Influence of Chitosan or Keratin on Titanium Implant Surface - A Systematic Review

Purpose: This systematic review was carried out to investigate the effects of keratin and chitosan hydrogel preparations on dental implant osseointegration. Materials and Methods: The electronic search was conducted on five databases: Scopus, EBSCOhost MEDLINE, EBSCOhost Dentistry and Oral Science, PubMed, and Web of Science. Studies that determined the in vitro or in vivo efficacy of keratin and chitosan hydrogel on osseointegration were included in the review. Results: Of the 760 studies initially gathered, nine met the inclusion criteria. These studies demonstrated that dental implants coated with keratin and chitosan hydrogels resulted in improved biological properties. It was also concluded that the inclusion of chitosan in keratin hydrogels improves the mechanical strength and helps increase durability through ameliorating degradation and swelling characters. Both the polymers increased bone-implant contact and new bone formation in animal models. Conclusion: This systematic review demonstrates that keratin and chitosan hydrogel, is effective in initiating osteogenesis, reinforcing the currently available evidence that these polymers could be a substrate in dental implant treatment.