Biofilm Removal and Bacterial Re-Colonization Inhibition of a Novel Erythritol/Chlorhexidine Air-Polishing Powder on Titanium Disks.

Magda Mensi,Lia Rimondini,Francesca Uberti,Andrea Cochis,Annamaria Sordillo

doi:10.3390/ma11091510

Magda Mensi, Lia Rimondini + Show 3 more

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https://doi.org/10.3390/ma11091510

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Abstract

Air-polishing with low abrasiveness powders is fast arising as a valid and mini-invasive instrument for the management of biofilm colonizing dental implants. In general, the reported advantage is the efficient removal of plaque with respect to the titanium integrity. In the present study, we evaluated the in situ plaque removal and the preventive efficacy in forestalling further infection of an innovative erythritol/chlorhexidine air-polishing powder and compared it with sodium bicarbonate. Accordingly, two peri-implantitis-linked biofilm formers, strains Staphylococcus aureus and Aggregatibacter actinomycetemcomitans, were selected and used to infect titanium disks before and after the air-polishing treatment to test its ability in biofilm removal and re-colonization inhibition, respectively. Biofilm cell numbers and viability were assayed by colony-forming unit (CFU) count and metabolic-colorimetric (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) (XTT) assay. Results demonstrated that air-polishing performed with either sodium bicarbonate or erythritol/chlorhexidine was effective in reducing bacteria biofilm viability and number on pre-infected specimens, thus showing a similar ability in counteracting existing infection in situ; on the other hand, when air-polished pre-treated disks were infected, only erythritol/chlorhexidine powder showed higher post-treatment biofilm re-growth inhibition. Finally, surface analysis via mechanical profilometry failed to show an increase in titanium roughness, regardless of the powder selected, thus excluding any possible surface damage due to the use of either sodium bicarbonate or erythritol/chlorhexidine.

Highlights

Dental implants’ placement makes them part of the intra-oral microenvironment, where a complex microbial community tends to adhere to any available surface and build a biofilm [1,2,3].Bacterial colonisation at implant surface occurs within 30 min of the implant trans-mucosal portion being connected to the surgical site, while a mature sub-gingival microbiota can be observed within a week [2,4]
To test the efficacy in biofilm removal, Grade II titanium disks were infected for 24 h with the periodontal S. aureus and A. actinomycetemcomitans pathogens prior to undergoing air-polishing treatment
These findings are in line with the results of Drago et al [31] who tested the bacterial viability of S. aureus, C. albicans and B. fragilis biofilm on titanium sandblasted disks after 5 s of air-polishing with glycine and erythritol/CHX

Summary

Introduction

Dental implants’ placement makes them part of the intra-oral microenvironment, where a complex microbial community tends to adhere to any available surface and build a biofilm [1,2,3].Bacterial colonisation at implant surface occurs within 30 min of the implant trans-mucosal portion being connected to the surgical site, while a mature sub-gingival microbiota can be observed within a week [2,4]. Mechanical debridement with manual and/or power-driven instruments can lead to resolution of the inflammatory process [9], it may fail to restore the biocompatibility of the implant due to surface alteration and deposit of debris from the instruments, impairing cell viability and attachment [10,11] For these reasons, a large literature is focused on the development of innovative intrinsic antibacterial dental restorative compounds; so, dental materials can be directly doped with antibacterial agents such as metal ions [12,13], natural compounds such as polyphenols [14] or chemicals such as quaternary ammonium compounds [15,16] or peptides [17], as well as coupled with fillers containing the same antibacterial compounds [18]

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