Bacterial response to Ti-35Nb-7Zr-5Ta alloy incorporated with calcium, phosphate and magnesium

High implant survival rates have been achieved in recent decades due to continual modifications in implant design and surface topography, however there is still an ongoing quest to control peri-implant bone loss. The objective of this work was to develop Ti-35Nb-7Zr-5Ta (TNZT) alloys, perform physicochemical and morphological characterization of their surface modified by electrolytic oxidative plasma technique with ions related to osseointegration and lastly evaluate bacterial colonization in vitro. Three groups were evaluated: C group (polished TNZT), CaP group (sodium β glycerophosphate + calcium acetate) and Mg group (magnesium acetate). Before and after anodizing the surfaces, physicochemical and morphological analyses were performed: scanning electron microscopy with field emission gun (FEG-SEM), energy dispersion spectroscopy (EDS), X-ray diffraction (DRX), wettability (goniometer) and roughness (rugometer). Controlled and treated specimens were contaminated with unstimulated saliva collected from 10 healthy volunteers. Then, biofilm samples were collected and up to 35 microbial species, including commensal and pathogenic microorganisms, were identified and quantified by the Checkerboard DNA-DNA Hybridization method. The CaP group modified the surface morphology in the form of pores, while the Mg group modified it in the form of flakes. The contact angle was significantly smaller in the CaP group. The average roughness was higher in the CaP and Mg groups. A smaller total amount of bacteria was identified in the Mg group and relevant differences were found in the microbial profile associated with different surface treatments. Therefore, considering the microbiological profile and for the prevention of peri-implantitis, the Mg group presented more satisfactory and encouraging results for the manufacture of dental implants.

A fast and reliable method for semi-automated planimetric quantification of dental plaque in clinical trials

AIM

To develop a simple and reproducible method for semi-automated planimetric quantification of dental plaque.

MATERIALS AND METHODS

Plaque from 20 healthy volunteers was disclosed using erythrosine, and fluorescence images of the first incisors, first premolars, and first molars were recorded after 1, 7, and 14 days of de novo plaque formation. The planimetric plaque index (PPI) was determined using a semi-automated threshold-based image segmentation algorithm and compared with manually determined PPI and the Turesky modification of the Quigley-Hein plaque index (TM-QHPI). The decrease of tooth autofluorescence in plaque-covered areas was quantified as an index of plaque thickness (TI). Data were analysed by analysis of variance (ANOVA) and Pearson correlations.

RESULTS

The high contrast between teeth, disclosed plaque, and soft tissues in fluorescence images allowed for a fast threshold-based image segmentation. Semi-automated PPI is strongly correlated with manual planimetry (r = 0.92; p < .001) and TM-QHPI recordings (r = 0.88; p < .001), and may exhibit a higher discriminatory power than TM-QHPI due to its continuous scale. TI values corresponded to optically perceived plaque thickness, and no differences were observed over time (p > .05, ANOVA).

CONCLUSIONS

The proposed semi-automated planimetric analysis based on fluorescence images is a simple and efficient method for dental plaque quantification in multiple images with reduced human input.

Semi-Automated Planimetric Quantification of Dental Plaque Using an Intraoral Fluorescence Camera

Dental plaque accumulation is quantified using clinical indices or, otherwise, the planimetric plaque index (PPI), which measures the relative area of a tooth that is covered by plaque deposits. Compared to clinical indices, the PPI has a higher discriminatory power, but traditional planimetry is a time-consuming analysis, as the plaque-covered and clean tooth areas have to be determined manually for each image using image-processing software. Here, we present a method for the semi-automated planimetric quantification of dental plaque, which allows for the rapid processing of up to 1,000 images simultaneously. The method exploits the enhanced contrast between disclosed plaque, sound tooth surfaces, and soft tissues in fluorescence images acquired with an intraoral camera. Careful execution of the clinical procedures and accurate image acquisition are crucial steps for the successful semi-automated identification of the plaque-covered areas. The method is suitable for planimetry on sound facial and oral tooth surfaces, on most composite resin restorations, and on teeth with orthodontic brackets, but not on metallic restorations. Compared to traditional PPI recordings, semi-automated planimetry considerably reduces the amount of time spent on the analysis, as well as the subjective human input, thus increasing the reproducibility of planimetric measurements.

Fluorescence lectin binding analysis of carbohydrate components in dental biofilms grown in situ in the presence or absence of sucrose

Carbohydrate components, such as glycoconjugates and polysaccharides, are constituents of the dental biofilm matrix that play an important role in biofilm stability and virulence. Exopolysaccharides in Streptococcus mutans biofilms have been characterized extensively, but comparably little is known about the matrix carbohydrates in complex, in situ-grown dental biofilms. The present study employed fluorescence lectin binding analysis (FLBA) to investigate the abundance and spatial distribution of glycoconjugates/polysaccharides in biofilms (n = 306) from 10 participants, grown in situ with (SUC) and without (H2O) exposure to sucrose. Biofilms were stained with 10 fluorescently labeled lectins with different carbohydrate specificities (AAL, ABA, ASA, HPA, LEA, MNA-G, MPA, PSA, VGA and WGA) and analyzed by confocal microscopy and digital image analysis. Microbial composition was determined by 16S rRNA gene sequencing. With the exception of ABA, all lectins targeted considerable matrix biovolumes, ranging from 19.3% to 194.0% of the microbial biovolume in the biofilms, which illustrates a remarkable variety of carbohydrate compounds in in situ-grown dental biofilms. MNA-G, AAL, and ASA, specific for galactose, fucose, and mannose, respectively, stained the largest biovolumes. AAL and ASA biovolumes were increased in SUC biofilms, but the difference was not significant due to considerable biological variation. SUC biofilms were enriched in streptococci and showed reduced abundances of Neisseria and Haemophilus spp., but no significant correlations between lectin-stained biovolumes and bacterial abundance were observed. In conclusion, FLBA demonstrates the presence of a voluminous biofilm matrix comprising a variety of different carbohydrate components in complex, in situ-grown dental biofilms.

Prevention of Initial Bacterial Attachment by Osteopontin and Other Bioactive Milk Proteins

A considerable body of work has studied the involvement of osteopontin (OPN) in human physiology and pathology, but comparably little is known about the interaction of OPN with prokaryotic cells. Recently, bovine milk OPN has been proposed as a therapeutic agent to prevent the build-up of dental biofilms, which are responsible for the development of caries lesions. Bioactive milk proteins are among the most exciting resources for caries control, as they hamper bacterial attachment to teeth without affecting microbial homeostasis in the mouth. The present work investigated the ability of OPN to prevent the adhesion of three dental biofilm-forming bacteria to saliva-coated surfaces under shear-controlled flow conditions in comparison with the major milk proteins α-lactalbumin, β-lactoglobulin, αs1-casein, β-casein and κ-casein, as well as crude milk protein. OPN was the most effective single protein to reduce the adhesion of Actinomyces naeslundii, Lactobacillus paracasei subsp. paracasei and Streptococcus mitis. β-casein and crude milk protein also had a pronounced effect on all three species, which suggests binding to different microbial surface structures rather than the blocking of a specific bacterial adhesin. Bioactive milk proteins show potential to delay harmful biofilm formation on teeth and hence the onset of biofilm-related oral disease.

Clinical and In Situ Oral Biofilm Formation on Dental Implant Abutment Materials: A Systematic Review

PURPOSE

This review aimed to summarize the current literature on the oral biofilm formation on alternative abutment materials compared with titanium (Ti) or Ti alloy in clinical and in situ conditions.

MATERIALS AND METHODS

An electronic database search was conducted in PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, LIVIVO, BVS, ProQuest, and OpenGrey up to November 2020. Clinical and in situ studies evaluating the biofilm formed on metallic, ceramic, or polymeric abutment materials compared with Ti or Ti alloy were included. Outcome measures were microbial counts/profile, cell viability, and biofilm coverage/thickness. Clinical parameters were deemed secondary outcomes. Risk of bias was assessed by RoB 2 and ROBINS-I tools.

RESULTS

A total of 10 clinical and 9 in situ studies were included. Meta-analysis was not performed due to heterogeneity across studies. The abutment materials polytetrafluoroethylene, gold alloy, gold-platinum alloy, cobalt-chromium, alumina, and zirconia were reported. Six out of ten clinical studies (60%) and four out of nine in situ studies (44%) found no qualitative or quantitative microbiologic differences between tested materials. When significant differences were detected, conflicting results were reported. Clinical outcomes were consistent with healthy conditions for all investigated materials.

CONCLUSION

There is not enough evidence to support the existence of relevant microbiologic differences in the biofilm formed on alternative abutment materials over Ti and its alloys in oral conditions. No evident relationship between microbiologic results and clinical outcomes were found. In situ studies and polymicrobial analyses showed a higher tendency to find significant differences between materials.

Attitude of Brazilian dentists and dental students regarding the future role of artificial intelligence in oral radiology: a multicenter survey

OBJECTIVES

The aim of this study was to assess the attitude of dentists and dental students in Brazil regarding the impact of artificial intelligence (AI) in oral radiology, and to evaluate the effect of an introductory AI lecture on their attitude.

METHODS

A questionnaire was prepared, comprising statements regarding the future role of AI in oral radiology and dentistry. A lecture of approx. 1 h was prepared, comprising the basic principles of AI and a non-exhaustive overview of AI research in medicine and dentistry. Participants filled in the questionnaire prior to the lecture. After the lecture, the questionnaire was repeated.

RESULTS

Throughout 7 sessions at 6 locations, 293 questionnaires were collected. The majority of participants were undergraduate dental students (57%). Prior to the lecture, there was a strong agreement regarding the various future roles and expected impact of AI in oral radiology. Approximately, one-third of participants was concerned about AI. After the lecture, agreement regarding the different roles of AI in oral radiology increased, overall excitement regarding AI increased, and concerns regarding the potential replacement of oral radiologists decreased.

CONCLUSIONS

A generally positive attitude towards AI was found; an introductory lecture was beneficial towards this attitude and alleviated concerns regarding the effect of AI on the oral radiology profession. Given the unprecedented, ongoing revolution of AI-augmented radiology, it is pivotal to incorporate AI topics in dental training curricula.

Microbial communities of titanium versus zirconia abutments on implant-supported restorations: Biodiversity composition and its impact on clinical parameters over a 3-year longitudinal prospective study

BACKGROUND

Shifts in microbial communities are common over time, but they may disturb the host-microbiome homeostasis and result in inflammation of the peri-implant issues if a dysbiotic biofilm is established.

PURPOSE

Considering that different oral substrate surfaces may have a relevant impact on the microbial adhesion and colonization, the aim of this study was to investigate the microbial communities of the biofilm formed on single-implant restorations using titanium or zirconia abutments and how they correlate with clinical parameters after 3-years of implant loading.

MATERIALS AND METHODS

MiSeq sequencing of 16S rRNA amplicons was used to characterize the oral biofilms of individuals (n = 20) who were sampled longitudinally during 3 years of masticatory loading. Bioinformatics analysis and multivariate statistical analysis were used to evaluate the microbial diversity and clinical outcomes.

RESULTS

Microbiomes of both abutment materials presented high alpha-diversity indices during all the experimental period, irrespective of the time of sampling. Microbial communities of titanium and zirconia were quite different over time, differing about 30% after 3 years of functional loading. Similarity of microbiomes between tested abutments and contralateral teeth was also low, ranging between 45% and 50% after 3 years of investigation. Periodontal pathogens commonly associated with peri-implantitis were found in both groups. Furthermore, both abutment materials presented strong correlations of diversity indices and microbial taxa with clinical outcomes.

CONCLUSIONS

The type of abutment substrate significantly influenced diversity and clustering of communities during 3 years of functional loading. The time of sampling had no effect on the variables. Large correlations were found between microbial findings and clinical outcomes.