A New Strategy Against Peri-Implantitis: Antibacterial Internal Coating

Abstract

The bacterial biofilm formation in the oral cavity and the microbial activity around the implant tissue represent a potential factor on the interface between bone and implant fixture that could induce an inflammatory phenomenon and generate an increased risk for mucositis and peri-implantitis. The aim of the present clinical trial was to investigate the bacterial quality of a new antibacterial coating of the internal chamber of the implant in vivo at six months. The PIXIT implant (Edierre srl, Genova Italy) is prepared by coating the implant with an alcoholic solution containing polysiloxane oligomers and chlorhexidine gluconate at 1%. A total of 15 healthy patients (60 implants) with non-contributory past medical history (nine women and six men, all non-smokers, mean age of 53 years, ranging from 45–61 years) were scheduled to receive bilateral fixed prostheses or crown restorations supported by an implant fixture. No adverse effects and no implant failure were reported at four months. All experimental sites showed a good soft tissue healing at the experimental point times and no local evidence of inflammation was observed. Real-Time Polymerase Chain Reaction (PCR) analysis on coated and uncoated implants showed a decrease of the bacterial count in the internal part of the implant chamber. The mean of total bacteria loading (TBL) detected in each PCR reaction was lower in treated implants (81038 units/reaction) compared to untreated implants (90057 units/reaction) (p < 0.01). The polymeric chlorhexydine coating of the internal chamber of the implant showed the ability to control the bacterial loading at the level of the peri-implant tissue. Moreover, the investigation demonstrated that the coating is able to influence also the quality of the microbiota, in particular on the species involved in the pathogenesis of peri-implantitis that are involved with a higher risk of long-term failure of the dental implant restoration.

Optimized Dental Implant Fixture Design for the Desirable Stress Distribution in the Surrounding Bone Region: A Biomechanical Analysis

“…Through this study, the superiority of IS-III was demonstrated using biomechanical evaluations, but further pre-clinical/clinical research and fatigue testing are required for data on aspects such as osteointegration relating to characteristics of the micro-grooves at the platform of the fixture and the fatigue strength. In addition, a recent study has reported an antibacterial internal coating to prevent bone reduction around fixtures of an internal type, and thus, the antibacterial coating of fixture internals should be considered in future implant development [54].…”

Emerging Applications of Drug Delivery Systems in Oral Infectious Diseases Prevention and Treatment

“…PLGA(Ag-Fe3O4)-coated dental implants [175] Sm 7 inhibited bacteria adherence Ag nanoparticles coated on titanium [179] E coli, Sa showed antibacterial effect and sustained release for 7 days Antibiotics doxycycline-coated abutment surfaces [180] Se 8 inhibited the bacterial growth; showed sustained release for least 2 weeks Tetracycline-containing fibers coated titanium implant [171] Pg, Fn 9 ,Pi 10 , Aa showed inhibition of biofilm and kept releasing for 3 days silica-gentamycin coated titanium implant [170] Sa showed antibacterial effect and sustained release for 14 days Tetracycline loaded nanofibers coated titanium implant [43] Aa, Fn, Pg, Pi Showed anti-bacterial effect Tetracycline loaded titanium [181] Pg showed antibacterial efficiency and sustained release for 15 days Cationic antibacterial agents chlorhexidine hexametaphosphate nanoparticles coated titanium [182] Sg demonstrated antibacterial effect and sustained release of soluble chlorhexidine for 99 days The PIXIT implant containing polysiloxane oligomers and chlorhexidine gluconate [183] Clinic trail controlled bacterial adhesion; reduced the bacterial species involved with long-term failure of dental implant Dimethylaminododecyl Methacrylate(DMADDM) coated dental implant [172] saliva-derived biofilm inhibited biofilm growth and regulated microecosystem Bioactive antibacterial agents Chitosan/P-HAP bi-layers coated titanium implant [184] Sg Demonstrated an appropriate mouse pre-osteoblastic cell response, and significant anti-bacterial activity * The bacterial model were showed in abbreviated form: 1 Such kinds of dual-functional DDS not only show antibacterial effects without affecting biocompatibility, but also help promote bone regeneration, which has excellent application potential. However, long-term drug release and multifunctional dental implant research are still limited.…”

The Effects of Erbium-Doped Yttrium Aluminum Garnet Laser (Er: YAG) Irradiation on Sandblasted and Acid-Etched (SLA) Titanium, an In Vitro Study

“…The impact of two different protocols of Er: YAG laser irradiation on SLA titanium disks for the treatment of peri-implantitis has been evaluated in this study. The treatment of peri-implantitis includes granulation tissue removal, the decontamination of exposed implant surfaces, the application of antibacterial agent, and the smoothening of rough implant surfaces, thus rendering those surfaces less attractive for bacterial accumulation [32,33]. Hauser-Gerspachave et al showed that bactericidal effects of Er: YAG increase with laser dose, but with the risk to surface alterations [15].…”