Abstract
Implants have been considered the treatment of choice to replace missing teeth, unfortunately, peri-implant disease is still an unresolved issue. Contaminated implants may be decontaminated by physical debridement and chemical disinfectants; however, there is a lack of consensus regarding the ideal techniques/agents to be used for the decontamination. The objective of our study was to compare the decontaminating efficacy of different chemical agents on a titanium surface contaminated with Porphyromonas gingivalis, a typical representative of the bacterial flora associated with peri-implantitis. Commercially pure Ti grade 4 discs with a polished surface were treated with a mouthwash containing chlorhexidine digluconate (0.1%), povidone-iodine (PVP-iodine) solution (10%) or citric acid monohydrate (40%). Qualitative and quantitative assessment of cellular growth and survival were assessed by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and scanning electron microscopy (SEM). Significant differences in the quantity of P. gingivalis could be observed after 6 days of incubation. A numerical, but not statistically significant (P = 0.066) decrease in the amount of living bacteria was observed in the group treated with the PVP-iodine solution as compared to the control group. The chlorhexidine (CHX)-treated group presented with significantly higher cell counts, as compared to the PVP-iodine-treated group (P = 0.032), while this was not observed compared to the control group and citric acid-treated group. Our results have also been verified by SEM measurements. Our results suggest that for P. gingivalis contamination on a titanium surface in vitro, PVP-iodine is a superior decontaminant, compared to citric acid and chlorhexidine-digulconate solution.
Highlights
Over the past decades, implants have been considered the treatment of choice to replace missing teeth, as they have shown high survival rates after being in function for at least 10 years [1,2,3,4,5,6]
The objective of our study was to compare the decontaminating efficacy of different chemical agents on a titanium surface contaminated with Porphyromonas gingivalis, a typical representative of the bacterial flora associated with peri-implantitis
The objective of our study was to compare the decontaminating efficacy of the abovementioned three chemical agents on polished titanium (Ti) surfaces infected with Porphyromonas gingivalis, a typical representative of the bacterial flora associated with peri-implantitis
Summary
Implants have been considered the treatment of choice to replace missing teeth, as they have shown high survival rates (ranging from 90 to 98%) after being in function for at least 10 years [1,2,3,4,5,6]. Subsequent development of peri-implant diseases is still an unresolved issue [7,8,9,10]. Peri-implant infections include peri-implant mucositis (which can be defined as a reversible inflammatory response of the peri-implant soft tissues without bone loss) and peri-implantitis (an inflammatory process resulting in the loss of supporting bone associated with suppuration and bleeding) [11,12,13,14]. One of the key events in the pathogenesis is the development of microbial colonization on the surface of the dental implant [16, 17]. Peri-implant infections have mostly been linked to Gram-negative anaerobic bacteria [18, 19]; the toxin release by these pathogens provokes a massive immune response, which causes bone degradation, leading to implant loss [20]
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