Abstract
ObjectiveTreatment of implants with peri-implantitis is often unsuccessful due to residual microbial biofilm hindering re-osseointegration. The aim of this study was to treat biofilm-grown titanium (Ti) implants with different modalities involving air abrasion (AA) and cold atmospheric plasma (CAP) to compare the effectiveness in surface decontamination and the alteration/preservation of surface topography.Materials and methodsSaliva collected from a peri-implantitis patient was used to in vitro develop human biofilm over 35 implants with moderately rough surface. The implants were then mounted onto standardized acrylic blocks simulating peri-implantitis defects and treated with AA (erythritol powder), CAP in a liquid medium, or a combination (COM) of both modalities. The remaining biofilm was measured by crystal violet (CV). Surface features and roughness before and after treatment were assessed by scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis followed by Tukey’s multiple comparison test.ResultsIn the present peri-implantitis model, the human complex biofilm growth was successful as indicated by the statistical significance between the negative and positive controls. All the treatment groups resulted in a remarkable implant surface decontamination, with values very close to the negative control for AA and COM. Indeed, statistically significant differences in the comparison between the positive control vs. all the treatment groups were found. SEM analysis showed no post-treatment alterations on the implant surface in all the groups.ConclusionsDecontamination with AA delivering erythritol with or without CAP in liquid medium demonstrated compelling efficacy in the removal of biofilm from implants. All the tested treatments did not cause qualitative alterations to the Ti surface features. No specific effects of the CAP were observed, although further studies are necessary to assess its potential as monotherapy with different settings or in combination with other decontamination procedures.Clinical relevanceCAP is a promising option in the treatment of peri-implantitis because it has potential to improve the elimination of bacterial plaque from implant surfaces, in inaccessible pockets or during open-flap debridement, and should stimulate the process of the re-osseointegration of affected dental implants by not altering surface features and roughness.
Highlights
Biofilm-induced implant disease, peri-implantitis, has been reported to occur in 1–47% of all implants placed globally [1]
The measured percentage of biofilm removal revealed an effective decontamination following all the treatments and almost complete biofilm removal after both AA application (94.87%) and when cold atmospheric plasma (CAP) was used in combination with AA in the COM treatment (95.32%)
These results are in line with the ones achieved in the present study where AA showed 94.87% of biofilm removal, the combined treatment only a slight additional effect (95.32%), and CAP alone 52.10%, it was used in a liquid environment
Summary
Biofilm-induced implant disease, peri-implantitis, has been reported to occur in 1–47% of all implants placed globally [1]. While regular professional and home care can maintain healthy peri-implant tissues, once a mature biofilm has established itself on the subgingival implant surface, it becomes a big challenge for management [3] This is because the implant surface is both macroscopically and microscopically rough, which makes it notoriously difficult to clean. Altering the surface of a titanium (Ti) implant to increase its roughness does not compromise its biocompatibility but enhances the total area available for host cells attachment, integration with bone osseointegration [5]. These altered implant surfaces with complex topographies do not differentiate between prokaryotes and eukaryotes. This effect promotes biofilm formation, the leading etiology of peri-implantitis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
