar] [CrossRef]
  7. Dewhirst, F.E.; Chen, T.; Izard, J.; Paster, B.J.; Tanner, A.C.; Yu, W.H.; Lakshmanan, A.; Wade, W.G. The human oral microbiome. J. Bacteriol. 2010, 192, 5002–5017. [Google Scholar] [CrossRef]
  8. Kilian, M.; Chapple, I.L.; Hannig, M.; Marsh, P.D.; Meuric, V.; Pedersen, A.M.; Tonetti, M.S.; Wade, W.G.; Zaura, E. The oral microbiome—An update for oral healthcare professionals. Br. Dent. J. 2016, 221, 657–666. [Google Scholar] [CrossRef]
  9. Lindhe, J.; Meyle, J. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J. Clin. Periodontol. 2008, 35, 282–285. [Google Scholar] [CrossRef]
  10. Schwarz, F.; Derks, J.; Monje, A.; Wang, H.L. Peri-implantitis. J. Clin. Periodontol. 2018, 45 (Suppl. 20), S246–S266. [Google Scholar] [CrossRef]
  11. Derks, J.; Tomasi, C. Peri-implant health and disease. A systematic review of current epidemiology. J. Clin. Periodontol. 2015, 42 (Suppl. 16), S158–S171. [Google Scholar] [CrossRef]
  12. Carcuac, O.; Derks, J.; Abrahamsson, I.; Wennström, J.L.; Petzold, M.; Berglundh, T. Surgical treatment of peri-implantitis: 3-year results from a randomized controlled clinical trial. J. Clin. Periodontol. 2017, 44, 1294–1303. [Google Scholar] [CrossRef]
  13. Albrektsson, T.; Wennerberg, A. On osseointegration in relation to implant surfaces. Clin. Implant. Dent. Relat. Res. 2019, 21, 4–7. [Google Scholar] [CrossRef] [PubMed]
  14. Teulé-Trull, M.; Altuna, P.; Arregui, M.; Rodriguez-Ciurana, X.; Aparicio, C. Antibacterial coatings for dental implants: A systematic review. Dent. Mater. 2025, 41, 229–247. [Google Scholar] [CrossRef] [PubMed]
  15. Alenezi, A.; Naito, Y.; Andersson, M.; Chrcanovic, B.R.; Wennerberg, A.; Jimbo, R. Characteristics of 2 Different Commercially Available Implants with or without Nanotopography. Int. J. Dent. 2013, 2013, 769768. [Google Scholar] [CrossRef] [PubMed]
  16. Teughels, W.; Van Assche, N.; Sliepen, I.; Quirynen, M. Effect of material characteristics and/or surface topography on biofilm development. Clin. Oral Implants Res. 2006, 17 (Suppl. 2), 68–81. [Google Scholar] [CrossRef]
  17. Subramani, K.; Jung, R.E.; Molenberg, A.; Hammerle, C.H. Biofilm on dental implants: A review of the literature. Int. J. Oral Maxillofac. Implants 2009, 24, 616–626. [Google Scholar]
  18. Akshaya, S.; Rowlo, P.K.; Dukle, A.; Nathanael, A.J. Antibacterial Coatings for Titanium Implants: Recent Trends and Future Perspectives. Antibiotics 2022, 11, 1719. [Google Scholar] [CrossRef]
  19. Morones, J.R.; Elechiguerra, J.L.; Camacho, A.; Holt, K.; Kouri, J.B.; Ramírez, J.T.; Yacaman, M.J. The bactericidal effect of silver nanoparticles. Nanotechnology 2005, 16, 2346–2353. [Google Scholar] [CrossRef]
  20. Franci, G.; Falanga, A.; Galdiero, S.; Palomba, L.; Rai, M.; Morelli, G.; Galdiero, M. Silver nanoparticles as potential antibacterial agents. Molecules 2015, 20, 8856–8874. [Google Scholar] [CrossRef]
  21. Lok, C.N.; Ho, C.M.; Chen, R.; He, Q.Y.; Yu, W.Y.; Sun, H.; Tam, P.K.; Chiu, J.F.; Che, C.M. Proteomic analysis of the mode of antibacterial action of silver nanoparticles. J. Proteome Res. 2006, 5, 916–924. [Google Scholar] [CrossRef] [PubMed]
  22. Haugen, H.J.; Makhtari, S.; Ahmadi, S.; Hussain, B. The Antibacterial and Cytotoxic Effects of Silver Nanoparticles Coated Titanium Implants: A Narrative Review. Materials 2022, 15, 25. [Google Scholar] [CrossRef] [PubMed]
  23. Burdușel, A.C.; Gherasim, O.; Grumezescu, A.M.; Mogoantă, L.; Ficai, A.; Andronescu, E. Biomedical Applications of Silver Nanoparticles: An Up-to-Date Overview. Nanomaterials 2018, 8, 681. [Google Scholar] [CrossRef] [PubMed]
  24. Zhao, L.; Wang, H.; Huo, K.; Cui, L.; Zhang, W.; Ni, H.; Zhang, Y.; Wu, Z.; Chu, P.K. Antibacterial nano-structured titania coating incorporated with silver nanoparticles. Biomaterials 2011, 32, 5706–5716. [Google Scholar] [CrossRef]
  25. Choi, S.; Jo, Y.H.; Han, J.S.; Yoon, H.I.; Lee, J.H.; Yeo, I.L. Antibacterial activity and biocompatibility of silver coating via aerosol deposition on titanium and zirconia surfaces. Int. J. Implant Dent. 2023, 9, 24. [Google Scholar] [CrossRef]
  26. Xu, L.; Pei, H.; Qian, Q.; Shi, X.; Bang, L.T.; Li, B.; Wang, Y. Fabrication of silver-containing antibacterial coating on titanium by alkaline-heat treatment and hydrothermal sterilization. J. Mater. Res. Technol. 2024, 33, 5863–5873. [Google Scholar] [CrossRef]
  27. Sycińska-Dziarnowska, M.; Ziąbka, M.; Cholewa-Kowalska, K.; Klesiewicz, K.; Spagnuolo, G.; Lindauer, S.J.; Park, H.S.; Woźniak, K. Antibacterial and Antibiofilm Activity of Layers Enriched with Silver Nanoparticles on Orthodontic Microimplants. J. Funct. Biomater. 2025, 16, 78. [Google Scholar] [CrossRef]
  28. Nakashima, T.; Morimoto, T.; Hashimoto, A.; Kii, S.; Tsukamoto, M.; Miyamoto, H.; Todo, M.; Sonohata, M.; Mawatari, M. Osteoconductivity and neurotoxicity of silver-containing hydroxyapatite coating cage for spinal interbody fusion in rats. JOR Spine 2023, 6, e1236. [Google Scholar] [CrossRef]
  29. van Hengel, I.A.J.; Tierolf, M.W.A.M.; Fratila-Apachitei, L.E.; Apachitei, I.; Zadpoor, A.A. Antibacterial Titanium Implants Biofunctionalized by Plasma Electrolytic Oxidation with Silver, Zinc, and Copper: A Systematic Review. Int. J. Mol. Sci. 2021, 22, 3800. [Google Scholar] [CrossRef]
  30. Chouirfa, H.; Bouloussa, H.; Migonney, V.; Falentin-Daudré, C. Review of titanium surface modification techniques and coatings for antibacterial applications. Acta Biomater. 2019, 83, 37–54. [Google Scholar] [CrossRef]
  31. Roe, D.; Karandikar, B.; Bonn-Savage, N.; Gibbins, B.; Roullet, J.B. Antimicrobial surface functionalization of plastic catheters by silver nanoparticles. J. Antimicrob. Chemother. 2008, 61, 869–876. [Google Scholar] [CrossRef]
  32. Zhang, T.; Wang, L.; Chen, Q.; Chen, C. Cytotoxic potential of silver nanoparticles. Yonsei Med. J. 2014, 55, 283–291. [Google Scholar] [CrossRef] [PubMed]
  33. Hardes, J.; von Eiff, C.; Streitbuerger, A.; Balke, M.; Budny, T.; Henrichs, M.P.; Hauschild, G.; Ahrens, H. Reduction of periprosthetic infection with silver-coated megaprostheses in patients with bone sarcoma. J. Surg. Oncol. 2010, 101, 389–395. [Google Scholar] [CrossRef] [PubMed]
  34. Shao, H.; Zhang, T.; Gong, Y.; He, Y. Silver-Containing Biomaterials for Biomedical Hard Tissue Implants. Adv. Healthc. Mater. 2023, 12, 2300932. [Google Scholar] [CrossRef] [PubMed]
  35. Zhao, L.; Chu, P.K.; Zhang, Y.; Wu, Z. Antibacterial coatings on titanium implants. J. Biomed. Mater. Res. B Appl. Biomater. 2009, 91, 470–480. [Google Scholar] [CrossRef]
  36. Croes, M.; Bakhshandeh, S.; van Hengel, I.A.J.; Lietaert, K.; van Kessel, K.P.M.; Pouran, B.; van der Wal, B.C.H.; Vogely, H.C.; Van Hecke, W.; Fluit, A.C.; et al. Antibacterial and immunogenic behavior of silver coatings on additively manufactured porous titanium. Acta Biomater. 2018, 81, 315–327. [Google Scholar] [CrossRef]
  37. Lansdown, A.B. A pharmacological and toxicological profile of silver as an antimicrobial agent in medical devices. Adv. Pharmacol. Sci. 2010, 2010, 910686. [Google Scholar] [CrossRef]
  38. Pauksch, L.; Hartmann, S.; Rohnke, M.; Szalay, G.; Alt, V.; Schnettler, R.; Lips, K.S. Biocompatibility of silver nanoparticles and silver ions in primary human mesenchymal stem cells and osteoblasts. Acta Biomater. 2014, 10, 439–449. [Google Scholar] [CrossRef]
  39. Qian, Y.; Zhou, X.; Zhang, F.; Diekwisch, T.G.H.; Luan, X.; Yang, J. Triple PLGA/PCL Scaffold Modification Including Silver Impregnation, Collagen Coating, and Electrospinning Significantly Improve Biocompatibility, Antimicrobial, and Osteogenic Properties for Orofacial Tissue Regeneration. ACS Appl. Mater. Interfaces 2019, 11, 37381–37396. [Google Scholar] [CrossRef]
  40. Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009, 6, e1000097. [Google Scholar] [CrossRef]
  41. Percie du Sert, N.; Ahluwalia, A.; Alam, S.; Avey, M.T.; Baker, M.; Browne, W.J.; Clark, A.; Cuthill, I.C.; Dirnagl, U.; Emerson, M.; et al. Reporting animal research: Explanation and elaboration for the ARRIVE guidelines 2.0. PLoS Biol. 2020, 18, e3000411. [Google Scholar] [CrossRef] [PubMed]
  42. Hooijmans, C.R.; Rovers, M.M.; de Vries, R.B.; Leenaars, M.; Ritskes-Hoitinga, M.; Langendam, M.W. SYRCLE’s risk of bias tool for animal studies. BMC Med. Res. Methodol. 2014, 14, 43. [Google Scholar] [CrossRef]
  43. Cheng, H.; Li, Y.; Huo, K.; Gao, B.; Xiong, W. Long-lasting in vivo and in vitro antibacterial ability of nanostructured titania coating incorporated with silver nanoparticles. J. Biomed. Mater. Res. A 2014, 102, 3488–3499. [Google Scholar] [CrossRef] [PubMed]
  44. Svensson, S.; Suska, F.; Emanuelsson, L.; Palmquist, A.; Norlindh, B.; Trobos, M.; Bäckros, H.; Persson, L.; Rydja, G.; Ohrlander, M.; et al. Osseointegration of titanium with an antimicrobial nanostructured noble metal coating. Nanomedicine 2013, 9, 1048–1056. [Google Scholar] [CrossRef] [PubMed]
  45. Qiao, S.; Cao, H.; Zhao, X.; Lo, H.; Zhuang, L.; Gu, Y.; Shi, J.; Liu, X.; Lai, H. Ag-plasma modification enhances bone apposition around titanium dental implants: An animal study in Labrador dogs. Int. J. Nanomed. 2015, 10, 653–664. [Google Scholar] [CrossRef]
  46. Devlin-Mullin, A.; Todd, N.M.; Golrokhi, Z.; Geng, H.; Konerding, M.A.; Ternan, N.G.; Hunt, J.A.; Potter, R.J.; Sutcliffe, C.; Jones, E.; et al. Atomic Layer Deposition of a Silver Nanolayer on Advanced Titanium Orthopedic Implants Inhibits Bacterial Colonization and Supports Vascularized de Novo Bone Ingrowth. Adv. Healthc. Mater. 2017, 6, 33. [Google Scholar] [CrossRef]
  47. Zhao, Y.; Cao, H.; Qin, H.; Cheng, T.; Qian, S.; Cheng, M.; Peng, X.; Wang, J.; Zhang, Y.; Jin, G.; et al. Balancing the Osteogenic and Antibacterial Properties of Titanium by Codoping of Mg and Ag: An in Vitro and in Vivo Study. ACS Appl. Mater. Interfaces 2015, 7, 17826–17836. [Google Scholar] [CrossRef]
  48. Godoy-Gallardo, M.; Manzanares-Céspedes, M.C.; Sevilla, P.; Nart, J.; Manzanares, N.; Manero, J.M.; Gil, F.J.; Boyd, S.K.; Rodríguez, D. Evaluation of bone loss in antibacterial coated dental implants: An experimental study in dogs. Mater. Sci. Eng. C Mater. Biol. Appl. 2016, 69, 538–545. [Google Scholar] [CrossRef]
  49. Cheng, H.; Xiong, W.; Fang, Z.; Guan, H.; Wu, W.; Li, Y.; Zhang, Y.; Alvarez, M.M.; Gao, B.; Huo, K.; et al. Strontium (Sr) and silver (Ag) loaded nanotubular structures with combined osteoinductive and antimicrobial activities. Acta Biomater. 2016, 31, 388–400. [Google Scholar] [CrossRef]
  50. Smeets, R.; Precht, C.; Hahn, M.; Jung, O.; Hartjen, P.; Heiland, M.; Gröbe, A.; Holthaus, M.G.; Hanken, H. Biocompatibility and Osseointegration of Titanium Implants with a Silver-Doped Polysiloxane Coating: An In Vivo Pig Model. Int. J. Oral Maxillofac. Implant. 2017, 32, 1338–1345. [Google Scholar] [CrossRef]
  51. Liu, X.; Chen, C.; Zhang, H.; Tian, A.; You, J.; Wu, L.; Lei, Z.; Li, X.; Bai, X.; Chen, S. Biocompatibility evaluation of antibacterial Ti-Ag alloys with nanotubular coatings. Int. J. Nanomed. 2019, 14, 457–468. [Google Scholar] [CrossRef]
  52. Xie, K.; Zhou, Z.; Guo, Y.; Wang, L.; Li, G.; Zhao, S.; Liu, X.; Li, J.; Jiang, W.; Wu, S.; et al. Long-Term Prevention of Bacterial Infection and Enhanced Osteoinductivity of a Hybrid Coating with Selective Silver Toxicity. Adv. Healthc. Mater. 2019, 8, e1801465. [Google Scholar] [CrossRef]
  53. Stein, S.; Kruck, L.; Warnecke, D.; Seitz, A.; Dürselen, L.; Ignatius, A. Osseointegration of titanium implants with a novel silver coating under dynamic loading. Eur. Cell Mater. 2020, 39, 249–259. [Google Scholar] [CrossRef]
  54. Chen, Y.; Guan, M.; Ren, R.; Gao, C.; Cheng, H.; Li, Y.; Gao, B.; Wei, Y.; Fu, J.; Sun, J.; et al. Improved Immunoregulation of Ultra-Low-Dose Silver Nanoparticle-Loaded TiO(2) Nanotubes via M2 Macrophage Polarization by Regulating GLUT1 and Autophagy. Int. J. Nanomed. 2020, 15, 2011–2026. [Google Scholar] [CrossRef] [PubMed]
  55. Yao, L.; Wang, H.; Li, L.; Cao, Z.; Dong, Y.; Yao, L.; Lou, W.; Zheng, S.; Shi, Y.; Shen, X.; et al. Development and evaluation of osteogenesis and antibacterial properties of strontium/silver-functionalized hierarchical micro/nano-titanium implants. Mater. Des. 2022, 224, 111425. [Google Scholar] [CrossRef]
  56. Li, K.; Tang, Z.; Song, K.; Fischer, N.G.; Wang, H.; Guan, Y.; Deng, Y.; Cai, H.; Hassan, S.U.; Ye, Z.; et al. Multifunctional nanocoating for enhanced titanium implant osseointegration. Colloids Surf. B Biointerfaces 2023, 232, 113604. [Google Scholar] [CrossRef] [PubMed]
  57. Piñera-Avellaneda, D.; Buxadera-Palomero, J.; Ginebra, M.P.; Calero, J.A.; Manero, J.M.; Rupérez, E. Surface competition between osteoblasts and bacteria on silver-doped bioactive titanium implant. Biomater. Adv. 2023, 146, 213311. [Google Scholar] [CrossRef]
  58. Smeets, R.; Henningsen, A.; Jung, O.; Heiland, M.; Hammächer, C.; Stein, J.M. Definition, etiology, prevention and treatment of peri-implantitis--a review. Head. Face Med. 2014, 10, 34. [Google Scholar] [CrossRef]
  59. Berglundh, T.; Armitage, G.; Araujo, M.G.; Avila-Ortiz, G.; Blanco, J.; Camargo, P.M.; Chen, S.; Cochran, D.; Derks, J.; Figuero, E.; et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J. Clin. Periodontol. 2018, 45 (Suppl. 20), S286–S291. [Google Scholar] [CrossRef]
  60. Rai, M.K.; Deshmukh, S.D.; Ingle, A.P.; Gade, A.K. Silver nanoparticles: The powerful nanoweapon against multidrug-resistant bacteria. J. Appl. Microbiol. 2012, 112, 841–852. [Google Scholar] [CrossRef]
  61. Yamanaka, M.; Hara, K.; Kudo, J. Bactericidal actions of a silver ion solution on Escherichia coli, studied by energy-filtering transmission electron microscopy and proteomic analysis. Appl. Environ. Microbiol. 2005, 71, 7589–7593. [Google Scholar] [CrossRef]
  62. Morones-Ramirez, J.R.; Winkler, J.A.; Spina, C.S.; Collins, J.J. Silver enhances antibiotic activity against gram-negative bacteria. Sci. Transl. Med. 2013, 5, 190ra181. [Google Scholar] [CrossRef] [PubMed]
  63. Hardes, J.; Ahrens, H.; Gebert, C.; Streitbuerger, A.; Buerger, H.; Erren, M.; Gunsel, A.; Wedemeyer, C.; Saxler, G.; Winkelmann, W.; et al. Lack of toxicological side-effects in silver-coated megaprostheses in humans. Biomaterials 2007, 28, 2869–2875. [Google Scholar] [CrossRef] [PubMed]
  64. Zajonz, D.; Birke, U.; Ghanem, M.; Prietzel, T.; Josten, C.; Roth, A.; Fakler, J.K.M. Silver-coated modular Megaendoprostheses in salvage revision arthroplasty after periimplant infection with extensive bone loss—A pilot study of 34 patients. BMC Musculoskelet. Disord. 2017, 18, 383. [Google Scholar] [CrossRef] [PubMed]
  65. Zheng, Y.; Li, J.; Liu, X.; Sun, J. Antimicrobial and osteogenic effect of Ag-implanted titanium with a nanostructured surface. Int. J. Nanomed. 2012, 7, 875–884. [Google Scholar] [CrossRef]
  66. Ferraris, S.; Spriano, S. Antibacterial titanium surfaces for medical implants. Mater. Sci. Eng. C Mater. Biol. Appl. 2016, 61, 965–978. [Google Scholar] [CrossRef]
  67. Greulich, C.; Diendorf, J.; Simon, T.; Eggeler, G.; Epple, M.; Köller, M. Uptake and intracellular distribution of silver nanoparticles in human mesenchymal stem cells. Acta Biomater. 2011, 7, 347–354. [Google Scholar] [CrossRef]
  68. Stewart, P.S.; William Costerton, J. Antibiotic resistance of bacteria in biofilms. Lancet 2001, 358, 135–138. [Google Scholar] [CrossRef]
  69. Parnia, F.; Yazdani, J.; Javaherzadeh, V.; Dizaj, S.M. Overview of nanoparticle coating of dental implants for enhanced osseointegration and antimicrobial purposes. J. Pharm. Pharm. Sci. 2017, 20, 148–160. [Google Scholar] [CrossRef]
  70. Sopchenski, L.; Popat, K.; Soares, P. Bactericidal activity and cytotoxicity of a zinc doped PEO titanium coating. Thin Solid. Films 2018, 660, 477–483. [Google Scholar] [CrossRef]
  71. Pfau, E.A.; Avila-Campos, M.J. Prevotella intermedia and Porphyromonas gingivalis isolated from osseointegrated dental implants: Colonization and antimicrobial susceptibility. Braz. J. Microbiol. 2005, 36, 281–285. [Google Scholar] [CrossRef]
  72. Molenda, M.; Kolmas, J. The Role of Zinc in Bone Tissue Health and Regeneration-A Review. Biol. Trace Elem. Res. 2023, 201, 5640–5651. [Google Scholar] [CrossRef] [PubMed]
  73. Hu, H.; Zhang, W.; Qiao, Y.; Jiang, X.; Liu, X.; Ding, C. Antibacterial activity and increased bone marrow stem cell functions of Zn-incorporated TiO2 coatings on titanium. Acta Biomater. 2012, 8, 904–915. [Google Scholar] [CrossRef] [PubMed]
  74. Zhuang, Y.; Zhang, S.; Yang, K.; Ren, L.; Dai, K. Antibacterial activity of copper-bearing 316L stainless steel for the prevention of implant-related infection. J. Biomed. Mater. Res. B Appl. Biomater. 2020, 108, 484–495. [Google Scholar] [CrossRef] [PubMed]
  75. Zhuang, Y.; Ren, L.; Zhang, S.; Wei, X.; Yang, K.; Dai, K. Antibacterial effect of a copper-containing titanium alloy against implant-associated infection induced by methicillin-resistant Staphylococcus aureus. Acta Biomater. 2021, 119, 472–484. [Google Scholar] [CrossRef]
  76. Xie, H.; Kang, Y.J. Role of copper in angiogenesis and its medicinal implications. Curr. Med. Chem. 2009, 16, 1304–1314. [Google Scholar] [CrossRef]
  77. Chen, W.; Liu, Y.; Courtney, H.; Bettenga, M.; Agrawal, C.; Bumgardner, J.; Ong, J. In vitro anti-bacterial and biological properties of magnetron co-sputtered silver-containing hydroxyapatite coating. Biomaterials 2006, 27, 5512–5517. [Google Scholar] [CrossRef]
  78. Page, M.J.; McKenziem, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021, 372, n71. [Google Scholar] [CrossRef]
Jfb 16 00369 g001
Figure 1. PRISMA flow diagram for the search process to identify studies to include in this review. The “*” represent the three main databases used for the electronic search: PubMed, Web of Science, and Scopus.
Figure 1. PRISMA flow diagram for the search process to identify studies to include in this review. The “*” represent the three main databases used for the electronic search: PubMed, Web of Science, and Scopus.
Jfb 16 00369 g001
Jfb 16 00369 g002
Figure 2. ARRIVE 2.0-based quality evaluation of included studies. Values are presented as percentages.
Figure 2. ARRIVE 2.0-based quality evaluation of included studies. Values are presented as percentages.
Jfb 16 00369 g002
Jfb 16 00369 g003
Figure 3. Risk of bias distribution according to Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Values are presented as percentages.
Figure 3. Risk of bias distribution according to Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Values are presented as percentages.
Jfb 16 00369 g003
Jfb 16 00369 g004
Figure 4. Forest plot summarizing the BIC values from the included studies on Ti implants with silver coatings [28,43,44,45,47,48,50,52,53,56]. The pooled analysis revealed a statistically significant overall effect in favor of silver-coated implants (Z = 2.01, p = 0.04).
Figure 4. Forest plot summarizing the BIC values from the included studies on Ti implants with silver coatings [28,43,44,45,47,48,50,52,53,56]. The pooled analysis revealed a statistically significant overall effect in favor of silver-coated implants (Z = 2.01, p = 0.04).
Jfb 16 00369 g004
Jfb 16 00369 g005
Figure 5. Forest plot summarizing the BA values from the included studies on Ti implants with silver coatings [28,43,44,45,46,47,49,51,56]. The pooled analysis demonstrated no significant difference between silver-coated and control implants (Z = 1.09, p = 0.28).
Figure 5. Forest plot summarizing the BA values from the included studies on Ti implants with silver coatings [28,43,44,45,46,47,49,51,56]. The pooled analysis demonstrated no significant difference between silver-coated and control implants (Z = 1.09, p = 0.28).
Jfb 16 00369 g005
Jfb 16 00369 g006
Figure 6. Forest plot summarizing the BV/TV values from the included studies on Ti implants with silver coatings [28,46,47,48,49,51,54,55,56,57]. The analysis of BV/TV showed no statistically significant overall difference (Z = 0.35, p = 0.73).
Figure 6. Forest plot summarizing the BV/TV values from the included studies on Ti implants with silver coatings [28,46,47,48,49,51,54,55,56,57]. The analysis of BV/TV showed no statistically significant overall difference (Z = 0.35, p = 0.73).
Jfb 16 00369 g006
Table 1. Overview of characteristics of included studies.
Table 1. Overview of characteristics of included studies.
AuthorSilver Coating
Technique		Silver FormAnimal ModelBone
Formation Outcome(s)		Evaluation Method(s)Evaluated GroupsHealing Period
Cheng, 2013 [43]Silver nanoparticle (Ag NPs) incorporated nanostructured Ti coatingAg NPsSD ratsBIC and BAHistological evaluationControl: Ti oxide nanotubes (TiO2-NT); test group: NT-Ag8 weeks
Svensson, 2013 [44]Wet chemical plating processNanostructured coatingNew Zealand White rabbitsBIC and BAHistological evaluationControl: non-coated implants; test group: coated implants6 and 12 weeks
Qiao, 2015 [45]Plasma immersion ion implantation of silver (Ag-PIII)Ag NPsLabrador dogsBA and BICMicro-CT and
histological evaluation		Control: sandblasted and acid-etched (SLA) implants; test groups: implants treated for (1) 30 min with 30 Ag PIII, (2) 60 min with 30 Ag PIII, and (3) 90 min with 30 Ag PIII3 months
Devlin-Mullin, 2015 [46]Silver nanolayer deposition via atomic layer depositionAg NanolayerWistar ratsBAMicro-CT analysisControl: Ti; test group: Ti-Ag12 weeks
Zhao, 2015 [47]Plasma immersion ion implantation of silver (Ag-PIII)Ag NPsNew Zealand White rabbitsBIC, BA, and BV/TVMicro-CT and
histological evaluation		Control: Ti; test groups: (1) Ag-PIII and (2) Mg/Ag-PIII8 weeks
Godoy-Gallardoa, 2016 [48]Implants with silver electrodepositionAg electrodepositionBeagle dogsBIC
and BV/TV		Micro-CT and
histological evaluation		Control: Ti; test group: Ti-Ag2 months
Cheng, 2016 [49]Silver (Ag)-loaded nanotubular structuresAg NPsRatsBIC, BA, and BV/TVMicro-CT and
histological evaluation		Control: TiO2-NTs; test groups: (1) NT10-Ag1, (2) NT10-Ag2, and (3) NT40-Ag16 weeks
Smeets, 2017 [50]Silver-doped polysiloxane coatingAg particlesPigsBICHistological evaluationControl: grit-blasted and acid-etched Ti implants coated with polysiloxane; test group: silver-doped polysiloxane3 months
Liu, 2019 [51]Ti-Ag
alloy nanotubular coatings (TNT)		Ag ionsSprague–Dawley ratsBAMicro-CT and
histological evaluation		Control: TNT; test groups: (1) Ti1% Ag-NT, (2) Ti2% Ag-NT, and (3) Ti4% Ag-NT(1, 2, and
4 weeks)
Xie, 2019 [52]Coating consisting of hydroxyapatite (HA), AgNPs, and
chitosan (CS)		Ag NPsSD ratsBICMicro-CT and
histological evaluation		Control: Ti implants; test group: HA/Ag/CS-coated
implants		12 weeks
Stein, 2020 [53]Titanium–vanadium implants (Ti6Al4V)
coated with a polysiloxane layer with embedded
elementary silver particles		Ag particlesMerino sheepBICHistological evaluationControl: uncoated Ti implants; test group: silver-coated implants6 months
Chen, 2020 [54]TiO2 nanotubes loaded with silver nanoparticlesAg NPsSprague–Dawley ratsBV/TVMicro-CT analysisControl: TiO2
nanotubes (TiO2-NTs); test group: AgTiO2-NTs		2 weeks
Nakashima, 2022 [28]Silver-containing
hydroxyapatite coating		Silver oxideSprague–Dawley ratsBIC, BA, and BV/TVMicro-CT and
histological evaluation		Control: HA; test group: Ag-HA4 and 8 weeks
Yao, 2022 [55]Magnetron sputtering was used to form uniform Ag and strontium titanate (SrTiO3) coatings on TiAg ionsNew Zealand White
rabbits		BV/TVMicro-CT analysisControl: AH-Ti; test groups: (1) AH-Ti/Ag and (2) AH-Ti/Ag/Sr1 month
Li, 2023 [56]Ti implants immersed in AgNP solutionAg NPsSprague–Dawley ratsBIC, BA, and BV/TVMicro-CT and
histological evaluation		Control: Ti; test group: AgNP4 weeks
Pinera-Avellaneda, 2023 [57]Ti implants with an Ag-doped calcium–Ti surface layerAg ionsNew Zealand albino rabbitsBV/TVMicro-CT analysisControl: Ti; test group: Ti-Ag2 and 4 weeks
Table 2. Quality coefficients of included studies.
Table 2. Quality coefficients of included studies.
AuthorsYearAnimal ModelCoefficientQuality
Cheng et al. [43]2013Rat0.761Average
Svensson et al. [44]2013Rabbit0.809Excellent
Qiao et al. [45]2015Dog0.880Excellent
Devlin-Mullin et al. [46]2015Rat0.785Average
Zhao et al. [47]2015Rabbit0.714Average
Godoy-Gallardoa et al. [48]2016Dog0.904Excellent
Cheng et al. [49]2016Rat0.738Average
Smeets et al. [50]2017Pig0.904Excellent
Liu et al. [51]2019Rat0.761Average
Xie et al. [52]2019Rat0.904Excellent
Stein et al. [53]2020Sheep0.857Excellent
Chen et al. [54]2020Rat0.714Average
Nakashima et al. [28]2022Rat0.928Excellent
Yao et al. [55]2022Rabbit0.761Average
Li et al. [56]2023Rat0.857Excellent
Pinera-Avellaneda et al. [57]2023Rabbit0.761Average
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Alenezi, A. Effects of Implant Silver Coatings on Bone Formation in Animal Models: A Systematic Review and Meta-Analysis. J. Funct. Biomater. 2025, 16, 369. https://doi.org/10.3390/jfb16100369

AMA Style

Alenezi A. Effects of Implant Silver Coatings on Bone Formation in Animal Models: A Systematic Review and Meta-Analysis. Journal of Functional Biomaterials. 2025; 16(10):369. https://doi.org/10.3390/jfb16100369

Chicago/Turabian Style

Alenezi, Ali. 2025. "Effects of Implant Silver Coatings on Bone Formation in Animal Models: A Systematic Review and Meta-Analysis" Journal of Functional Biomaterials 16, no. 10: 369. https://doi.org/10.3390/jfb16100369

APA Style

Alenezi, A. (2025). Effects of Implant Silver Coatings on Bone Formation in Animal Models: A Systematic Review and Meta-Analysis. Journal of Functional Biomaterials, 16(10), 369. https://doi.org/10.3390/jfb16100369

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop