Porphyromonas gingivalis endotoxin affinity for dental ceramics

Overview of strategies to improve the antibacterial property of dental implants

The increasing number of peri-implant diseases and the unsatisfactory results of conventional treatment are causing great concern to patients and medical staff. The effective removal of plaque which is one of the key causes of peri-implant disease from the surface of implants has become one of the main problems to be solved urgently in the field of peri-implant disease prevention and treatment. In recent years, with the advancement of materials science and pharmacology, a lot of research has been conducted to enhance the implant antimicrobial properties, including the addition of antimicrobial coatings on the implant surface, the adjustment of implant surface topography, and the development of new implant materials, and significant progress has been made in various aspects. Antimicrobial materials have shown promising applications in the prevention of peri-implant diseases, but meanwhile, there are some shortcomings, which leads to the lack of clinical widespread use of antimicrobial materials. This paper summarizes the research on antimicrobial materials applied to implants in recent years and presents an outlook on the future development.

How Porphyromonas gingivalis Navigate the Map: The Effect of Surface Topography on the Adhesion of Porphyromonas gingivalis on Biomaterials

The main purpose of this study is to develop an understanding of how Porphyromonas gingivalis responds to subperiosteal implant surface topography. A literature review was drawn from various electronic databases from 2000 to 2021. The two main keywords used were "Porphyromonas gingivalis" and "Surface Topography". We excluded all reviews and or meta-analysis articles, articles not published in English, and articles with no surface characterization process or average surface roughness (Ra) value. A total of 26 selected publications were then included in this study. All research included showed the effect of topography on Porphyromonas gingivalis to various degrees. It was found that topography features such as size and shape affected Porphyromonas gingivalis adhesion to subperiosteal implant materials. In general, a smaller Ra value reduces Porphyromonas gingivalis regardless of the type of materials, with a threshold of 0.3 µm for titanium.

In vitro study of structural and mechanical properties of latex and non-latex intermaxillary orthodontic elastics

PURPOSE

We evaluated bacterial endotoxin adhesion, superficial micromorphology and mechanical properties of latex and non-latex intermaxillary orthodontic elastics.

METHODS

To quantify the adhered bacterial endotoxin, elastics were divided into 5 groups: experimental (n = 12) latex and non-latex elastics, previously contaminated by an endotoxin solution, negative control (n = 6) latex and non-latex elastics without contamination, and positive control (n = 6) stainless steel specimens (metallic replicas), contaminated by an endotoxin solution. In parallel, the structural micromorphology (n = 6) and surface roughness of latex and non-latex intermaxillary orthodontic elastics were assessed using confocal laser microscopy. Force degradation (g) and deformation of the internal diameter change (mm) were also evaluated. Structural micromorphology, surface roughness (µm), force degradation (g) and internal diameter (mm) change were evaluated at time 0 and after 24 and 72 h in a deformation test. Data were analyzed by the Shapiro-Wilk, Kruskal-Wallis, Dunn, ANOVA and Bonferroni tests (α = 5%).

RESULTS

Endotoxin adhered similarly to both types of elastics with scores of 3 (> 1.0 EU/mL). The surface microstructure of both types of elastics showed irregularities and porosities at all times. Initially, the latex elastics had a higher surface roughness (p < 0.001) than the non-latex ones. After 24 h loading, surface roughness of the latex elastics was significantly reduced (p < 0.001), while after 72 h, the values were similar for both types (p > 0.05). The non-latex elastics had significantly higher force generation values (p < 0.05) at 0, 24 and 72 h compared with the latex elastics, although there was a significant reduction (p < 0.001) in force over time for both elastics. Despite similar initial values, non-latex elastics had a significantly larger internal diameter (p < 0.001) after the loading periods of 24 and 72 h compared with the latex elastics.

CONCLUSION

Both elastics showed high affinity with endotoxin and microstructural irregularities of their surface. The non-latex elastics generated higher force values but demonstrated greater deformation of the internal diameter after loading.

Effects of dextrose and lipopolysaccharide on the corrosion behavior of a Ti-6Al-4V alloy with a smooth surface or treated with double-acid-etching

Diabetes and infections are associated with a high risk of implant failure. However, the effects of such conditions on the electrochemical stability of titanium materials remain unclear. This study evaluated the corrosion behavior of a Ti-6Al-4V alloy, with a smooth surface or conditioned by double-acid-etching, in simulated body fluid with different concentrations of dextrose and lipopolysaccharide. For the electrochemical assay, the open-circuit-potential, electrochemical impedance spectroscopy, and potentiodynamic test were used. The disc surfaces were characterized by scanning electron microscopy and atomic force microscopy. Their surface roughness and Vickers microhardness were also tested. The quantitative data were analyzed by Pearson's correlation and independent t-tests (α = 0.05). In the corrosion parameters, there was a strong lipopolysaccharide correlation with the Ipass (passivation current density), Cdl (double-layer capacitance), and Rp (polarization resistance) values (p<0.05) for the Ti-6Al-4V alloy with surface treatment by double-acid-etching. The combination of dextrose and lipopolysaccharide was correlated with the Icorr (corrosion current density) and Ipass (p<0.05). The acid-treated groups showed a significant increase in Cdl values and reduced Rp values (p<0.05, t-test). According to the topography, there was an increase in surface roughness (R2 = 0.726, p<0.0001 for the smooth surface; R2 = 0.405, p = 0.036 for the double-acid-etching-treated surface). The microhardness of the smooth Ti-6Al-4V alloy decreased (p<0.05) and that of the treated Ti-6Al-4V alloy increased (p<0.0001). Atomic force microscopy showed changes in the microstructure of the Ti-6Al-4V alloy by increasing the surface thickness mainly in the group associated with dextrose and lipopolysaccharide. The combination of dextrose and lipopolysaccharide affected the corrosion behavior of the Ti-6Al-4V alloy surface treated with double-acid-etching. However, no dose-response corrosion behavior could be observed. These results suggest a greater susceptibility to corrosion of titanium implants in diabetic patients with associated infections.

In vitro macrophage response to polyethylene and polycarbonate-urethane particles

This study was undertaken to compare macrophage response to polycarbonate-urethane (PCU), a proposed alternative material to polyethylene in acetabular components of total hip arthroplasty to cross-linked ultra-high molecular weight polyethylene (xUHMWPE) in the presence or absence of endotoxin. Polyethylene wear debris that is generated by total hip and knee replacements has been linked to osteolysis and limiting the lifespan of the implant. We added both lipopolysaccharide (LPS)-free and endotoxin-associated xUHMWPE and PCU particles to a human monocyte cell line (TH1) in culture and measured cell viability and tumor necrosis factor (TNF)alpha, interleukin (IL)-1beta, and prostaglandin E(2) (PGE(2)) in the medium after 24 h. Results indicate that particles (both xUHMWPE and PCU) free of endotoxin did not significantly induce secretion of TNFalpha, IL-1beta, or PGE(2) above basal levels. However, endotoxin-exposed PCU particles induced significantly less TNFalpha and IL-1beta than endotoxin-exposed xUHMWPE particles. This indicates that if endotoxin is available for binding to particles in vivo, then xUHMWPE may be more inflammatory to periprosthetic tissue and bone in part because of its affinity/reactivity with endotoxin when compared with PCU.

Effect of pH on endotoxin affinity for metal-ceramic alloys

STATEMENT OF PROBLEM

Crevicular pH may modify bacterial endotoxin affinity for high-noble metal-ceramic alloys.

PURPOSE

Porphyromonas gingivalis lipopolysaccharide (LPS) affinity for 3 metal-ceramic alloys at 3 different pH levels was compared in vitro by measuring adsorption to and release from the alloy surface.

MATERIAL AND METHODS

Metallographically polished disks were fabricated from Pd-Ag-Sn, Au-Pd-Ag-Sn-In, and Au-Pd-In-Ga alloys. Clean disks were placed individually into 1 mL at pH 6.5, 7.0, or 7.5 phosphate-buffered saline solution containing 0.9 endotoxin units per square millimeter tritiated LPS (n = 3 disks per alloy-pH group). The disks were incubated for 24 hours at 37 degrees C before being transferred to LPS-free buffer and incubated, again for 24 hours at 37 degrees C, to evaluate elution. This transfer continued at 24-hour intervals up to 96 hours total elution incubation. Lipopolysaccharide adsorption to and elution from disks was determined through liquid scintillation spectrometry. Adsorption data were evaluated with a 2-way analysis of variance (alpha=.05) and the post hoc Tukey honestly significant difference test.

RESULTS

Lipopolysaccharide adsorption values ranged from 0.48 +/- 0.04 EU/mm(2) for the Au-Pd-Ag-Sn-In alloy at pH 7.5 to 0.75 +/- 0.04 EU/mm(2) for the Pd-Ag-Sn alloy at pH 6.5. Alloy type (P=.0001) and environmental pH (P=.0001) significantly influenced adsorption. Adsorption to the Pd-Ag-Sn and Au-Pd-In-Ga alloys at pH 6.5, 7.0, and 7.5 were similar and decreased with increasing pH. In contrast, adsorption to the Au-Pd-Ag-Sn-In alloy was significantly less than to other alloys at pH 6.5 but did not differ at other pH levels. Lipopolysaccharide release from the alloy surface could not be detected.

CONCLUSION

P. gingivalis LPS affinity for metal-ceramic alloys was modified by environmental pH. The degree of LPS adsorption depended on the composition and surface chemistry of each alloy.

In vitro TNF-α release from THP-1 monocytes in response to dental casting alloys exposed to lipopolysaccharide

STATEMENT OF PROBLEM

Studies have found that lipopolysaccharide (LPS) attaches to and is eluted from dental alloys, but the biologic effects of LPS are not known.

PURPOSE

This study evaluated the ability of dental casting alloys pre-exposed to LPS to activate human monocytes with and without subsequent elution of the LPS.

MATERIAL AND METHODS

Eight types of casting alloys (n = 6 specimens per type) were exposed to LPS (Escherichia coli @ 100 micrograms/mL) for 24 hours. Controls were not exposed to LPS. Teflon (Tf) (+/- LPS) served as the material control. Treated alloys were transferred to THP-1 human monocytes for 24 hours or placed into phosphate-buffered saline (PBS) solution for 120 hours before monocyte exposure. Monocyte activation was assessed by tumor necrosis factor alpha (TNF-alpha) secretion into the medium. Alloys without LPS, with LPS but without PBS elution, and with LPS and elution were compared with ANOVA and Turkey intervals (alpha=.05).

RESULTS

Specimens without LPS exposure but with elution caused no detectable TNF-alpha secretion from monocytes. Specimens without elution into PBS caused low-to-moderate TNF-alpha secretion, indicating a possible false-positive result from the alloy conditioning solution used. After LPS exposure but no elution, high levels of TNF-alpha were found. When alloys were eluted for 120 hours after LPS exposure, there was no detectable TNF-alpha released.

CONCLUSION

In this in vitro system as in past studies, LPS appeared to adhere to and elute from the alloys. Monocytes were activated initially but not after elution into PBS for 120 hours. Alloy conditioning solutions may also have an artifactual effect on cytokine release.

The influence of intracrevicular crown margins on gingival health: Preliminary findings

STATEMENT OF PROBLEM

The effect on gingival tissue of various crown materials in combination with different abutment biomaterials should be investigated.

PURPOSE

This in vivo study determined the gingival health and subgingival levels of periodontal inflammation-associated bacteria adjacent to various crown and abutment material combinations.

MATERIAL AND METHODS

. Patients in the study received 1 of 5 treatments: an all-ceramic crown luted to a natural tooth, a metal-ceramic (titanium) crown luted to natural tooth, a metal-ceramic (high noble alloy) crown luted to natural tooth, an all-ceramic crown luted to a titanium implant abutment, or a metal-ceramic (high noble alloy) crown luted to a titanium implant abutment. Plaque was collected at least 6 months after luting by paper point from the gingival sulcus of each crown and an adjacent unrestored (control) tooth. DNA probe analysis was performed to determine the levels of Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans. In addition, plaque, gingival redness, swelling, and bleeding scores were recorded with use of the California Dental Association scale. Statistical analysis was used to determine the effect of restoration/abutment type on levels of the bacterial species and clinical parameters pertaining to gingival health.

RESULTS

None of the sulci sampled contained detectable levels of the 3 bacteria. Plaque levels and gingival redness, swelling, and bleeding scores were low. All treatment groups had similar soft tissue response as measured by gingival redness, swelling, and bleeding. Plaque scores from all-ceramic crown/implant abutment sites were higher than plaque scores from all-ceramic crown/natural tooth sites. However, differences between experimental and control sites within the same treatment group were not observed (P>.05) with any of the 4 clinical measures.

CONCLUSION

In patients with suitable oral hygiene, tooth-supported and implant-supported crowns with intracrevicular margins were not predisposed to unfavorable gingival and microbial responses.

Endotoxin affinity for orthodontic brackets

Endotoxin, cell envelope lipopolysaccharide produced by gram-negative bacteria can activate an immune response through a variety of pathways. In addition, it can stimulate bone resorption and reduce the periodontal tissue's healing capacity. Previous studies have documented the affinity of lipopolysaccharide for restorative materials. This study evaluated the affinity of lipopolysaccharide for commercially available orthodontic brackets. Stainless steel, ceramic, plastic, and "gold" brackets were exposed to 10 EU/mm2radiolabeled Porphyromonas gingivalis or Escherichia coli lipolpoysaccharide in water and incubated for 24 hours at 37 degrees C. Brackets were then transferred to fresh lipopolysaccharide-free water and incubated for 24 hours at 37 degrees C to evaluate elution. This elution transfer was continued up to 96 hours total incubation. Lipopolysaccharide adherence and elution levels were calculated after treatment, and elution solutions were evaluated through liquid scintillation spectrometry. Mean initial lipopolysaccharide adherence ranged from 2.42 +/- 0.26 EU/mm2(E. coli, plastic) to 6.75 +/- 0.34 EU/mm2 (P. gingivalis, stainless steel). P. gingivalis lipopolysaccharide adherence was significantly greater than E. coli lipopolysaccharide adherence for all bracket types. Moreover, for each lipopolysaccharide type, stainless steel brackets exhibited significantly greater lipopolysaccharide adherence. Regarding elution, only the P. gingivalis lipopolysaccharide-exposed ceramic and plastic brackets at 24 hours and the stainless steel and ceramic brackets at 48 hours eluted measurable lipopolysaccharide. Results from this study demonstrate that P. gingivalis and E. coli LPS exhibit a high affinity for orthodontic brackets. In vivo, this affinity could affect the concentration of LPS in the gingival sulcus, thereby contributing to inflammation in tissues adjacent to the brackets.

Dental materials: 1996 literature review. Part 2

This critical review of the published literature on dental materials for the year 1996 has been compiled by the Dental Materials Panel of the UK. It continues the series of annual reviews started in 1973 and published in the Journal of Dentistry. Emphasis has been placed upon publications which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, dentine bonding, dental amalgam, endodontic materials, casting alloys, resin-bonded bridges and ceramo-metallic restorations, ceramics, denture base resins and soft lining materials, impression materials, implants materials, orthodontic materials, biomechanics and image processing, resin composites and casting investment materials and waxes). Three hundred and thirteen articles have been reviewed.

Lipopolysaccharide affinity for titanium implant biomaterials

STATEMENT OF PROBLEM

Lipopolysaccharide (LPS) affinity for titanium implant biomaterials could affect crevicular LPS concentrations and thereby influence periimplant inflammation.

PURPOSE OF STUDY

The purpose of this study was to evaluate Porphyromonas gingivalis and Escherichia coli LPS affinity for titanium biomaterials groups that differed in surface oxide composition and surface roughness.

MATERIAL AND METHOD

Polished and abraded grade 1 commercially pure titanium and grade 5 alloyed extra low interstitial titanium specimens were treated with 10 EU/mm2 and radiolabeled LPS.

RESULTS

The resultant mean +/- SD LPS adherence values ranged from 4.17 +/- 0.29 to 4.79 +/- 0.40 EU/ mm2. No difference in adherence and elution was indicated on the basis of LPS type, surface oxide composition, or surface roughness. Moreover, P. gingivalis and F. coli LPS desorption was below detection.

CONCLUSION

Clinically, the high affinity of both LPS types for titanium biomaterials may adversely influence the periimplant tissue response.