Polymicrobial infections
are one of the most common reasons for inflammation of surrounding
tissues and failure of implanted biomaterials. Because microorganism
adhesion is the first step for biofilm formation, physical–chemical
modifications of biomaterials have been proposed to reduce the initial
microbial attachment. Thus, the use of superhydrophobic coatings has
emerged because of their anti-biofilm properties. However, these coatings
on the titanium (Ti) surface have been developed mainly by dual-step
surface modification techniques and have not been tested using polymicrobial
biofilms. Therefore, we developed a one-step superhydrophobic coating
on the Ti surface by using a low-pressure plasma technology to create
a biocompatible coating that reduces polymicrobial biofilm adhesion
and formation. The superhydrophobic coating on Ti was created by the
glow discharge plasma using Ar, O2, and hexamethyldisiloxane
gases, and after full physical, chemical, and biological characterizations,
we evaluated its properties regarding oral biofilm inhibition. The
newly developed coating presented an increased surface roughness and,
consequently, superhydrophobicity (contact angle over 150°) and
enhanced corrosion resistance (p < 0.05) of the
Ti surface. Furthermore, proteomic analysis showed a unique pattern
of protein adsorption on the superhydrophobic coating without drastically
changing the biologic processes mediated by proteins. Additionally,
superhydrophobic treatment did not present a cytotoxic effect on fibroblasts
or reduction of proliferation; however, it significantly reduced (≈8-fold
change) polymicrobial adhesion (bacterial and fungal) and biofilm
formation in vitro. Interestingly, superhydrophobic coating shifted
the microbiological profile of biofilms formed in situ in the oral
cavity, reducing by up to ≈7 fold pathogens associated with
the peri-implant disease. Thus, this new superhydrophobic coating
developed by a one-step glow discharge plasma technique is a promising
biocompatible strategy to drastically reduce microbial adhesion and
biofilm formation on Ti-based biomedical implants.