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Fardi A, Lillis T, Podaropoulos L, Papadimitriou S, Veis A, Dabarakis Ν. Hard and soft tissue healing around implants with Ag coating: An experimental study in dogs. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101714. [PMID: 38013117 DOI: 10.1016/j.jormas.2023.101714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/24/2023] [Indexed: 11/29/2023]
Abstract
Introduction The purpose of this randomized controlled canine experimental study was to evaluate peri‑implant hard and soft tissue healing around implants with silver coating. Methods All mandibular premolars and molars of five male beagle dogs were extracted. 25 test and 25 control implants were randomly installed and connected with the healing abutments. After 2 and 4 month healing period, implants with soft and hard tissues were obtained for histologic and histomorphometric analysis. Results In mesio-distal sections, supracrestal tissue attachment dimensions were 4.03±0.48 mm and 4.25±0.66 mm for test and 4.34±0.6 mm and 5.21±0.72 mm for control implants at 2 and 4 month healing time. The respective crestal bone loss values were 1.10±0.69 mm and 0.74±0.67 mm for test and 1.13±0.48 mm and 1.49±0.65 mm for control implants. The differences were statistically significant only in the 4-month healing period. In buccolingual sections, supracrestal tissue attachment height at 2 and 4 month healing periods were 4.09±0.64 mm and 4.5±0.8 mm for test implants and 4.17±0.76 mm and 4.48±0.76 mm for control implants. The respective mean values for crestal bone loss were 1.31±0.6 mm and 1.02±0.58 mm for test implants, and 1.28±0.61 mm and 1.29±0.69 mm for control implants. No statistical significant differences were recorded, apart from the height of connective tissue at the 2 month healing group. No significant difference in terms of BIC between implants or healing periods was recorded. Conclusions The Ag implant coating resulted in smaller supracrestal tissue attachment dimensions and less bone loss. Within the limits of a canine study, prevention of crestal bone loss along with the effectiveness of Ag antimicrobial properties in dental implantology is demonstrated.
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Affiliation(s)
- Anastasia Fardi
- Department of Dentoalveolar Surgery, Surgical Implantology & Radiology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
| | - Theodoros Lillis
- Department of Dentoalveolar Surgery, Surgical Implantology & Radiology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Leonidas Podaropoulos
- Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Greece
| | | | - Alexander Veis
- Department of Dentoalveolar Surgery, Surgical Implantology & Radiology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Νikolaos Dabarakis
- Department of Dentoalveolar Surgery, Surgical Implantology & Radiology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Greece
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Maquera-Huacho PM, de Carvalho GG, Jafelicci M, Marcantonio E, Spolidorio DMP. Physical-chemical influences and cell behavior of natural compounds on titanium dental surfaces. Braz Dent J 2023; 34:53-62. [PMID: 38133473 PMCID: PMC10759949 DOI: 10.1590/0103-6440202305582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023] Open
Abstract
The present study evaluated the influence of carvacrol, terpinene-4-ol, and chlorhexidine on the physical-chemical properties of titanium surfaces, cell viability, proliferation, adhesion, and spreading of fibroblasts and osteoblasts in vitro. Titanium surfaces (Ti) were treated with Carvacrol (Cvc), Terpinen-4-ol (T4ol), Chlorhexidine (CHX), DMSO, and ultrapure water (Control group). Physical-chemical modifications were evaluated by surface wettability, the surface free energy (SFE) calculated from the contact angle values using the Owens-Wendt-Rabel-Kaeble (OWRK) equation, scanning electron microscopy (SEM) and energy dispersive spectrometry probe (EDS) system. Cells were seeded onto Ti-treated surfaces and incubated for 24 h and 72 h, then evaluated by Alamar blue assay and fluorescence microscopy. Surfaces treated with Cvc and T4ol showed the presence of Na, O, and Cl. All surfaces showed hydrophilic characteristics and SFE values between 5.5 mN/m and 3.4 mN/m. On the other hand, EDS peaks demonstrated the presence of O and Cl after CHX treatment. A reduction of cell viability and adhesion was noted on titanium surfaces treated with CHX after 24 and 72h. In conclusion, the results indicate that the decontamination with Cvc and T4ol on Ti surfaces does not alter the surface proprieties and allows an adequate interaction with cells involved in the re-osseointegration process such as fibroblasts and osteoblasts.
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Affiliation(s)
- Patricia Milagros Maquera-Huacho
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University(Unesp), Araraquara, SP, Brazil
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
| | - Gabriel Garcia de Carvalho
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University(Unesp), Araraquara, SP, Brazil
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
| | - Miguel Jafelicci
- Institute of Chemistry, Laboratory of Magnetic Materials and Colloids, São Paulo State University(Unesp), Araraquara, SP, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University(Unesp), Araraquara, SP, Brazil
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University(Unesp), Araraquara, São Paulo, Brazil
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Salaie RN, Hassan PA, Meran ZD, Hamad SA. Antibacterial Activity of Dissolved Silver Fractions Released from Silver-Coated Titanium Dental Implant Abutments: A Study on Streptococcus mutans Biofilm Formation. Antibiotics (Basel) 2023; 12:1097. [PMID: 37508193 PMCID: PMC10376167 DOI: 10.3390/antibiotics12071097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: The aim of this research was to investigate the antibacterial activity of dissolved silver from silver-coated titanium implants against Streptococcus mutans. (2) Methodology: Silver-coated titanium implant discs were immersed in 1.8 mL of brain heart infusion broth (BHIB) and incubated for 24 h in order to release the silver ions into the broth. The coating quality was confirmed via EDS, and the dissolved silver was measured via inductively coupled plasma mass spectrometry (ICP-MS). The experimental design used unconditioned broth (control) and broth conditioned with silver released from silver-coated titanium implants (n = 6). Regarding the antibacterial activity, isolated Streptococcus mutans was used. A turbidity test and lactate production test were performed to determine the effect of dissolved silver on bacterial growth in a suspension and biofilm formation. (3) Result: The results showed that the coating was successfully applied on the substrate. There was around 0.3 mg/L of silver released into the BHIB, and the turbidity of the control group was significantly higher than the treatment, with measured absorbance values of 1.4 and 0.8, respectively, indicating that the dissolved silver ions from the silver-coated titanium discs exhibited some degree of antibacterial activity by preventing the growth of Streptococcus mutans. However, the results of the antibiofilm activity test did not show any significant difference between the groups. (4) Conclusion: The dissolved silver from silver-coated titanium implants has an antibacterial activity but not a significant antimicrobial activity, indicating that the dissolved silver from silver-coated titanium abutments can significantly reduce the incidence of peri-implant mucositis.
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Affiliation(s)
- Ranj Nadhim Salaie
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishk International University, Erbil 44001, Iraq
| | - Pakhshan A Hassan
- Department of Biology, College of Science, Salahaddin University, Erbil 44001, Iraq
| | - Zhala Dara Meran
- Department of Prosthodontics, College of Dentistry, Hawler Medical University, Erbil 44001, Iraq
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Stein JM, Conrads G, Abdelbary MMH, Yekta-Michael SS, Buttler P, Glock J, Sadvandi G, Kaufmann R, Apel C. Antimicrobial efficiency and cytocompatibility of different decontamination methods on titanium and zirconium surfaces. Clin Oral Implants Res 2023; 34:20-32. [PMID: 36259118 DOI: 10.1111/clr.14014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/18/2022] [Accepted: 10/13/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the efficiency of different implant-decontamination methods regarding biofilm modification and potential cytotoxic effects. Therefore, the amount of biofilm reduction, cytocompatibility, and elementary surface alterations were evaluated after decontamination of titanium and zirconium surfaces. MATERIAL AND METHODS Titanium and zirconium disks were contaminated with a newly developed high-adherence biofilm consisting of six microbial species. Decontaminations were performed using titanium curette, stainless steel ultrasonic scaler (US), glycine (GPAP) and erythritol (EPAP) powder air-polishing, Er:YAG laser, 1% chlorhexidine (CHX), 10% povidone-iodine (PVI), 14% doxycycline (doxy), and 0.95% NaOCl solution. Microbiologic analysis was done using real-time qPCR. For assessment of cytocompatibility, a multiplex assay for the detection of cytotoxicity, viability, and apoptosis on human gingival fibroblasts was performed. X-ray photoelectron spectroscopy (XPS) was used to evaluate chemical alterations on implant surfaces. RESULTS Compared with untreated control disks, only GPAP, EPAP, US, and Er:YAG laser significantly reduced rRNA counts (activity) on titanium and zirconium (p < .01), whereas NaOCl decreased rRNA count on titanium (p < .01). Genome count (bacterial presence) was significantly reduced by GPAP, EPAP, and US on zirconium only (p < .05). X-ray photoelectron spectroscopy analyses revealed relevant re-exposure of implant surface elements after GPAP, EPAP, and US treatment on both materials, however, not after Er:YAG laser application. Cytocompatibility was impaired by CHX, PVI, doxy, and NaOCl. CHX and PVI resulted in the lowest viability and doxy in the highest apoptosis. CONCLUSIONS Within the limits of this in vitro study, air-polishing methods and ultrasonic device resulted in effective biofilm inactivation with surface re-exposure and favorable cytocompatibility on titanium and zirconium. Chemical agents, when applied on implant surfaces, may cause potential cytotoxic effects.
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Affiliation(s)
- Jamal M Stein
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany.,Private Practice, Aachen, Germany
| | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, Aachen, Germany
| | - Mohamed M H Abdelbary
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, Aachen, Germany
| | | | - Patricia Buttler
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany
| | - Joanna Glock
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany
| | - Gelareh Sadvandi
- Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany
| | - Robert Kaufmann
- DWI - Leibnitz-Institut für Interaktive Materialien, Aachen, Germany
| | - Christian Apel
- Department of Biohybrid & Medical Textiles (BioTex), Institute of Applied Medical Engineering, RWTH Aachen University & Hospital, Germany
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Bayrak M, Kocak-Oztug NA, Gulati K, Cintan S, Cifcibasi E. Influence of Clinical Decontamination Techniques on the Surface Characteristics of SLA Titanium Implant. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:4481. [PMID: 36558334 PMCID: PMC9784882 DOI: 10.3390/nano12244481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/04/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
The study aims: 1. To perform diode laser, titanium (Ti) brush, and Ti curette treatment on sandblasted and acid-etched (SLA) Ti surfaces, with/without H2O2 and CHX, 2. To investigate the influence of decontamination techniques on implant surface topography and hydrophilicity. Diode laser, Ti brush, and Ti curette treatments were performed on the Grade 4 Ti discs, with/without treatment with 3% H2O2 solution or 0.2% CHX. Surface characteristics were investigated via SEM, optical profilometry, and water contact angle meter. SEM findings revealed flat and scratched areas when treated with Ti curette and Ti brush. For diode laser, SEM showed melting in specific areas. Ra and Rt values were lower in all test groups than in the control group (p < 0.05). The adjunctive chemical treatment showed negligible effects in SEM images and surface roughness measurements compared to laser and mechanical treatment-only groups. H2O2 treatment resulted in enhanced hydrophilicity in either treatment modalities with a significant difference compared to the negative control group (p < 0.05). In all test groups, the hydrophilicity was enhanced compared to the negative control group (p < 0.05). Diode laser treatment had the least disruptive effect on the Ti surface characteristics. The use of other mechanical methods caused significant alterations in the surface roughness.
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Affiliation(s)
- Meltem Bayrak
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
- Institute of Graduate Studies in Health Sciences, Department of Periodontology, Istanbul University, Istanbul 34126, Turkey
| | - Necla Asli Kocak-Oztug
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia
| | - Karan Gulati
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia
| | - Serdar Cintan
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
| | - Emine Cifcibasi
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul 34116, Turkey
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Surface Free Energy and Composition Changes and Ob Cellular Response to CHX-, PVPI-, and ClO 2-Treated Titanium Implant Materials. J Funct Biomater 2022; 13:jfb13040202. [PMID: 36412843 PMCID: PMC9680491 DOI: 10.3390/jfb13040202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022] Open
Abstract
The study evaluated the interaction of a titanium dental implant surface with three different antibacterial solutions: chlorhexidine, povidone-iodine, and chlorine dioxide. Implant surface decontamination is greatly challenging modern implant dentistry. Alongside mechanical cleaning, different antibacterial agents are widely used, though these could alter implant surface properties. Commercially pure (CP) grade 4 titanium (Ti) discs were treated with three different chemical agents (chlorhexidine 0.2% (CHX), povidone-iodine 10% (PVPI), chlorine dioxide 0.12% (ClO2)) for 5 min. Contact angle measurements, X-ray photoelectron spectroscopy (XPS) analysis, and cell culture studies were performed. Attachment and proliferation of primary human osteoblast cells were investigated via MTT (dimethylthiazol-diphenyl tetrazolium bromide), alamarBlue, LDH (lactate dehydrogenase), and fluorescent assays. Contact angle measurements showed that PVPI-treated samples (Θ = 24.9 ± 4.1) gave no difference compared with controls (Θ = 24.6 ± 5.4), while CHX (Θ = 47.2 ± 4.1) and ClO2 (Θ = 39.2 ± 9.8) treatments presented significantly higher Θ values. All samples remained in the hydrophilic region. XPS analysis revealed typical surface elements of CP grade 4 titanium (Ti, O, and C). Both MTT and alamarBlue cell viability assays showed similarity between treated and untreated control groups. The LDH test revealed no significant difference, and fluorescent staining confirmed these results. Although there was a difference in surface wettability, a high proliferation rate was observed in all treated groups. The in vitro study proved that CHX, PVPI, and ClO2 are proper candidates as dental implant decontamination agents.
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Agarwalla SV, Ellepola K, Sorokin V, Ihsan M, Silikas N, Neto AHC, Seneviratne CJ, Rosa V. Antimicrobial-free graphene nanocoating decreases fungal yeast-to-hyphal switching and maturation of cross-kingdom biofilms containing clinical and antibiotic-resistant bacteria. BIOMATERIALS AND BIOSYSTEMS 2022; 8:100069. [PMID: 36824379 PMCID: PMC9934433 DOI: 10.1016/j.bbiosy.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 12/05/2022] Open
Abstract
Candida albicans and methicillin-resistant Staphylococcus aureus (MRSA) synergize in cross-kingdom biofilms to increase the risk of mortality and morbidity due to high resistance to immune and antimicrobial defenses. Biomedical devices and implants made with titanium are vulnerable to infections that may demand their surgical removal from the infected sites. Graphene nanocoating (GN) has promising anti-adhesive properties against C. albicans. Thus, we hypothesized that GN could prevent fungal yeast-to-hyphal switching and the development of cross-kingdom biofilms. Herein, titanium (Control) was coated with high-quality GN (coverage > 99%). Thereafter, mixed-species biofilms (C. albicans combined with S. aureus or MRSA) were allowed to develop on GN and Control. There were significant reductions in the number of viable cells, metabolic activity, and biofilm biomass on GN compared with the Control (CFU counting, XTT reduction, and crystal violet assays). Also, biofilms on GN were sparse and fragmented, whereas the Control presented several bacterial cells co-aggregating with intertwined hyphal elements (confocal and scanning electronic microscopy). Finally, GN did not induce hemolysis, an essential characteristic for blood-contacting biomaterials and devices. Thus, GN significantly inhibited the formation and maturation of deadly cross-kingdom biofilms, which can be advantageous to avoid infection and surgical removal of infected devices.
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Affiliation(s)
| | - Kassapa Ellepola
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, USA
| | - Vitaly Sorokin
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Mario Ihsan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nikolaos Silikas
- Dentistry, The University of Manchester, Manchester, United Kingdom
| | - AH Castro Neto
- Centre for Advanced 2D Materials, National University of Singapore, Singapore
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Australia,Co-corresponding author at: School of Dentistry, The University of Queensland, 288 Herston Road, Cnr Bramston Terrace & Herston Road Herston QLD 4006, Australia.
| | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore,Centre for Advanced 2D Materials, National University of Singapore, Singapore,ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore,Corresponding author at: Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore.
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Evaluation the loosening of abutment screws in fluid contamination: an in vitro study. Sci Rep 2022; 12:10797. [PMID: 35750776 PMCID: PMC9232564 DOI: 10.1038/s41598-022-14791-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/13/2022] [Indexed: 11/08/2022] Open
Abstract
Screw loosening is one of the most common clinical problems of dental implants. Research on the influencing factors of screw loosening is very important to prevent screw loosening. The purpose of this in vitro study was to evaluate the influence of liquid contamination on the screw loosening. According to the contamination condition, forty-five abutment screws were divided into three groups (n = 15): no contamination, artificial saliva contamination, and mouthwash contamination. The preload and friction coefficient of the abutment screws were recorded. Then, the reverse torque values (RTVs) and settlement were measured after 3.0 × 105 and 6.0 × 105 cycles. The surface wear of the screws was analyzed. Finally, the stress distribution of the abutment screws was calculated by finite element analysis (FEA). The results showed that fluid contamination reduced the friction coefficient, increased the preload, decrease the settlement, improved resistance to screw loosening, and reduced wear on the thread surface. Appropriate antimicrobial lubrication may improve the anti-loosening performance of abutment screws and prevent excessive wear on the threaded surface.
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Effectiveness of Different Chemotherapeutic Agents for Decontamination of Infected Dental Implant Surface: A Systematic Review. Antibiotics (Basel) 2022; 11:antibiotics11050593. [PMID: 35625237 PMCID: PMC9137954 DOI: 10.3390/antibiotics11050593] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 01/27/2023] Open
Abstract
Aim: To evaluate the most effective chemotherapeutic agent for decontamination of infected dental implants. Material and methods: A systematic electronic literature search in MEDLINE (PubMed) and Google scholar between January 2010 to December 2021 was carried out by using the PRISMA guidelines. A total of five studies related to chemical decontamination of the dental implant were evaluated. The search strategy was based on the PICOS framework. Randomized controlled trials (RCT’s) and cohort studies evaluating the effectiveness of different chemotherapeutic agents for the decontamination of dental implants were included in the study. The outcome variable examined was the most effective chemotherapeutic agent(s) for dental implant surface decontamination after comparing the chemotherapeutic agents used in the qualifying studies. Result: Out of the basic database of 1564 records, 1380 articles were excluded due to irrelevance, unavailability, and repetition. Furthermore, 134 articles were excluded from 184 studies for various reasons. After further filtration, 13 studies were shortlisted. Two investigators (SSA and SA) appraised the quality of the selected studies using the risk of bias assessment tool. After excluding eight studies, five articles were finally included in the present systematic review. Conclusion: The data reported for the efficacy of chemotherapeutic agents in cleaning contaminated titanium surfaces are scarce, thus it is not possible to draw a definite conclusion. However, chlorhexidine (CHX) (0.2%, 0.12%), citric acid (40%) and sodium hypochlorite (1%) are the most commonly used chemotherapeutic agents; amongst them, citric acid showed the highest potential for biofilm removal from the contaminated implant surface. All three agents [CHX (0.2%, 0.12%), citric acid (40%), and sodium hypochlorite (1%)] can be recommended as therapeutic agents along with their curbs.
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An In Vitro Study of Fluid Contaminations Influences on Reverse Torque Values of Implant-Abutment Connections. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4111710. [PMID: 35299888 PMCID: PMC8923780 DOI: 10.1155/2022/4111710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/25/2022] [Indexed: 11/20/2022]
Abstract
Purpose To examine the effects of fluid contamination on the reverse torque value (RTV) of abutment screws. 484 titanium fixtures were mounted into the stainless-steel holders. Methods 11 groups (44 specimens in each group) of implants were mounted in acrylic resin. Ten groups of fixture screw holes were contaminated with chlorhexidine, saliva, blood, fluoride, or combination groups, and one group served as a control without contamination. To simulate the oral environment, samples were subjected to thermal cycling and cyclic loading. Results The RTV means were less than the initial torque in both control and contamination groups. The maximum RTV mean was observed in the fluoride group (26.00 ± 1.02 Ncm). In other groups, this rate for control, blood, saliva, and chlorhexidine groups were 18.00 ± 1.78 Ncm, 22.12 ± 1.56 Ncm, 21.56 ± 1.43 Ncm, and 21.89 ± 1.02 Ncm, respectively. In combination groups, the maximum RTV mean was observed in the saliva+CHX group (23.89 ± 1.92 Ncm). In other combination groups, this rate for the blood+CHX, blood+saliva, saliva+fluoride, fluoride+CHX, and fluoride+blood groups were 22.56 ± 1.73 Ncm, 22.00 ± 1.54 Ncm, 20.11 ± 1.58 Ncm, 23.51 ± 1.19 Ncm, 21.02 ± 1.38 Ncm, and 20.11 ± 1.58 Ncm, respectively. The RTV was statistically significant (p < 0.05) for the contamination groups (except saliva) and combination groups compared to the control group. There is no statistically significant difference (p > 0.05) between the reverse torque value mean of the blood and saliva groups and between that of the fluoride and chlorhexidine groups. Conclusion Implant-abutment specimens are suggested to be placed in a saliva environment and should be subjected to cyclic loading.
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Amaliya A, Ramadhanti R, Hadikrishna I, Maulina T. The Effectiveness of 0.2% Chlorhexidine Gel on Early Wound Healing after Tooth Extraction: A Randomized Controlled Trial. Eur J Dent 2022; 16:688-694. [PMID: 35016228 PMCID: PMC9507567 DOI: 10.1055/s-0041-1739544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective
This study aimed to evaluate the effect of 0.2% chlorhexidine (CHX) gel on wound healing after tooth extraction.
Materials and Methods
A single blind, randomized controlled trial was performed recruiting 32 participants who underwent dental extractions. Patients were randomly allocated for CHX group or placebo group. The primary outcomes were wound closure measured with calipers and healings were assessed by Landry et al index after 7 days of topical application of allocated gels on extraction sites.
Results
The wound closures were greater in CHX group compared with placebo group and healing scores were correlated with the use of CHX gel (
p
-value < 0.05).
Conclusion
In a population of healthy nonsmoker adults, application of 0.2% CHX gel twice a day for 7 days after tooth extraction has a beneficial effect on wound healing.
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Affiliation(s)
- Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Rika Ramadhanti
- Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Indra Hadikrishna
- Department of Oral Surgery, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Tantry Maulina
- Department of Oral Surgery, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
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Stuani VDT, Kim DM, Nagai M, Chen CY, Sant'Ana ACP. The In Vitro Evaluation of Preosteoblast Migration From 3-D-printed Scaffolds to Decontaminated Smooth and Minimally Rough Titanium Surfaces: A Pilot Study. Altern Lab Anim 2021; 49:83-92. [PMID: 34218686 DOI: 10.1177/02611929211022165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In vitro evaluations are essential to gaining a better understanding of re-osseointegration, while reducing animal use and the overall costs of peri-implantitis studies. This pilot study evaluated preosteoblast migration from 3-D-printed scaffolds to decontaminated titanium microimplants, creating a system that tries to mimic the bone-implant interface. Smooth (S) and minimally rough (R) titanium microimplants were incubated in Escherichia coli cultures and divided into six groups according to the decontamination protocol applied: EDTA gel (EDTA); chlorhexidine (CHL); chlorhexidine-soaked gauze (GCHL); scaling (SC); titanium brush (TiB); and implantoplasty (IP). Pristine S and R microimplants were used as the controls (C). After the decontamination procedures, the microimplants were inserted in 3-D-printed polyurethane-based scaffolds previously inoculated with preosteoblast cell cultures. Cellular migration was assessed after 24, 72 and 120 hours by ATP quantification. At the 120-hour time point, there was no statistically significant difference between S-C, S-EDTA, S-CHL, S-GCHL and S-SC (p > 0.05), and between R-C, R-EDTA and R-GCHL (p > 0.05). The in vitro model developed in this pilot study successfully demonstrated cell migration on the different decontaminated surfaces. This methodology suggests that on smooth microimplants, EDTA, GCHL, SC and TiB decontamination may have a reduced impact on preosteoblast migration, while on minimally rough microimplants, EDTA and GCHL decontamination affected cell migration the least. However, when selecting a decontamination protocol, the effectiveness of the decontamination per se must also be considered.
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Affiliation(s)
- Vitor de Toledo Stuani
- Department of Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - David Minjoon Kim
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Masazumi Nagai
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Chia-Yu Chen
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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13
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Mostafavi AS, Memarian M, Seddigh MA. Effect of fluid contamination on reverse torque values in implant-abutment connections under oral conditions. J Adv Prosthodont 2021; 13:65-70. [PMID: 33747396 PMCID: PMC7943751 DOI: 10.4047/jap.2021.13.1.65] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/05/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Implant mechanical complications, including screw loosening, can influence dental implant success. It has been shown that torque values are affected by contamination occurred in implant-abutment (I/A) interface. This study aimed to examine the effects of blood, saliva, fluoride and chlorhexidine contamination on reverse torque values (RTVs) of abutment screws in oral conditions. MATERIALS AND METHODS 50 fixtures were mounted into the stainless-steel holders and divided into five groups (n = 10). Except control group (NC), fixture screw holes in other groups were contaminated with chlorhexidine (CG), saliva (SG), blood (BG), or fluoride (FG). Abutment screws were tightened with a digital torque meter. I/A assemblies were subjected to thermocycling and cyclic loading. The mean RTVs were recorded and data were analyzed with one-way ANOVA and Tukey test. RESULTS Except for specimens in SG (20.56 ± 1.33), other specimens in BG (21.11 ± 1.54), CG (22.89 ± 1.1) and FG (24.00 ± 1.12) displayed significantly higher RTVs compared to NC (19.00 ± 1.87). The highest RTVs were detected in CG and FG. CONCLUSION The obtained data robustly suggest that RTVs were significantly affected by fluid contaminations. Specimens in FG and CG displayed the highest RTVs. Therefore, clinicians should have enough knowledge about probable contaminations in I/A interface in order to manage them during clinical procedure and to inform patients about using oral care products.
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Affiliation(s)
- Azam Sadat Mostafavi
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Memarian
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Seddigh
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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14
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Gonçalves IMR, Herrero ER, Carvalho O, Henriques B, Silva FS, Teughels W, Souza JCM. Antibiofilm effects of titanium surfaces modified by laser texturing and hot-pressing sintering with silver. J Biomed Mater Res B Appl Biomater 2021; 109:1588-1600. [PMID: 33622023 DOI: 10.1002/jbm.b.34817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/23/2021] [Accepted: 02/01/2021] [Indexed: 11/07/2022]
Abstract
Peri-implant diseases are one of the main causes of dental implant failure. New strategies for dental implants manufacturing have been developed to prevent the accumulation of bacteria and related inflammatory reactions. The main aim of this work was to develop laser-treated titanium surfaces covered with silver that generate a electrical dipole to inhibit the oral bacteria accumulation. Two approaches were developed for that purpose. In one approach a pattern of different titanium dioxide thickness was produced on the titanium surface, using a Q-Switched Nd:YAG laser system operating at 1064 nm. The second approach was to incorporate silver particles on a laser textured titanium surface. The incorporation of the silver was performed by laser sintering and hot-pressing approaches. The anti-biofilm effect of the discs were tested against biofilms involving 14 different bacterial strains growth for 24 and 72 hr. The morphological aspects of the surfaces were evaluated by optical and field emission guns scanning electronical microscopy (FEGSEM) and therefore the wettability and roughness were also assessed. Physicochemical analyses revealed that the test surfaces were hydrophilic and moderately rough. The oxidized titanium surfaces showed no signs of antibacterial effects when compared to polished discs. However, the discs with silver revealed a decrease of accumulation of Porphyromonas gingivalis and Prevotella intermedia strains. Thus, the combination of Nd:YAG laser irradiation and hot-pressing was effective to produce silver-based patterns on titanium surfaces to inhibit the growth of pathogenic bacterial species. The laser parameters can be optimized to achieve different patterns, roughness, and thickness of the modified titanium layer regarding the type and region of the implant.
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Affiliation(s)
- Inês M R Gonçalves
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Esteban R Herrero
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, 3000, Belgium
| | - Oscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Bruno Henriques
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Filipe S Silva
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, 3000, Belgium
| | - Júlio C M Souza
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal.,Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, 4585-116, Portugal
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15
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The efficacy of convenient cleaning methods applicable for customized abutments: an in vitro study. BMC Oral Health 2021; 21:78. [PMID: 33602211 PMCID: PMC7890105 DOI: 10.1186/s12903-021-01436-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022] Open
Abstract
Background The demand for implant dentistry, which includes customized abutments, is increasing. A lot of pollutions are generated on the customized abutment surface following milling procedure. This study evaluated the surface topography and cleanliness of customized abutments after cleaning procedures, which are simply applicable in the dental clinic. Methods Thirty computer-aided design and computer-aided manufacturing internal connection type titanium abutments were produced, milled, and randomly divided into 3 groups: steam cleaning (control group), chlorhexidine (CHX) scrubbing (test group 1), and ultrasonic cleaning with CHX solution, acetone, and ethyl alcohol (test group 2). Each group was evaluated using microscopic and microbial analysis. Results Foreign bodies were observed on the abutment surfaces in control group and test group 1, but not in test group 2. Bacteria were observed on 40% of the agar plates following steam cleaning; most of the colonies consisted of Bacillus cereus and Staphylococcus warneri. Colony growth was absent following test group 1 and 2. Conclusion For customized abutments, cleaning with steam is ineffective. CHX scrubbing effectively eliminates only bacteria. Ultrasonic cleaning with CHX solution, acetone, and ethyl alcohol successfully removes both foreign bodies and bacteria. Thus, the ultrasonic cleaning method is conveniently applicable in the dental clinic for eliminating contamination of the customized abutment surface.
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16
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Stuani VT, Kim DM, Nagai M, Chen CY, Sant'Ana ACP. Effectiveness and surface changes of different decontamination protocols at smooth and minimally rough titanium surfaces. J Periodontol 2020; 92:704-715. [PMID: 32946119 DOI: 10.1002/jper.20-0324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/27/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The objective of this study is to evaluate titanium decontamination after different protocols while assessing changes in surface roughness, chemical composition, and wettability. METHODS Ninety-six smooth (S) and 96 minimally rough (R) titanium microimplants were used. Pristine microimplants were reserved for negative control (S-nC/R-nC, n = 9), while the remaining microimplants were incubated in Escherichia coli culture. Non-decontaminated microimplants were used as positive control (S-pC/R-pC, n = 3). The other microimplants were divided into seven different decontamination protocols (12 S/R per group): 24% EDTA, 2% chlorhexidine (CHL), gauze soaked in 2% chlorhexidine (GCHL), gauze soaked in ultrapure water (GMQ), scaling (SC), titanium brush (TiB), and implantoplasty (IP). Contaminated areas were assessed by scanning electron microscope images, chemical composition by energy dispersive X-ray spectroscopy, wettability by meniscus technique, and roughness by an optical profiler. RESULTS Higher residual bacteria were observed in R-pC compared with S-pC (P <0.0001). When comparing S and R with their respective pC groups, the best results were obtained with GCHL, SC, TiB, and IP, with no difference between these protocols (P >0.05). Changes in surface roughness were observed after all treatments, with S/R-IP presenting the smoother and a less hydrophilic surface (P <0.05). Apart from IP protocol, all the other groups presented a more hydrophilic surface in R than in S microimplants (P <0.003). All decontamination protocols resulted in a lower percentage of superficial Ti when compared with S/R-nC (P <0.002). CONCLUSIONS All decontamination protocols resulted in changes in roughness, wettability, and chemical composition, but GCHL, SC, TiB, an IP presented the best decontamination outcomes.
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Affiliation(s)
- Vitor T Stuani
- Department of Periodontology, Bauru School of Dentistry-University of Sao Paulo, Bauru, SP, Brazil.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - David M Kim
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Masazumi Nagai
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Chia-Yu Chen
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Adriana C P Sant'Ana
- Department of Periodontology, Bauru School of Dentistry-University of Sao Paulo, Bauru, SP, Brazil
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17
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Kotsakis GA, Black R, Kum J, Berbel L, Sadr A, Karoussis I, Simopoulou M, Daubert D. Effect of implant cleaning on titanium particle dissolution and cytocompatibility. J Periodontol 2020; 92:580-591. [PMID: 32846000 DOI: 10.1002/jper.20-0186] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/13/2020] [Accepted: 07/18/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Peri-implantitis treatments are mainly based on protocols for teeth but have not shown favorable outcomes for implants. The potential role of titanium dissolution products in peri-implantitis necessitate the consideration of material properties in devising treatment protocols. We assessed implant cleaning interventions on (1) bacterial removal from Ti-bound biofilms, (2) Ti surface alterations and related Ti particle dissolution, and (3) cytocompatibility. METHODS Acid-etched Ti discs were inoculated with human peri-implant plaque biofilms and mechanical antimicrobial interventions were applied on the Ti-bound biofilms for 30 seconds each: (1) rotary nylon brush; (2) Ti brush; (3) water-jet on high and (4) low, and compared to sterile, untreated and Chlorhexidine-treated controls. We assessed colony forming units (CFU) counts, biofilm removal, surface changes via scanning electron microscopy (SEM) and atomic force microscopy (AFM), and Ti dissolution via light microscopy and Inductively-coupled Mass Spectrometry (ICP-MS). Biological effects of Ti particles and surfaces changes were assessed using NIH/3T3 fibroblasts and MG-63 osteoblastic cell lines, respectively. RESULTS Sequencing revealed that the human biofilm model supported a diverse biofilm including known peri-implant pathogens. WJ and Nylon brush were most effective in reducing CFU counts (P < 0.01 versus control), whereas Chlorhexidine was least effective; biofilm imaging results were confirmatory. Ti brushes led to visible streaks on the treated surfaces, reduced corrosion resistance and increased Ti dissolution over 30 days of material aging as compared to controls, which increase was amplified in the presence of bacteria (all P-val < 0.05). Ti particles exerted cytotoxic effects against fibroblasts, whereas surfaces altered by Ti brushes exhibited reduced osteoconductivity versus controls (P < 0.05). CONCLUSIONS Present findings support that mechanical treatment strategies selected for implant biofilm removal may lead to Ti dissolution. Ti dissolution should become an important consideration in the clinical selection of peri-implantitis treatments and a necessary criterion for the regulatory approval of instruments for implant hygiene.
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Affiliation(s)
| | | | - Jason Kum
- Private Practice, Indianapolis, Indiana, USA
| | - Larissa Berbel
- Nuclear and Energy Research Institute-IPEN, University of São Paulo, São Paulo, Brazil
| | - Ali Sadr
- Comprehensive Dentistry, University of Washington, Seattle, Washington, USA
| | - Ioannis Karoussis
- Periodontics, National and Kapodistrian University of Athens, Athens, Greece
| | - Mara Simopoulou
- Experimental Physiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Diane Daubert
- Periodontics, University of Washington, Seattle, Washington, USA
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18
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Liu S, Li M, Yu J. Does chlorhexidine improve outcomes in non-surgical management of peri-implant mucositis or peri-implantitis?: a systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2020; 25:e608-e615. [PMID: 32683389 PMCID: PMC7473444 DOI: 10.4317/medoral.23633] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 05/03/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND With greater number of implants being placed in clinical practice, incidence of peri-implant diseases are on the rise. It is not known whether chlorhexidine (CHX) improves outcomes in the management of peri-implant diseases. The aim of this systematic review and meta-analysis was to evaluate the role of CHX in improving outcomes with non-surgical management of peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS An electronic search of PubMed, Scopus, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases up to 1st August 2019 was carried out to search for studies evaluating the efficacy of CHX for non-surgical management of peri-implant diseases. RESULTS Seven studies were included. Four studies evaluated the role of CHX in peri-implant mucositis and three in peri-implantitis. Oral prophylaxis with mechanical cleansing of implant surface prior to CHX use was carried out in all seven studies. Meta-analysis indicated that use of CHX did not improve probing depths in peri-implant mucositis (SMD= 0.11; 95% CI: -0.16 to 0.38; p=0.42, I2= 0%). Similarly, CHX did not significantly reduce probing depths in patients with peri-implantitis (MD= 1.57; 95% CI: -0.88 to 4.0; p=0.21, I2= 98%). Results on the efficacy of CHX in reducing BOP in peri-implantitis are conflicting. CONCLUSIONS Results of our study indicate that adjunctive therapy with CHX may not improve outcomes with non-surgical management of peri-implant mucositis. Conclusions with regards to its role in non-surgical management of peri-implantitis cannot be drawn. There is a need for more homogenous RCTs with large sample size to define the role of CHX in non-surgical management of peri-implant mucositis and peri-implantitis.
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Affiliation(s)
- S Liu
- Department of Stomatology affiliated Hospital of Shaoxing University 999 Zhongxing South Road, Shaoxing Zhejiang 312000, P.R. China
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19
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Barrak I, Baráth Z, Tián T, Venkei A, Gajdács M, Urbán E, Stájer A. Effects of different decontaminating solutions used for the treatment of peri-implantitis on the growth of Porphyromonas gingivalis-an in vitro study. Acta Microbiol Immunol Hung 2020; 68:40-47. [PMID: 32845853 DOI: 10.1556/030.2020.01176] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/22/2020] [Indexed: 01/22/2023]
Abstract
Implants have been considered the treatment of choice to replace missing teeth, unfortunately, peri-implant disease is still an unresolved issue. Contaminated implants may be decontaminated by physical debridement and chemical disinfectants; however, there is a lack of consensus regarding the ideal techniques/agents to be used for the decontamination. The objective of our study was to compare the decontaminating efficacy of different chemical agents on a titanium surface contaminated with Porphyromonas gingivalis, a typical representative of the bacterial flora associated with peri-implantitis. Commercially pure Ti grade 4 discs with a polished surface were treated with a mouthwash containing chlorhexidine digluconate (0.1%), povidone-iodine (PVP-iodine) solution (10%) or citric acid monohydrate (40%). Qualitative and quantitative assessment of cellular growth and survival were assessed by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and scanning electron microscopy (SEM). Significant differences in the quantity of P. gingivalis could be observed after 6 days of incubation. A numerical, but not statistically significant (P = 0.066) decrease in the amount of living bacteria was observed in the group treated with the PVP-iodine solution as compared to the control group. The chlorhexidine (CHX)-treated group presented with significantly higher cell counts, as compared to the PVP-iodine-treated group (P = 0.032), while this was not observed compared to the control group and citric acid-treated group. Our results have also been verified by SEM measurements. Our results suggest that for P. gingivalis contamination on a titanium surface in vitro, PVP-iodine is a superior decontaminant, compared to citric acid and chlorhexidine-digulconate solution.
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Affiliation(s)
- Ibrahim Barrak
- 1Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Szeged, Kálvária sugárút 57., 6720,Szeged, Hungary
| | - Zoltán Baráth
- 2Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 64-66.,Szeged, Hungary
| | - Tamás Tián
- 3Department of Periodontology, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 64-66.,Szeged, Hungary
| | - Annamária Venkei
- 4Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725, Szeged, Hungary
| | - Márió Gajdács
- 5Institute Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös utca 6.,Szeged, Hungary
- 6Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4., 1089, Budapest, Hungary
| | - Edit Urbán
- 7Department of Public Health, Faculty of Medicine, University of Szeged, Dóm tér 10., 6720, Szeged, Hungary
- 8Institute of Translational Medicine, University of Pécs, Medical School, Szigeti utca 12., 7624, Pécs, Hungary
| | - Anette Stájer
- 2Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 64-66.,Szeged, Hungary
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Thukkaram M, Vaidulych M, Kylián O, Hanuš J, Rigole P, Aliakbarshirazi S, Asadian M, Nikiforov A, Van Tongel A, Biederman H, Coenye T, Du Laing G, Morent R, De Wilde L, Verbeken K, De Geyter N. Investigation of Ag/a-C:H Nanocomposite Coatings on Titanium for Orthopedic Applications. ACS APPLIED MATERIALS & INTERFACES 2020; 12:23655-23666. [PMID: 32374146 DOI: 10.1021/acsami.9b23237] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
One of the leading causes of failure for any bone implant is implant-associated infections. The implant-bone interface is in fact the crucial site of infection where both the microorganisms and cells compete to populate the newly introduced implant surface. Most of the work dealing with this issue has focused on the design of implant coatings capable of preventing infection while ignoring cell proliferation or vice versa. The present study is therefore focused on investigating the antibacterial and biological properties of nanocomposite coatings based on an amorphous hydrocarbon (a-C:H) matrix containing silver nanoparticles (AgNPs). a-C:H coatings with varying silver concentrations were generated directly on medical grade titanium substrates using a combination of a gas aggregation source (GAS) and a plasma-enhanced chemical vapor deposition (PE-CVD) process. The obtained results revealed that the surface silver content increased from 1.3 at % to 5.3 at % by increasing the used DC magnetron current in the GAS from 200 to 500 mA. The in vitro antibacterial assays revealed that the nanocomposites with the highest number of silver content exhibited excellent antibacterial activities resulting in a 6-log reduction of Escherichia coli and a 4-log reduction of Staphylococcus aureus after 24 h of incubation. An MTT assay, fluorescence live/dead staining, and SEM microscopy observations of MC3T3 cells seeded on the uncoated and coated Ti substrates also showed that increasing the amount of AgNPs in the nanocomposites had no notable impact on their cytocompatibility, while improved cell proliferation was especially observed for the nanocomposites possessing a low amount of AgNPs. These controllable Ag/a-C:H nanocomposites on Ti substrates, which simultaneously provide an excellent antibacterial performance and good biocompatibility, could thus have promising applications in orthopedics and other biomedical implants.
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Affiliation(s)
- Monica Thukkaram
- Research Unit Plasma Technology (RUPT), Department of Applied Physics, Faculty of Engineering & Architecture, Ghent University, Ghent 9000, Belgium
| | - Mykhailo Vaidulych
- Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, Prague 116 36, Czech Republic
| | - Ondřej Kylián
- Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, Prague 116 36, Czech Republic
| | - Jan Hanuš
- Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, Prague 116 36, Czech Republic
| | - Petra Rigole
- Laboratory of Pharmaceutical Microbiology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent 9000, Belgium
| | - Sheida Aliakbarshirazi
- Research Unit Plasma Technology (RUPT), Department of Applied Physics, Faculty of Engineering & Architecture, Ghent University, Ghent 9000, Belgium
| | - Mahtab Asadian
- Research Unit Plasma Technology (RUPT), Department of Applied Physics, Faculty of Engineering & Architecture, Ghent University, Ghent 9000, Belgium
| | - Anton Nikiforov
- Research Unit Plasma Technology (RUPT), Department of Applied Physics, Faculty of Engineering & Architecture, Ghent University, Ghent 9000, Belgium
| | - Alexander Van Tongel
- Orthopaedic Surgery and Traumatology, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
| | - Hynek Biederman
- Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, Prague 116 36, Czech Republic
| | - Tom Coenye
- Laboratory of Pharmaceutical Microbiology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent 9000, Belgium
| | - Gijs Du Laing
- Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, Ghent 9000, Belgium
| | - Rino Morent
- Research Unit Plasma Technology (RUPT), Department of Applied Physics, Faculty of Engineering & Architecture, Ghent University, Ghent 9000, Belgium
| | - Lieven De Wilde
- Orthopaedic Surgery and Traumatology, Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
| | - Kim Verbeken
- Department of Materials, Textiles, and Chemical Engineering, Faculty of Engineering & Architecture, Ghent University, Ghent 9000, Belgium
| | - Nathalie De Geyter
- Research Unit Plasma Technology (RUPT), Department of Applied Physics, Faculty of Engineering & Architecture, Ghent University, Ghent 9000, Belgium
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21
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Koosha S, Toraji S, Mostafavi AS. Effect of fluid contamination on the reverse torque values of abutment screws at implant-abutment connections. J Prosthet Dent 2020; 123:618-621. [DOI: 10.1016/j.prosdent.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 04/05/2019] [Accepted: 05/01/2019] [Indexed: 11/26/2022]
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22
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Wang S, Yang Y, Li W, Wu Z, Li J, Xu K, Zhang W, Zheng X, Chen J. Study of the Relationship Between Chlorhexidine-Grafted Amount and Biological Performances of Micro/Nanoporous Titanium Surfaces. ACS OMEGA 2019; 4:18370-18380. [PMID: 31720539 PMCID: PMC6844109 DOI: 10.1021/acsomega.9b02614] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/10/2019] [Indexed: 05/05/2023]
Abstract
Biomaterial-associated infection and lack of sufficient osseointegration contribute to a large proportion of implant failures. Therefore, antibacterial and osseointegration-accelerating properties are important in implant surface design. In this study, a micro/nanoporous titanium surface was prepared through alkaline and heat treatments, covalently conjugated with aminosilane. Then, varying amounts of chlorhexidine (CHX) were covalently grafted onto the aminosilane-modified surface via glutaraldehyde to obtain different CHX-grafted surfaces. These as-prepared surfaces were evaluated in terms of their surface chemical composition, surface topography, CHX grafting amount, antibacterial activity, and osteoblast compatibility. The results showed that the CHX grafting amount increased with increasing CHX concentrations, leading to better antibacterial activity. CHX (1 mg/mL) resulted in the best antibacterial surface, which still retained good osteoblast compatibility. Meanwhile, competitive bacterial-cell adhesion analysis demonstrated that this surface has great value for osteoblast adhesion at the implant-bone interface even in the presence of bacteria. This effortless, easily performed, and eco-friendly technique holds huge promise for clinical applications.
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Affiliation(s)
| | | | - Wei Li
- Stomatologic Hospital and College, Key
Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China
| | - Zichen Wu
- Stomatologic Hospital and College, Key
Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China
| | - Jiaojiao Li
- Stomatologic Hospital and College, Key
Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China
| | - Kehui Xu
- Stomatologic Hospital and College, Key
Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China
| | - Weibo Zhang
- Stomatologic Hospital and College, Key
Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China
| | - Xianyu Zheng
- Stomatologic Hospital and College, Key
Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China
| | - Jialong Chen
- Stomatologic Hospital and College, Key
Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, Anhui 230032, China
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A Novel Small Molecule, ZY354, Inhibits Dental Caries-Associated Oral Biofilms. Antimicrob Agents Chemother 2019; 63:AAC.02414-18. [PMID: 30858201 DOI: 10.1128/aac.02414-18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/06/2019] [Indexed: 02/05/2023] Open
Abstract
Biofilm control is a critical approach to the better management of dental caries. Antimicrobial small molecules have shown their potential in the disruption of oral biofilm and control of dental caries. The objectives of this study were to examine the antimicrobial activity and cytotoxicity of a newly designed small-molecule compound, ZY354. ZY354 was synthesized, and its cytotoxicity was evaluated in human oral keratinocytes (HOK), human gingival epithelial cells (HGE), and macrophages (RAW) by CCK-8 assays. Minimal inhibitory concentrations (MICs), minimum bactericidal concentrations (MBCs), minimum biofilm inhibition concentrations (MBICs), and minimum biofilm reduction concentrations (MBRCs) of ZY354 against common oral streptococci (i.e., Streptococcus mutans, Streptococcus gordonii, and Streptococcus sanguinis) were determined by microdilution method. The exopolysaccharide (EPS)/bacterium ratio and the dead/live bacterium ratio in the ZY354-treated multispecies biofilms were determined by confocal laser scanning microscopy, and the microbial composition was visualized and quantified by fluorescent in situ hybridization and quantitative PCR (qPCR). The demineralizing activity of ZY354-treated biofilms was evaluated by transverse microradiography. The results showed that ZY354 exhibited low cytotoxicity in HOK, HGE, and RAW cells and exhibited potent antimicrobial activity against common oral streptococci. The EPS and the abundance of S. mutans were significantly reduced after ZY354 treatment, along with an increased dead/live microbial ratio in multispecies biofilms compared to the level with the nontreated control. The ZY354-treated multispecies biofilms exhibited reduced demineralizing activity at the biofilm/enamel interface. In conclusion, the small-molecule compound ZY354 exhibits low cytotoxicity and remarkable antimicrobial activity against oral streptococci, and it may have a great potential in anticaries clinical applications.
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Xie SX, Boone K, VanOosten SK, Yuca E, Song L, Ge X, Ye Q, Spencer P, Tamerler C. Peptide Mediated Antimicrobial Dental Adhesive System. APPLIED SCIENCES (BASEL, SWITZERLAND) 2019; 9:557. [PMID: 33542835 PMCID: PMC7857482 DOI: 10.3390/app9030557] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The most common cause for dental composite failures is secondary caries due to invasive bacterial colonization of the adhesive/dentin (a/d) interface. Innate material weakness often lead to an insufficient seal between the adhesive and dentin. Consequently, bacterial by-products invade the porous a/d interface leading to material degradation and dental caries. Current approaches to achieve antibacterial properties in these materials continue to raise concerns regarding hypersensitivity and antibiotic resistance. Herein, we have developed a multi-faceted, bio-functionalized approach to overcome the vulnerability of such interfaces. An antimicrobial adhesive formulation was designed using a combination of antimicrobial peptide and a ε-polylysine resin system. Effector molecules boasting innate immunity are brought together with a biopolymer offering a two-fold biomimetic design approach. The selection of ε-polylysine was inspired due to its non-toxic nature and common use as food preservative. Biomolecular characterization and functional activity of our engineered dental adhesive formulation were assessed and the combinatorial formulation demonstrated significant antimicrobial activity against Streptococcus mutans. Our antimicrobial peptide-hydrophilic adhesive hybrid system design offers advanced, biofunctional properties at the critical a/d interface.
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Affiliation(s)
- Sheng-Xue Xie
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Kyle Boone
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
| | - Sarah Kay VanOosten
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
| | - Esra Yuca
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Department of Molecular Biology and Genetics, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Linyong Song
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Xueping Ge
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Qiang Ye
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Paulette Spencer
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
- Department of Mechanical Engineering, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
| | - Candan Tamerler
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
- Department of Mechanical Engineering, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
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25
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Xu Z, Coriand L, Loeffler R, Geis-Gerstorfer J, Zhou Y, Scheideler L, Fleischer M, Gehring FK, Rupp F. Saliva-coated titanium biosensor detects specific bacterial adhesion and bactericide caused mass loading upon cell death. Biosens Bioelectron 2019; 129:198-207. [PMID: 30721795 DOI: 10.1016/j.bios.2019.01.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/07/2019] [Accepted: 01/13/2019] [Indexed: 12/11/2022]
Abstract
Bacteria adhering to implanted medical devices can cause invasive microbial infections, of e.g. skin, lung or blood. In dentistry, Streptococcus gordonii is an early oral colonizer initiating dental biofilm formation and also being involved in life-threatening infective endocarditis. To treat oral biofilms, antibacterial mouth rinses are commonly used. Such initial biomaterial-bacteria interactions and the influence of antibacterial treatments are poorly understood and investigated here in situ by quartz crystal microbalance with dissipation monitoring (QCM-D). A saliva-coated titanium (Ti) biosensor is applied to analyze possible specific signal patterns indicating microbial binding mechanisms and bactericide-caused changes in bacterial film rigidity or cell leakage caused by a clinically relevant antibacterial agent (ABA), i.e., a mouth rinse comprising chlorhexidine (CHX) and cetylpyridinium chloride (CPC). Apparent missing mass effects during the formation of microscopically proven dense and vital bacterial films indicate punctual, specific binding of S. gordonii to the saliva-coated biosensor, compared to unspecific adhesion to pure Ti. Coincidentally to ABA-induced killing of surface-adhered bacteria, an increase of adsorbed dissipative mass can be sensed, contrary to the prior mass-loss. This suggests the acoustic sensing of the leakage of cellular content caused by bacterial cell wall rupturing and membrane damage upon the bactericidal attack. The results have significant implications for testing bacterial adhesion mechanisms and cellular integrity during interaction with antibacterial agents.
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Affiliation(s)
- Zeqian Xu
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, D-72076 Tübingen, Germany; The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, PR China
| | - Luisa Coriand
- Fraunhofer Institute for Applied Optics and Precision Engineering, Albert-Einstein-Strasse 7, D-07745 Jena, Germany
| | - Ronny Loeffler
- Core Facility LISA(+), Eberhard Karls University Tübingen, Auf der Morgenstelle 15, D-72076 Tübingen, Germany
| | - Juergen Geis-Gerstorfer
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, D-72076 Tübingen, Germany
| | - Yi Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, PR China
| | - Lutz Scheideler
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, D-72076 Tübingen, Germany
| | - Monika Fleischer
- Core Facility LISA(+), Eberhard Karls University Tübingen, Auf der Morgenstelle 15, D-72076 Tübingen, Germany
| | | | - Frank Rupp
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, D-72076 Tübingen, Germany.
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Chouirfa H, Bouloussa H, Migonney V, Falentin-Daudré C. Review of titanium surface modification techniques and coatings for antibacterial applications. Acta Biomater 2019; 83:37-54. [PMID: 30541702 DOI: 10.1016/j.actbio.2018.10.036] [Citation(s) in RCA: 434] [Impact Index Per Article: 86.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 10/09/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023]
Abstract
Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. However, implant-related infections remain among the leading reasons for failure. The most critical pathogenic event in the development of infection on biomaterials is biofilm formation, which starts immediately after bacterial adhesion. In the last decade, numerous studies reported the ability of titanium surface modifications and coatings to minimize bacterial adhesion, inhibit biofilm formation and provide effective bacterial killing to protect implanted biomaterials. In the present review, the different strategies to prevent infection onto titanium surfaces are reported: surface modification and coatings by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers. STATEMENT OF SIGNIFICANCE: Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. Microbial infection is one of the main causes of implant failure. Currently, the global infection risk is 2-5% in orthopedic surgery. Numerous solutions exist to render titanium surfaces antibacterial. The LBPS team is an expert on the functionalization of titanium surfaces by using bioactive polymers to improve the biologiocal response. In this review, the different strategies to prevent infection are reported onto titanium and titanium alloy surfaces such as surface modification by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers.
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Daud NM, Masri NA, Nik Malek NAN, Abd Razak SI, Saidin S. Long-term antibacterial and stable chlorhexidine-polydopamine coating on stainless steel 316L. PROGRESS IN ORGANIC COATINGS 2018; 122:147-153. [DOI: 10.1016/j.porgcoat.2018.05.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Gómez-Polo M, Gómez-Polo C, Celemín A, Ortega R. Interim restoration using dynamic abutments to re-treat a single-implant crown with a labial angulation: A clinical report. J Prosthet Dent 2018; 120:791-795. [PMID: 29807738 DOI: 10.1016/j.prosdent.2018.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 11/25/2022]
Abstract
The cause of some peri-implant problems may be primarily attributable to the design of the prosthesis. A screw-retained interim implant may be advisable for reversibility and to avoid peri-implant cement, although screw retention may be difficult for maxillary anterior implants with a labial angulation. In the treatment described, a interim screw-retained crown was attached to a dynamic abutment with a lingual screw access hole to obtain a correctly fitting restoration.
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Affiliation(s)
- Miguel Gómez-Polo
- Part-time Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Cristina Gómez-Polo
- Part-time Professor, Department of Surgery, Medicine School, University of Salamanca, Salamanca, Spain
| | - Alicia Celemín
- Full-time Professor, Department of Surgery, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Ortega
- Part-time Professor, Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
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Abstract
The chemical composition, surface structure and topography of a biomaterial have an essential influence on the effects of an implant in the human body. In orthopedic and trauma surgery they make a relevant contribution to solve the current and future challenges. Particularly high are the requirements of permanent implants in bone. Besides material aging due to oxidation, implants are subjected to cyclic loading that leads to relevant biomechanical wear and abrasion. To date significant efforts have been made to minimize adverse implant-associated immunoreactions as well as the risk of periprosthetic infections. This review gives an overview of surface modifications of implants designed for clinical application and their effects in vivo. Beside material-specific and biological principles, different surface modifications for distinct clinical applications are presented. Furthermore, current developmental strategies for the targeted clinical application of implant surfaces are outlined.
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Affiliation(s)
- Marcus Jäger
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandst. 55, 45147, Essen, Deutschland.
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30
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Stein JM, Hammächer C, Michael SSY. Combination of ultrasonic decontamination, soft tissue curettage, and submucosal air polishing with povidone-iodine application for non-surgical therapy of peri-implantitis: 12 Month clinical outcomes. J Periodontol 2017; 89:139-147. [PMID: 29381189 DOI: 10.1902/jop.2017.170362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/27/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND The aim of this study is to evaluate clinical outcomes of a concept for non-surgical peri-implantitis combining stepwise mechanical debridement measures with adjuvant povidone-iodine application with and without systemic antibiotics. METHODS Forty-five patients with chronic periodontitis and a total of 164 screw-typed implants with peri-implantitis were included. Peri-implantitis was defined as radiographic bone loss of > 2 mm, probing depth (PD) ≥5 mm with bleeding on probing (BOP). Stepwise treatment of implants was performed with ultrasonic debridement, soft tissue curettage (STC), glycine powder air polishing (GPAP), and a repeated submucosal application of povidone-iodine. Teeth with PD > 4 mm were treated simultaneously according to the same concept except STC. In cases with severe periodontitis (n = 24), amoxicillin and metronidazole (AM) were prescribed for 7 days. RESULTS After 12 months, implants treated without AM showed significant reductions (P < 0.05) of mean PD (1.4 ± 0.7 mm), clinical attachment level (CAL) (1.3 ± 0.8 mm), and BOP (33.4% ± 17.2%). In deep pockets (PD > 6 mm) changes of mean PD (2.3 ± 1.3 mm), CAL (2.0 ± 1.6 mm), and BOP (44.0% ± 41.7%) were more pronounced. Intake of AM did not significantly influence the changes in these parameters. However, the reduction of implant sites with PD > 4 mm and BOP was significantly higher in patients with AM than in those without AM (31.8% ± 12.6% versus 20.8% ± 14.7%; P < 0.05). CONCLUSIONS The combination of ultrasonic debridement, STC, and GPAP with adjuvant povidone-iodine led to significant clinical improvements at implants. Systemic antibiotics had limited effects on the reduction of persisting implant sites with treatment need.
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Affiliation(s)
- Jamal M Stein
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital Aachen (RWTH), Aachen, Germany
- Private practice, Aachen, Germany
| | | | - Sareh Said-Yekta Michael
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital Aachen (RWTH), Aachen, Germany
- Interdisciplinary Center for Clinical Research, University Hospital Aachen (RWTH)
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31
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Mesenchymal stromal cell and osteoblast responses to oxidized titanium surfaces pre-treated with λ = 808 nm GaAlAs diode laser or chlorhexidine: in vitro study. Lasers Med Sci 2017; 32:1309-1320. [PMID: 28551763 DOI: 10.1007/s10103-017-2243-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/19/2017] [Indexed: 12/15/2022]
Abstract
Preservation of implant biocompatibility following peri-implantitis treatments is a crucial issue in odontostomatological practice, being closely linked to implant re-osseointegration. Our aim was to assess the responses of osteoblast-like Saos2 cells and adult human bone marrow-mesenchymal stromal cells (MSCs) to oxidized titanium surfaces (TiUnite®, TiU) pre-treated with a 808 ± 10 nm GaAlAs diode laser operating in non-contact mode, in continuous (2 W, 400 J/cm2; CW) or pulsed (20 kHz, 7 μs, 0.44 W, 88 J/cm2; PW) wave, previously demonstrated to have a strong bactericidal effect and proposed as optional treatment for peri-implantitis. The biocompatibility of TiU surfaces pre-treated with chlorhexidine digluconate (CHX) was also evaluated. In particular, in order to mimic the in vivo approach, TiU surfaces were pre-treated with CHX (0.2%, 5 min); CHX and rinse; and CHX, rinse and air drying. In some experiments, the cells were cultured on untreated TiU before being exposed to CHX. Cell viability (MTS assay), proliferation (EdU incorporation assay; Ki67 confocal immunofluorescence analysis), adhesion (morphological analysis of actin cytoskeleton organization), and osteogenic differentiation (osteopontin confocal immunofluorescence analysis; mineralized bone-like nodule formation) analyses were performed. CHX resulted cytotoxic in all experimental conditions. Diode laser irradiation preserved TiU surface biocompatibility. Notably, laser treatment appeared even to improve the known osteoconductive properties of TiU surfaces. Within the limitations of an in vitro experimentation, this study contributes to provide additional experimental basis to support the potential use of 808 ± 10 nm GaAlAs diode laser at the indicated irradiation setting, in the treatment of peri-implantitis and to discourage the use of CHX.
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32
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Jia L, Qiu J, Du L, Li Z, Liu H, Ge S. TiO2 nanorod arrays as a photocatalytic coating enhanced antifungal and antibacterial efficiency of Ti substrates. Nanomedicine (Lond) 2017; 12:761-776. [DOI: 10.2217/nnm-2016-0398] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aim: To investigate the photocatalytic inactivation of fungi and bacteria mediated by TiO2 nanorod arrays (TNRs). Materials & methods: The features of TNRs were characterized by scanning electron microscopy, atomic force microscopy, transmission electron microscopy, x-ray diffraction (XRD) and contact angle measurement. The antimicrobial efficiency was detected on biofilm and planktonic forms of Candida albicans, Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis by crystal violet and XTT (2,3-bis [2-methoxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-caboxanilide) assay, confocal laser scanning microscope and colony-forming assay. Fluorogenic quantitative assay was used to explore the underlying mechanism. Results & conclusion: TNRs were well aligned and vertically oriented on Ti with a diameter of about 100 μm, possessing a rougher surface and better hydrophilicity. Moreover, TNRs exhibited significantly higher antifungal and antibacterial efficiency compared with Ti under UV irradiation, laying the foundation for surface modification of implants with TNRs.
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Affiliation(s)
- Lu Jia
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan 250012, China
- Department of Periodontology, School of Stomatology, Shandong University, Jinan 250012, China
| | - Jichuan Qiu
- Center of Bio & Micro/Nano Functional Materials, State Key Laboratory of Crystal Materials, Shandong University, Jinan 250010, China
| | - Lingqian Du
- Department of Stomatology, The Second Hospital of Shandong University, Jinan 250033, China
| | - Zhi Li
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan 250012, China
- Department of Periodontology, School of Stomatology, Shandong University, Jinan 250012, China
| | - Hong Liu
- Center of Bio & Micro/Nano Functional Materials, State Key Laboratory of Crystal Materials, Shandong University, Jinan 250010, China
| | - Shaohua Ge
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan 250012, China
- Department of Periodontology, School of Stomatology, Shandong University, Jinan 250012, China
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33
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Besinis A, Hadi SD, Le HR, Tredwin C, Handy RD. Antibacterial activity and biofilm inhibition by surface modified titanium alloy medical implants following application of silver, titanium dioxide and hydroxyapatite nanocoatings. Nanotoxicology 2017; 11:327-338. [PMID: 28281851 DOI: 10.1080/17435390.2017.1299890] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
One of the most common causes of implant failure is peri-implantitis, which is caused by bacterial biofilm formation on the surfaces of dental implants. Modification of the surface nanotopography has been suggested to affect bacterial adherence to implants. Silver nanoparticles are also known for their antibacterial properties. In this study, titanium alloy implants were surface modified following silver plating, anodisation and sintering techniques to create a combination of silver, titanium dioxide and hydroxyapatite (HA) nanocoatings. Their antibacterial performance was quantitatively assessed by measuring the growth of Streptococcus sanguinis, proportion of live/dead cells and lactate production by the microbes over 24 h. Application of a dual layered silver-HA nanocoating to the surface of implants successfully inhibited bacterial growth in the surrounding media (100% mortality), whereas the formation of bacterial biofilm on the implant surfaces was reduced by 97.5%. Uncoated controls and titanium dioxide nanocoatings showed no antibacterial effect. Both silver and HA nanocoatings were found to be very stable in biological fluids with material loss, as a result of dissolution, to be less than 0.07% for the silver nanocoatings after 24 h in a modified Krebs-Ringer bicarbonate buffer. No dissolution was detected for the HA nanocoatings. Thus, application of a dual layered silver-HA nanocoating to titanium alloy implants creates a surface with antibiofilm properties without compromising the HA biocompatibility required for successful osseointegration and accelerated bone healing.
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Affiliation(s)
- A Besinis
- a School of Biological Sciences , University of Plymouth , Plymouth , UK.,b Plymouth University Peninsula Schools of Medicine and Dentistry, University of Plymouth , Plymouth , UK.,c School of Engineering, University of Plymouth , Plymouth , UK
| | - S D Hadi
- a School of Biological Sciences , University of Plymouth , Plymouth , UK
| | - H R Le
- c School of Engineering, University of Plymouth , Plymouth , UK
| | - C Tredwin
- b Plymouth University Peninsula Schools of Medicine and Dentistry, University of Plymouth , Plymouth , UK
| | - R D Handy
- a School of Biological Sciences , University of Plymouth , Plymouth , UK
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Batsukh N, Feng SW, Lee WF, Leu SJ, Tsai PY, Ho KN, Lin CT, Su CH, Chang WJ. Effects of Porphyromonas gingivalis on Titanium Surface by Different Clinical Treatment. J Med Biol Eng 2017. [DOI: 10.1007/s40846-016-0194-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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35
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Kotsakis GA, Lan C, Barbosa J, Lill K, Chen R, Rudney J, Aparicio C. Antimicrobial Agents Used in the Treatment of Peri‐Implantitis Alter the Physicochemistry and Cytocompatibility of Titanium Surfaces. J Periodontol 2016; 87:809-19. [DOI: 10.1902/jop.2016.150684] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
| | - Caixia Lan
- Department of Restorative Sciences, University of Minnesota, Minneapolis, MN
| | - Joao Barbosa
- Department of Restorative Sciences, University of Minnesota, Minneapolis, MN
| | - Krista Lill
- Department of Restorative Sciences, University of Minnesota, Minneapolis, MN
| | - Ruoqiong Chen
- Department of Diagnostic and Biological Sciences, University of Minnesota
| | - Joel Rudney
- Department of Diagnostic and Biological Sciences, University of Minnesota
| | - Conrado Aparicio
- Department of Restorative Sciences, University of Minnesota, Minneapolis, MN
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36
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Cheng Y, Gao B, Liu X, Zhao X, Sun W, Ren H, Wu J. In vivo evaluation of an antibacterial coating containing halogenated furanone compound-loaded poly(l-lactic acid) nanoparticles on microarc-oxidized titanium implants. Int J Nanomedicine 2016; 11:1337-47. [PMID: 27099494 PMCID: PMC4821396 DOI: 10.2147/ijn.s100763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
To prevent peri-implant infection, a new antibacterial coating containing a halogenated furanone compound, (Z-)-4-bromo-5-(bromomethylene)-2(5H)-furanone-loaded poly(l-lactic acid) nanoparticles, has been fabricated. The current study was designed to evaluate the preventive effect of the antibacterial coating under a simulated environment of peri-implant infection in vivo. Microarc-oxidized titanium implants treated with minocycline hydrochloride ointment were used as positive control group, and microarc-oxidized titanium implants without any treatment were used as blank control group. Three kinds of implants were implanted in dogs’ mandibles, and the peri-implant infection was simulated by silk ligation and feeding high sugar diet. After 2-month implantation, the results showed that no significant differences were detected between the experimental and positive control groups (P>0.05), but the data of clinical measurements of the blank control group were significantly higher than those of the other two groups (P<0.05), and the bone–implant contact rate and ultimate interfacial strength were significantly lower than those of the other two groups (P<0.05). Scanning electron microscope observation and histological examination showed that more new bone was formed on the surface of the experimental and positive control groups. It can be concluded that the antibacterial coating fabricated on implants has remarkable preventive effect on peri-implant infection at the early stage.
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Affiliation(s)
- Yicheng Cheng
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Stomatology, Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
| | - Bo Gao
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
| | - Xianghui Liu
- Department of Stomatology, Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China
| | - Xianghui Zhao
- Institute of Neuroscience, School of Basical Medical Science, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Weige Sun
- Department of Stomatology, Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, People's Republic of China
| | - Huifang Ren
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
| | - Jiang Wu
- Department of Prosthodontics, State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Prosthodontics, Shaanxi Key Laboratory of Stomatology, Xi'an, People's Republic of China
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Ryu HS, Kim YI, Lim BS, Lim YJ, Ahn SJ. Chlorhexidine Uptake and Release From Modified Titanium Surfaces and Its Antimicrobial Activity. J Periodontol 2015; 86:1268-75. [DOI: 10.1902/jop.2015.150075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mor-Reinoso C, Pascual A, Nart J, Quirynen M. Inhibition of de novo plaque growth by a new 0.03 % chlorhexidine mouth rinse formulation applying a non-brushing model: a randomized, double blind clinical trial. Clin Oral Investig 2015; 20:1459-67. [PMID: 26475499 DOI: 10.1007/s00784-015-1625-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the plaque inhibitory effect of a new 0.03 % chlorhexidine digluconate (CHX) and 0.05 % cetylpyridinium chloride (CPC) mouthrinse formulation and to explore patients' experience and side effects after its use. MATERIALS AND METHODS This short-term, randomized, double blind, parallel, clinical trial enrolled 150 periodontally healthy patients. These volunteers were randomly allocated to one of following mouthrinse groups (n = 50/group): 0.12 % CHX + 0.05 % CPC (Perio-Aid® Treatment alcohol-free), 0.03 % CHX + 0.05 % CPC new test formulation or to the placebo group. Clinical parameters (plaque, gingival, and stain indexes) and microbiological samples were taken at baseline, before supragingival cleaning, and after 4 days of undisturbed plaque growth, rinsing twice/day with one of the mouthrinses. RESULTS Plaque reduction was similar for the 0.12 % CHX (-0.52 ± 0.55) and 0.03 % CHX (-0.47 ± 0.49) groups. Both showed significant reductions in plaque accumulation compared to the placebo (p < 0.001). The new formulation had less of a negative impact on taste perception when compared to the 0.12 % CHX solution. The new CHX mouthrinse was also able to control bacterial loads and reduce some periodontopathogens. CONCLUSIONS This study indicated that the new 0.03 % CHX + 0.05 % CPC formulation exerted clinical efficacy similar to that achieved by an already-marketed 0.12 % CHX + 0.05 % CPC mouthrinse, but with slightly fewer side effects. CLINICAL RELEVANCE Lower CHX mouthrinse formulations could be effective in the inhibition of plaque regrowth with reduced unpleasant subjective side effects.
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Affiliation(s)
- Carolina Mor-Reinoso
- Department of Periodontology, Hospital General de Catalunya, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, C.P. 08195, Sant Cugat del Vallès, Barcelona, Spain
| | - Andres Pascual
- Department of Periodontology, Hospital General de Catalunya, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, C.P. 08195, Sant Cugat del Vallès, Barcelona, Spain.
| | - Jose Nart
- Department of Periodontology, Hospital General de Catalunya, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, C.P. 08195, Sant Cugat del Vallès, Barcelona, Spain
| | - Marc Quirynen
- Departments of Oral Health Sciences and Periodontology, Katholieke Universiteit Leuven, University Hospitals & Dentistry Leuven, Leuven, Belgium
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Romanò CL, Scarponi S, Gallazzi E, Romanò D, Drago L. Antibacterial coating of implants in orthopaedics and trauma: a classification proposal in an evolving panorama. J Orthop Surg Res 2015; 10:157. [PMID: 26429342 PMCID: PMC4591707 DOI: 10.1186/s13018-015-0294-5] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 09/16/2015] [Indexed: 02/07/2023] Open
Abstract
Implanted biomaterials play a key role in current success of orthopedic and trauma surgery. However, implant-related infections remain among the leading reasons for failure with high economical and social associated costs. According to the current knowledge, probably the most critical pathogenic event in the development of implant-related infection is biofilm formation, which starts immediately after bacterial adhesion on an implant and effectively protects the microorganisms from the immune system and systemic antibiotics. A rationale, modern prevention of biomaterial-associated infections should then specifically focus on inhibition of both bacterial adhesion and biofilm formation. Nonetheless, currently available prophylactic measures, although partially effective in reducing surgical site infections, are not based on the pathogenesis of biofilm-related infections and unacceptable high rates of septic complications, especially in high-risk patients and procedures, are still reported.In the last decade, several studies have investigated the ability of implant surface modifications to minimize bacterial adhesion, inhibit biofilm formation, and provide effective bacterial killing to protect implanted biomaterials, even if there still is a great discrepancy between proposed and clinically implemented strategies and a lack of a common language to evaluate them.To move a step forward towards a more systematic approach in this promising but complicated field, here we provide a detailed overview and an original classification of the various technologies under study or already in the market. We may distinguish the following: 1. Passive surface finishing/modification (PSM): passive coatings that do not release bactericidal agents to the surrounding tissues, but are aimed at preventing or reducing bacterial adhesion through surface chemistry and/or structure modifications; 2. Active surface finishing/modification (ASM): active coatings that feature pharmacologically active pre-incorporated bactericidal agents; and 3. Local carriers or coatings (LCC): local antibacterial carriers or coatings, biodegradable or not, applied at the time of the surgical procedure, immediately prior or at the same time of the implant and around it. Classifying different technologies may be useful in order to better compare different solutions, to improve the design of validation tests and, hopefully, to improve and speed up the regulatory process in this rapidly evolving field.
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Affiliation(s)
- Carlo Luca Romanò
- Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, IRCCS Galeazzi Orthopaedic Institute, Via R. Galeazzi 4, 20161, Milan, Italy.
| | - Sara Scarponi
- Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, IRCCS Galeazzi Orthopaedic Institute, Via R. Galeazzi 4, 20161, Milan, Italy.
| | - Enrico Gallazzi
- Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, IRCCS Galeazzi Orthopaedic Institute, Via R. Galeazzi 4, 20161, Milan, Italy.
| | - Delia Romanò
- Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, IRCCS Galeazzi Orthopaedic Institute, Via R. Galeazzi 4, 20161, Milan, Italy.
| | - Lorenzo Drago
- Laboratory of Clinical Chemistry and Microbiology, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milan, Italy.
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Effect of chlorhexidine in preventing plaque biofilm on healing abutment: a crossover controlled study. IMPLANT DENT 2015; 23:64-8. [PMID: 24368588 DOI: 10.1097/id.0000000000000018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The study aimed at evaluating the effect of chlorhexidine (CHX) in preventing plaque biofilm (PB) formation on healing abutments (HAs) in patients rehabilitated with osseointegrated implants. MATERIALS AND METHODS Fifty HAs were placed in 34 voluntary patients 1 week after implant surgery (test group). After 7 days, a new set of 50 HAs was placed in the same implant sites and removed 1 week after (control group). During the 2 testing periods, patients were instructed to apply: CHX mouth rinsing twice daily and no brushing (test); no CHX mouth rinsing and no brushing (control). Scanning electron microscopy and image analysis were blindly used to objectively quantify PB amount on removed HAs. RESULTS Median values and interquartile ranges of the percent ratio of titanium surface covered from PB were 0.9 (0.1-4.1) and 1.2 (0.1-11.6) for test and control groups, respectively (P = 0.0275). CONCLUSIONS CHX mouth rinsing significantly limited plaque formation on HAs, being a valid contribution to mechanical brushing in early phases of plaque control on dental implants.
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Massa MA, Covarrubias C, Bittner M, Fuentevilla IA, Capetillo P, Von Marttens A, Carvajal JC. Synthesis of new antibacterial composite coating for titanium based on highly ordered nanoporous silica and silver nanoparticles. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 45:146-53. [PMID: 25491813 DOI: 10.1016/j.msec.2014.08.057] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/07/2014] [Accepted: 08/29/2014] [Indexed: 11/28/2022]
Abstract
Infection is the most common factor that leads to dental titanium implant failure. Antibacterial implant surfaces based on nano-scale modifications of the titanium appear as an attractive strategy for control of peri-implantitis. In the present work, the preparation and antibacterial properties of a novel composite coating for titanium based on nanoporous silica and silver nanoparticles are presented. Starch-capped silver nanoparticles (AgNPs) were synthesized and then incorporated into sol-gel based solution system. The AgNP-doped nanoporous silica coatings were prepared on titanium surface using a combined sol-gel and evaporation-induced self-assembly (EISA) method. The coating nanostructure was characterized by XRD, SEM-EDX, and HR-TEM. Antibacterial activity was evaluated against Aggregatibacter actinomycetemcomitans, a representative pathogen of dental peri-implantitis. Colony-forming units (CFUs) were counted within the biofilm and at the planktonic state. Biofilm development was quantified using crystal violet staining and viability of adherent bacteria was confirmed with the Live/Dead fluorescence assay. Silica-based composite coating containing AgNPs (AgNP/NSC) was prepared on titanium surface by direct incorporation of AgNP suspension into the sol-gel system. The self-assembly technique enabled the spontaneous formation of a highly ordered nanoporosity in the coating structure, which is a desired property for osseointegration aspects of titanium implant surface. AgNP/NSC coating produces a strong antibacterial effect on titanium surface by not only killing the adherent bacteria but also reducing the extent of biofilm formation. Biofilm survival is reduced by more than 70% on the AgNP/NSC-modified titanium surface, compared to the control. This antibacterial effect was verified for up to 7 days of incubation. The long-term antibacterial activity exhibited by the nanostructured AgNP/NSC-titanium surface against A. actinomycetemcomitans suggests that this type of nano-scale surface modification is a promissory strategy to control infections associated with dental implant rehabilitation.
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Affiliation(s)
- Miguel A Massa
- Laboratory of Nanobiomaterials, Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Independencia, Santiago, Chile
| | - Cristian Covarrubias
- Laboratory of Nanobiomaterials, Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Independencia, Santiago, Chile.
| | - Mauricio Bittner
- Laboratory of Oral Microbiology and Biotechnology, Faculty of Biological Sciences, Andrés Bello University, Santiago, Chile; Laboratory of Oral Microbiology and Biotechnology, Faculty of Dentistry, Andrés Bello University, Santiago, Chile
| | - Ignacio Andrés Fuentevilla
- Laboratory of Oral Microbiology and Biotechnology, Faculty of Biological Sciences, Andrés Bello University, Santiago, Chile
| | - Pavel Capetillo
- Laboratory of Nanobiomaterials, Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Independencia, Santiago, Chile
| | - Alfredo Von Marttens
- Laboratory of Nanobiomaterials, Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Independencia, Santiago, Chile
| | - Juan Carlos Carvajal
- Laboratory of Nanobiomaterials, Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Independencia, Santiago, Chile
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Müller G, Benkhai H, Matthes R, Finke B, Friedrichs W, Geist N, Langel W, Kramer A. Poly (hexamethylene biguanide) adsorption on hydrogen peroxide treated Ti–Al–V alloys and effects on wettability, antimicrobial efficacy, and cytotoxicity. Biomaterials 2014; 35:5261-5277. [DOI: 10.1016/j.biomaterials.2014.03.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 03/14/2014] [Indexed: 11/16/2022]
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PARK JUNBEOM, LEE GIL, YUN BYEONGGON, KIM CHANGHYEN, KO YOUNGKYUNG. Comparative effects of chlorhexidine and essential oils containing mouth rinse on stem cells cultured on a titanium surface. Mol Med Rep 2014; 9:1249-53. [DOI: 10.3892/mmr.2014.1971] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 02/06/2014] [Indexed: 11/06/2022] Open
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Park JB, Koh M, Jang YJ, Choi BK, Kim KK, Ko Y. Removing bacteria from rough surface titanium discs with chlorhexidine and additional brushing with dentifrice. Gerodontology 2014; 33:28-35. [PMID: 24417576 DOI: 10.1111/ger.12106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This in vitro study was conducted: (i) to evaluate the effect of using cotton pellets soaked with chlorhexidine (CHX) on titanium surface roughness; (ii) to assess the removal of Porphyromonas gingivalis (P. gingivalis) from resorbable blast material (RBM) titanium surfaces using CHX pellets; and (iii) to evaluate the effects of additional brushing on bacterial removal efficiency. MATERIALS AND METHODS RBM titanium discs were treated with CHX-soaked cotton pellets, and change in surface roughness was measured using confocal microscopy. After the titanium discs were incubated with P. gingivalis for 2 days, the discs were cleaned with CHX pellets for 40 s. The quantity of remaining adherent bacteria was measured using crystal violet assay. Additional brushing was performed with dentifrice for a total of 40 s, and bacterial removal efficiency with brushing and dentifrice was evaluated using crystal violet assay and scanning electron microscopy. RESULTS The changes in surface roughness after treatment were observed by confocal microscopy. Statistically significant decrease in surface roughness was seen in CHX 40-s group (p < 0.05). Cleaning with CHX-soaked pellets resulted in significant decrease in remaining adherent bacteria. Brushing the bacteria-incubated discs with dentifrice reduced adhering bacteria. There were fewer bacteria left on the CHX-pre-treated discs compared with the brushing-only group, but there were no significant differences when compared with the brushing-only group (p > 0.05). CONCLUSIONS This study clearly showed that burnishing with CHX influenced the RBM titanium surface, and burnishing with CHX pellets and brushing with dentifrice were efficient in removing bacteria from the contaminated titanium surface.
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Affiliation(s)
- Jun-Beom Park
- Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Minchul Koh
- Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul, Korea
| | - Yun-Ji Jang
- Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Bong-Kyu Choi
- Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kack-Kyun Kim
- Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Youngkyung Ko
- Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Shpack N, Greenstein RBN, Gazit D, Sarig R, Vardimon AD. Efficacy of three hygienic protocols in reducing biofilm adherence to removable thermoplastic appliance. Angle Orthod 2014; 84:161-170. [PMID: 23786595 PMCID: PMC8683063 DOI: 10.2319/012413-75.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 05/01/2013] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To examine the ability of a removable thermoplastic appliance (RTA) to adsorb hygienic solutions and inhibit bacterial growth and to examine the efficacy of three hygiene protocols in reducing bacterial biofilm adherence to RTA. MATERIALS AND METHODS Solution adsorption and bacterial growth inhibition were examined in vitro using paper vs RTA discs. Subsequently, 11 patients treated with RTA (mean age, 29.1 ± 4.7 years) were assigned into a sequence of three hygiene protocols: regular RTA brushing (baseline), immersion RTAs in chlorhexidine mouthwash (CHX), and using a vibrating bath with cleaning solution (VBC). For each patient, 12 upper RTAs were examined (2 baseline RTAs, 5 CHX RTAs, and 5 VBC RTAs), for a total of 132 RTAs. All RTAs were stained with gentian violet, and biofilm presence was measured using a photodensitometer. RESULTS The RTA discs did not adsorb CHX or cleaning solution. The later agent did not show antibacterial features. Baseline RTAs showed significant biofilm adherence (P < .001) on the posterior palatal side of the aligner and on the anterior incisal edge. CHX and VBC hygienic protocols significantly (P < .001) reduced baseline biofilm adherence by 16% and 50%, respectively. Hygienic improvement was maintained over 140 days when CHX and VBC were used. However, VBC was three times more efficient than CHX. CONCLUSIONS This study highly recommends the use of a VBC protocol. Biofilm deposits on the RTA, especially on incisal edges and attachment dimples, could lead to inadequate tooth/RTA and attachment/RTA overlap and consequently impair tooth alignment.
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Affiliation(s)
- Nir Shpack
- Lecturer, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Bar-Ness Greenstein
- Senior Lecturer, Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Gazit
- Postgraduate student, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rachel Sarig
- Instructor, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexander Dan Vardimon
- Professor and Head, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lim BS, Cheng Y, Lee SP, Ahn SJ. Chlorhexidine release from orthodontic adhesives after topical chlorhexidine treatment. Eur J Oral Sci 2013; 121:211-7. [DOI: 10.1111/eos.12033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Bum-Soon Lim
- Dental Research Institute and Department of Dental Biomaterials; School of Dentistry; Seoul National University; Seoul Korea
| | - Yanping Cheng
- Dental Research Institute and Department of Dental Biomaterials; School of Dentistry; Seoul National University; Seoul Korea
| | - Seung-Pyo Lee
- Dental Research Institute and Department of Oral Anatomy; School of Dentistry; Seoul National University; Seoul Korea
| | - Sug-Joon Ahn
- Dental Research Institute and Department of Orthodontics; School of Dentistry; Seoul National University; Seoul Korea
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Goodman SB, Yao Z, Keeney M, Yang F. The future of biologic coatings for orthopaedic implants. Biomaterials 2013; 34:3174-83. [PMID: 23391496 DOI: 10.1016/j.biomaterials.2013.01.074] [Citation(s) in RCA: 423] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 01/20/2013] [Indexed: 12/12/2022]
Abstract
Implants are widely used for orthopaedic applications such as fixing fractures, repairing non-unions, obtaining a joint arthrodesis, total joint arthroplasty, spinal reconstruction, and soft tissue anchorage. Previously, orthopaedic implants were designed simply as mechanical devices; the biological aspects of the implant were a byproduct of stable internal/external fixation of the device to the surrounding bone or soft tissue. More recently, biologic coatings have been incorporated into orthopaedic implants in order to modulate the surrounding biological environment. This opinion article reviews current and potential future use of biologic coatings for orthopaedic implants to facilitate osseointegration and mitigate possible adverse tissue responses including the foreign body reaction and implant infection. While many of these coatings are still in the preclinical testing stage, bioengineers, material scientists and surgeons continue to explore surface coatings as a means of improving clinical outcome of patients undergoing orthopaedic surgery.
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Affiliation(s)
- Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA.
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Cheng Y, Wu J, Gao B, Zhao X, Yao J, Mei S, Zhang L, Ren H. Fabrication and in vitro release behavior of a novel antibacterial coating containing halogenated furanone-loaded poly(L-lactic acid) nanoparticles on microarc-oxidized titanium. Int J Nanomedicine 2012; 7:5641-52. [PMID: 23152682 PMCID: PMC3496405 DOI: 10.2147/ijn.s37022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Dental implants have become increasingly common for the management of missing teeth. However, peri-implant infection remains a problem, is usually difficult to treat, and may lead eventually to dental implant failure. The aim of this study was to fabricate a novel antibacterial coating containing a halogenated furanone compound, ie, (Z-)-4-bromo-5-(bromomethylene)-2(5H)-furanone (BBF)-loaded poly(L-lactic acid) (PLLA) nanoparticles on microarc-oxidized titanium and to evaluate its release behavior in vitro. Methods BBF-loaded PLLA nanoparticles were prepared using the emulsion solvent-evaporation method, and the antibacterial coating was fabricated by cross-linking BBF-loaded PLLA nanoparticles with gelatin on microarc-oxidized titanium. Results The BBF-loaded PLLA nanoparticles had a small particle size (408 ± 14 nm), a low polydispersity index (0.140 ± 0.008), a high encapsulation efficiency (72.44% ± 1.27%), and a fine spherical shape with a smooth surface. The morphology of the fabricated antibacterial coating showed that the BBF-loaded PLLA nanoparticles were well distributed in the pores of the microarc oxidation coating, and were cross-linked with each other and the wall pores by gelatin. The release study indicated that the antibacterial coating could achieve sustained release of BBF for 60 days, with a slight initial burst release during the first 4 hours. Conclusion The novel antibacterial coating fabricated in this study is a potentially promising method for prevention of early peri-implant infection.
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Affiliation(s)
- Yicheng Cheng
- Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Machtei EE, Frankenthal S, Levi G, Elimelech R, Shoshani E, Rosenfeld O, Tagger‐Green N, Shlomi B. Treatment of peri‐implantitis using multiple applications of chlorhexidine chips: a double‐blind, randomized multi‐centre clinical trial. J Clin Periodontol 2012; 39:1198-205. [DOI: 10.1111/jcpe.12006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Eli E. Machtei
- Department of Periodontology School of Graduate Dentistry Rambam HCC and Faculty of Medicine Technion – Israeli Institute of Technology Haifa Israel
| | - Shai Frankenthal
- Department of Periodontology School of Graduate Dentistry Rambam HCC and Faculty of Medicine Technion – Israeli Institute of Technology Haifa Israel
| | - Guy Levi
- Department of Periodontology School of Graduate Dentistry Rambam HCC and Faculty of Medicine Technion – Israeli Institute of Technology Haifa Israel
| | - Rina Elimelech
- Department of Periodontology School of Graduate Dentistry Rambam HCC and Faculty of Medicine Technion – Israeli Institute of Technology Haifa Israel
| | | | - Olivia Rosenfeld
- Department of Oral and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Tel‐Aviv Israel
| | - Nirit Tagger‐Green
- Department of Oral and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Tel‐Aviv Israel
| | - Benjamin Shlomi
- Department of Oral and Maxillofacial Surgery Tel Aviv Sourasky Medical Center Tel‐Aviv Israel
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