The Effectiveness of Chlorhexidine and Air Polishing System in the Treatment of Candida albicans Infected Dental Implants: An Experimental In Vitro Study

Abstract

Background: Peri-implantitis is an inflammatory disease with an increasing diffusion rate which can affect the long-term survival of a prosthetic rehabilitation. The present study focused on the decontaminating efficacy of chlorhexidine and air polishing system with sodium bicarbonate powder against Candida albicans, a microorganism which seems to have a superinfecting opportunistic role in the pathology. The aim of the authors was to investigate and compare the effectiveness of these treatments, commonly used in clinical practice. Methods: An in vitro study was conducted to analyze the effects of two widely used therapeutic aids for the disinfection of affected titanium implants: chlorhexidine (CHX) and air polishing with sodium bicarbonate powder (P). A qualitative and quantitative comparative analysis of the residual biofilm was carried out using a colorimetric assay (XTT) and scanning electron microscopy (SEM) observation. The experiment was conducted both on machined titanium surfaces and on rough sandblasted ones with the aim of bringing out differences in the therapeutic outcomes concerning the superficial texture of the implant. The null hypothesis was that no difference could be detected between the samples, regarding both the treatments performed and the nano-structural features of titanium. Results: The best results (on both types of implant surfaces) were obtained when combining the use of chlorhexidine and air polishing (C + P). A linear decrease in the optical density (OD) values recorded at three different time points (30 s, 1 min, 5 min) was also observed passing from the first to the last one. When observed under scanning electron microscope rough surfaces showed an extensive and highly structured biofilm, more complex if compared to the one encountered when analyzing machined implants. Conclusions: the present pilot study showed that rough surfaces can promote fungal adhesion and eventually hinder the outcome of a decontaminating treatment. For this purpose, the physio-chemical technique is always more efficient if compared to a single-technique approach regardless of the surface characteristics.

Susceptibility to biofilm formation on 3D-printed titanium fixation plates used in the mandible: a preliminary study

“…The irregular rough surface of biomaterials, especially their micro and macro-structures improve osseointegration which is a desirable process in implantology. Surface roughness and topography have a significant correlation with bone regeneration and mechanical retention in the human maxilla and mandible [ 60 ] but they also facilitate initial microbial adhesion and the formation of biofilms [ 61 ].…”

“…Park et al found decreased adhesion of streptococci and other species at surface roughness values of around 0.15 µm [ 73 ]. The results of in vitro studies conducted by Yoda et al suggested that even a quite a low surface roughness ranging from 7.1 to 16.5 nm Ra for Ti-6Al-4 V can influence bacterial adhesion [ 61 ]. Plates tested in the present study had a lower mean Sa of 0.102 μm; however, all used strains were able to form biofilms.…”

Photodynamic Therapy by Diaryl-Porphyrins to Control the Growth of Candida albicans

“…However, even if a good binding yield is crucial, a certain intrinsic toxicity should be avoided. Indeed, among the diaryl-porphyrins showing a good binding yield, few (5,10,11) were intrinsically toxic, regardless of irradiation and elicited photo-oxidative stress. Their toxicity was directly dependent on dark incubation time and inversely dependent on fungal cell concentration.…”

“…The chemical denomination and structure of diaryl-porphyrins used In this study are listed In Table 1 [35,38,39]. Four porphyrins were neutral (1)(2)(3)(4), four were monocationic (5)(6)(7)(8), and three were dicationic (9)(10)(11). Porphyrin solutions (0.5 or 1 mM) were prepared In DMSO and stored at 4 • C until needed.…”

Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants—A Narrative Review

“…The weighted mean prevalence of these conditions is clinically very important and may even be as high as 47% for subject-based peri-implant mucositis [ 29 ]. The high incidence of peri-implant pathologies forces clinicians to search for novel treatments, including the site decontamination of dental implants and dental implant sites [ 30 , 31 ].…”