Determinants of biofilm formation and cleanability of titanium surfaces

Zaugg, Lucia K.; Astasov‐Frauenhoffer, Monika; Braissant, Olivier; Hauser-Gerspach, Irmgard; Waltimo, Tuomas; Zitzmann, Nicola U.

doi:10.1111/clr.12821

Cited by 27 publications

(54 citation statements)

References 33 publications

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“…Zaugg and coworkers, evaluating the in situ brushing efficacy of a powered toothbrush on titanium disks, compared biofilm formation on laser-treated surfaces, machined surfaces and grit-blasted, acid etched, and chemically modified surfaces. [ 25 ] They demonstrated that laser-treated and grit-blasted surfaces showed significantly higher biofilm formation than machined surfaces. The difference between these results and those of the present study can be explained by some relevant differences in the setup as well as in the surface design.…”

Section: Discussionmentioning

confidence: 99%

“…The difference between these results and those of the present study can be explained by some relevant differences in the setup as well as in the surface design. Zaugg and coworkers [ 25 ] used titanium disks with a flat surface instead of a threaded implant surface design. Additionally, the laser-treated surface showed parallel 7-micron deep grooves instead of regularly distributed 20-micron deep pits.…”

Section: Discussionmentioning

confidence: 99%

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Laser microtextured titanium implant surfaces reduce in vitro and in situ oral biofilm formation

et al. 2018

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IntroductionMicro- or nano-topography can both provide antimicrobial properties and improve osseointegration of dental implant titanium surfaces. Laser treatment is one of the best surface microtexturing techniques. The aim of this study was to evaluate in vitro and in situ biofilm formation on a laser-treated titanium surface, comparing it with two conventional surfaces, machined and grit-blasted.MethodsFor the in vitro experiment, an oral microcosm biofilm model was developed on the surface of titanium disks and reference human enamel using a bioreactor for 48 h. For the in situ experiment, titanium implants with laser-treated, machined and grit-blasted surfaces were mounted on intraoral trays and worn by ten volunteers for 48 h. Biofilm formation was quantitatively evaluated, and surfaces were analyzed using confocal laser scanning microscopy, scanning electron microscopy and energy-dispersive X-ray spectroscopy.Results–in vitro studyBiofilm structures with a prevalence of viable cells covered most of the machined, grit-blasted and human enamel surfaces, whereas less dense biofilm structures with non-confluent microcolonies were observed on the laser-treated titanium. Laser-treated titanium showed the lowest biofilm formation, where microorganisms colonized the edges of the laser-created pits, with very few or no biofilm formation observed inside the pits.Results–in situ studyThe biofilm formation pattern observed was similar to that in the in vitro experiment. Confocal laser scanning microscopy showed complete coverage of the implant threads, with mostly viable cells in grit-blasted and machined specimens. Unexpectedly, laser-treated specimens showed few dead microbial cells colonizing the bottom of the threads, while an intense colonization was found on the threading sides.ConclusionThis data suggests that laser-created microtopography can reduce biofilm formation, with a maximum effect when the surface is blasted orthogonally by the laser beam. In this sense the orientation of the laser beam seems to be relevant for the biological interaction with biofilms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laser microtextured titanium implant surfaces reduce in vitro and in situ oral biofilm formation

et al. 2018

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“…Different in vivo (Al‐Ahmad et al, , ; de Melo, do Nascimento, Souza, & de Albuquerque, ; Ferreira Ribeiro et al, ; Groessner‐Schreiber, Hannig, Duck, Griepentrog, & Wenderoth, ; John, Becker, & Schwarz, , ; Xing, Lyngstadaas, Ellingsen, Taxt‐Lamolle, & Haugen, ; Zaugg et al, ) and in vitro (Badihi Hauslich, Sela, Steinberg, Rosen, & Kohavi, ; Di Giulio et al, ; Drake, Paul, & Keller, ; Montelongo‐Jauregui, Srinivasan, Ramasubramanian, & Lopez‐Ribot, ; Pita et al, ; Sanchez et al, ; Schmidlin et al, ; Violant, Galofre, Nart, & Teles, ) investigations have studied the impact of implant surface characteristics on biofilm formation, demonstrating that the physic‐chemical characteristics of the surface, mainly its roughness, significantly affected early bacterial colonization, biofilm formation and maturation(Burgers et al, ; Teughels et al, ). However, most of these studies have not used dental implants, but rather specimens, such as discs or slabs made of the implant surfaces, but without taking into account the implant macroscopic and topographic characteristics, such as the threads and the inter‐thread concavities.…”

Section: Introductionmentioning

confidence: 99%

Biofilm formation on dental implants with different surface micro‐topography: An in vitro study

Bermejo

Sanchez

Llama‐Palacios

et al. 2019

Clinical Oral Implants Res

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Objectives:To compare biofilm formation on whole dental titanium implants with different surface micro-topography. Methods:A multispecies in vitro biofilm model consisting of initial (Streptococcus oralis and Actinomyces naeslundii), early (Veillonella parvula), secondary (Fusobacterium nucleatum) and late colonizers (Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans) was grown for 96 hr on sterile titanium dental implants with either minimal (S a : 0.5-1.0 mm) or moderate-roughness titanium surfaces (S a : 1.1-2.0 mm).The resulting biofilms were studied with Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscope. Concentrations (colony-forming units per mL [CFU/ml]) of each bacterium were measured by quantitative Polymerase Chain Reaction (qPCR) and compared by Student t tests.Results: A biofilm, located mainly at the peak and lateral areas of the implant threads, was observed on both implant surfaces, with a greater biomass and a greater live/dead ratio in moderate-compared to minimal-roughness surface implants. Statistically significant higher values of total bacteria (mean difference = 2.61 × 10 7 CFU/ml; 95% confidence interval -CI [1.91 × 10 6 ; 5.02 × 10 7 ]; p = 0.036), F. Nucleatum (mean difference = 4.43 × 10 6 CFU/ml; 95% CI [1.06 × 10 6 ; 7.80 × 10 6 ]; p = 0.013) andA. actinomycetemcomitans (mean difference = 2.55 × 10 7 CFU/ml; 95% CI [1.07 × 10 7 ; 4.04 × 10 7 ]; p = 0.002), were found in the moderate-compared to minimal-roughness surface dental implants.Conclusions: Implants with moderate-roughness surfaces accumulated more bacterial biomass and significant higher number of pathogenic bacteria (F. nucleatum and A. actinomycetemcomitans), when compared to implants with minimal-roughness surfaces, within a similar biofilm structure.

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“…One particular difference in this study was the use of a commercially available screw-shaped implant. As the implant shape and design have rather complicated macro-and microstructures compared with titanium disks or different forms of titanium commonly used in experimental studies, previous results could not be easily interpreted and extrapolated to the clinical setting [14,19]. However, the use of genuine implants allowed us to evaluate the cleansability of each method on contaminated implant surfaces.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of decontamination methods of oral biofilms formed on screw-shaped, rough and machined surface implants: an ex vivo study

et al. 2020

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Background: To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces. Material and methods: Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the titanium surfaces of the implants. Apart from surface roughness, the morphology of all implants was identical. After detaching the implants from the splints, the ability of the following decontamination methodsgauze soaked in saline (G), ultrasonic scaler (US), air abrasive (Air), rotary stainless steel instrument (Rot), and Er:YAG laser (Las)-to cleanse the contaminated implant surface for 1 min extra-orally was tested. The control (Cont) group did not receive any decontamination. Scanning electron microscopic (SEM) investigation of one participant's samples was employed to examine the post-instrumented implant surface for qualitative analysis, and bacterial culture of the remaining 10 participants' samples was performed to count the number of colony-forming units (CFU) for quantitative analysis. The experimental sequence was initially performed for the rough surface implants and then similarly repeated for the machined surface implants. Bacterial CFU counts among the six groups were analyzed using the Steel-Dwass test, and differences between rough and machined surface implants were determined using the Mann-Whitney U test. Results: G and Rot eliminated most biofilms on machined surface implants according to SEM analysis. G, Air, and Rot removed significantly more of the biofilms on rough and machined surface implants compared with US according to CFU counts. Moreover, G significantly reduced more biofilms than Las on machined surface implants. The analysis between rough and machined surface implants showed that Cont, G, and US were better able to cleanse biofilms on machined surface implants compared with rough surface implants.

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Determinants of biofilm formation and cleanability of titanium surfaces

Cited by 27 publications

References 33 publications

Laser microtextured titanium implant surfaces reduce in vitro and in situ oral biofilm formation

Laser microtextured titanium implant surfaces reduce in vitro and in situ oral biofilm formation

Biofilm formation on dental implants with different surface micro‐topography: An in vitro study

Evaluation of decontamination methods of oral biofilms formed on screw-shaped, rough and machined surface implants: an ex vivo study

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