Abstract

Oral biofilms play an essential role on peri-implant disease development. Synthetic hydroxyapatite nanoparticles (nHAP) are a bioinspired material that has structural and functional similarities to dental enamel apatite and may provide preventive properties against biofilm formation. This study aimed to investigate the effects of an experimental nHAP solution on biofilm formation on polished and non-polished titanium under oral conditions. Five volunteers carried maxillary splints with non-polished and polished titanium and followed a 48 h rinsing protocol with the proposed nHAP solution, and with chlorhexidine 0.2% (CHX) and water, as controls. Samples were analyzed by fluorescence microscopy (FM), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). FM showed a significant reduction of biofilms on polished samples treated with nHAP (p = 0.0485) compared with water, without differences between nHAP and CHX (p > 0.9999). Analyzing biofilm viability, polished samples rinsed with nHAP showed significantly fewer dead bacteria than CHX (p = 0.0079), but there was no significant difference in viability between polished samples rinsed with water and nHAP (p = 0.9268). A significantly higher biofilm coverage was observed on the non-polished surfaces compared to the polished surfaces when nHAP was applied (p = 0.0317). This difference between polished and non-polished surfaces was not significant when water (p = 0.1587) or CHX (p = 0.3413) rinsing were applied. SEM and TEM analysis supported the FM findings, that polished samples rinsed with nHAP presented fewer biofilm coverage compared to samples rinsed with water. In conclusion, the nHAP solution reduced the biofilm formation on polished Ti surfaces without altering bacterial viability, providing a novel approach for the management of biofilm formation on biomaterials.

Highlights

  • Dental implants are one of the greatest advancements in dentistry

  • There was no significant difference between polished and non-polished surfaces when rinsed with water (p = 0.1587) or with chlorhexidine 0.2% (CHX) (p = 0.3413)

  • Another predictable result was the significantly lower biofilm coverage after treatment with CHX 0.2% when compared with the water rinse (p = 0.0215) on polished samples

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Summary

Introduction

Dental implants are one of the greatest advancements in dentistry. They are a well-established and predictable method for partial and total oral rehabilitation. Periimplantitis is an inflammatory disease that affects the soft and hard tissue around an implant. It starts with pellicle formation followed by bacteria adhesion to the titanium surface, leading to biofilm formation. The inflammatory process starts on the soft tissue surrounding the dental implant (peri-implant mucositis) and can evolve causing progressive loss of supporting bone, leading to implant failure (Smeets et al, 2014; Schwarz et al, 2018)

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