Effects of simulated long-term exposure to bottled, neutral pH electrolyzed oxidizing water on the properties of denture base resins.

STATEMENT OF PROBLEM: Denture stomatitis can pose serious health risks, especially to older people. Chemical denture cleaning agents must be effective, yet not adversely affect the longevity of removable dentures. Ready-to-use (RTU) neutral pH electrolyzed oxidizing water (EOW) is an effective biocide against Candida albicans biofilms on denture resins, but the effects of daily disinfection with EOW on the physical and mechanical properties of resins have not been established. PURPOSE: The purpose of this in vitro study was to investigate the effects of simulated long-term exposure to RTU EOW on the color, surface characteristics, and flexural strength of denture base resins. MATERIAL AND METHODS: Heat-polymerized (HP), 3D printed (3D) and computer-aided design and computer-aided manufacture (CAD-CAM)-milled (CC) denture resin specimens (square: 20×20×3.3 mm; beam: 64×10×3.3 mm) were immersed in tap water (TW), RTU EOW (Neutral Anolyte ANK; Envirolyte; EOW), or a commercial denture cleaning tablet solution (Polident 3-Minute; Glaxo SmithKline; PD), mimicking a 5-minute once daily disinfection routine performed up to 3.0 years. Color and surface roughness were recorded (n=3, squares), and changes in color (∆E00) and surface roughness (∆Ra) were calculated. Flexural strength (n=12, beams) and surface hardness (n=18, beams) were measured with a universal testing machine. The fractured surfaces of specimens were examined by scanning electron microscopy and energy dispersive spectroscopy. Data were assessed by performing the Shapiro-Wilk or D'Agostino and Pearson normality tests. Two-way ANOVA or the Kruskal-Wallis test with a post hoc Tukey HSD or Dunn multiple comparisons (α=.05) was used for statistical analyses. RESULTS: No significant changes were found in either color or surface roughness for HP, 3D, and CC resins after 1.5-year and 3.0-year immersion in any of the agents (P>.05). The surface hardness of 3D resins reduced by 14% with TW and by 23% with EOW and PD at 3.0 years. The flexural strengths of all 3 resins were unaffected by 3.0-year immersion (P>.05). CONCLUSIONS: Simulated long-term immersion disinfection with RTU neutral pH EOW did not adversely affect the physical and mechanical properties of HP or CC denture resins.

Electrolysed oxidising water as a multi-purpose biocide in dental healthcare-A scoping review.

OBJECTIVES: The objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps. BACKGROUND: EOW is an emerging, "green," and cost-effective biocide. There are no reviews on the landscape of EOW research as either an antiseptic or disinfectant in dental healthcare or its suitability for the oral healthcare of older people. MATERIALS AND METHODS: The review follows the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Database searches (Google Scholar, PubMed, Web of Science, Ovid, Scopus and Science Direct) were undertaken using MESH terms and Boolean operators with no date restrictions, to identify full-text, original reports published in English-language peer-reviewed journals. RESULTS: The search yielded 114 papers that met the inclusion/exclusion criteria. Dental applications of EOW include its use as an endodontic irrigant (39%); mouth rinse/surgical irrigant (21%); disinfectant for dental unit water lines (19%) and dental biomaterials (17%); and for antimicrobial efficacy, effects on oral tissues and on dental material properties. Most studies (83%) evaluated a single EOW formulation (acidic, moderately acidic or neutral) that was either generated at 'point-of-use' (POU; 72%), bottled ('ready-to-use', RTU; 24%) or from unspecified (3%) sources. Six reports evaluated storage-related parameters and 25 evaluated clinical applications; 89 were in vitro studies and one investigated the cost-effectiveness of POU EOW. CONCLUSIONS: Neutral-pH, EOW is effective as an antimicrobial agent without deleterious effects on oral tissues. However, research on the impact of storage conditions, anti-Candida biofilm efficacy and mechanism of action against yeasts, long-term effects on denture materials and cost-effectiveness is required to establish the suitability of EOW as a multipurpose biocide for dental healthcare, including infection-control requirements relating to older people.

Formulation of a Semisolid Emulsion Containing Leptospermum scoparium Essential Oil and Evaluation of In Vitro Antimicrobial and Antibiofilm Efficacy.

Manuka oil, an essential oil derived from the Leptospermum scoparium, has been traditionally used for wound care and as a topical antibacterial, antifungal, and anti-inflammatory. However, the essential oil is not well retained at mucosal sites, such as the oral cavity, where the benefits of the aforementioned properties could be utilized toward the treatment of persistent biofilms. Within this study, L. scoparium essential oil was incorporated into a semisolid emulsion for improved delivery. The safety profile of L. scoparium essential oil on human gingival fibroblasts was determined via cell viability, cytotoxicity, and caspase activation. The minimal bactericidal concentration of L. scoparium essential oil was determined, and the emulsion's antibiofilm effects visualized using confocal laser scanning microscopy. L. scoparium essential oil demonstrated a lower IC50 (0.02% at 48 h) when compared to the clinical control chlorhexidine (0.002% at 48 h) and displayed lower cumulative cytotoxicity. Higher concentrations of L. scoparium essential oil (≥ 0.1%) at 6 h resulted in higher caspase 3/7 activation, suggesting an apoptotic pathway of cell death. A minimal bactericidal concentration of 0.1% w/w was observed for 6 oral bacteria and 0.01% w/v for Porphyromonas gingivalis. Textural and rheometric analysis indicated increased stability of emulsion with a 1 : 3 ratio of L. scoparium essential oil: Oryza sativa carrier oil. The optimized 5% w/w L. scoparium essential oil emulsion showed increased bactericidal penetrative effects on Streptococci gordonii biofilms compared to oil alone and to chlorhexidine controls. This study has demonstrated the safety, formulation, and antimicrobial activity of L. scoparium essential oil emulsion for potential antibacterial applications at mucosal sites.

Streptococcus salivarius Isolates of Varying Acid Tolerance Exhibit F1F0-ATPase Conservation.

Genes encoding the subunits of the membrane-bound F1F0-ATPase (responsible for exporting protons from the cytoplasm and contributing to acid tolerance) were sequenced for 24 non-mutans streptococci isolated from carious lesions. Isolates, mostly Streptococcus salivarius, displayed a continuum of acid tolerance thresholds ranging from pH 4.55 to 3.39, but amino acid alignments of F1F0-ATPase subunits revealed few non-synonymous substitutions and these were unrelated to acid tolerance. Thus, the F1F0-ATPase is highly-conserved among S. salivarius isolates despite varying acid tolerance thresholds, supporting the contention that acid tolerance is determined by the level of gene/protein expression rather than variation in molecular structure.

Colony polymerase chain reaction of heme-accumulating bacteria.

Colony PCR of anaerobic black-pigmenting Bacteroidetes species Porphyromonas gingivalis and Prevotella intermedia was modified by addition of bovine serum albumin to reverse the inhibitory action of accumulated heme.

Enhancing the student learning experience: Co-teaching biochemistry and clinical sciences within the dental curriculum.

Basic knowledge of biochemistry underpins oral and dental care. Undergraduate dental students do not always engage well with basic science teaching due to not appreciating its clinical relevance. Co-teaching provides one approach to overcome students' disengagement and involves two lecturers, with complementary expertise, presenting the curriculum together. This study investigated student experiences and engagement using co-teaching to integrate biochemistry with clinical sciences in the students' second-year dental curriculum. Two successive second year dental student cohorts were co-taught. Content was delivered by a biochemist and an oral biologist, either online (during the 2020 COVID lockdown) or in-person (2021). Each cohort was surveyed at the end of the teaching module using an online questionnaire containing both interval scale and free-text questions. Responses were received from 39 (42%) and 64 (85%) of students in 2020 and 2021, respectively. Students from both cohorts preferred the co-teaching approach with a mean of 8.74 on a 10-point interval scale. In 2020 and 2021, 77% and 76% of participants, respectively, preferred a combined biochemistry and clinical dentistry delivery, either in-person (37%), via Zoom (19%) or via video recording (14%). Thematic analysis of responses revealed students experienced enhanced engagement when co-taught and they attributed this to integration of the curriculum making the content more relevant and stimulating. Students preferred co-teaching to individual subjects being taught by a single teacher. Co-teaching established the relevance of theoretical biochemistry to clinical dental sciences and enhanced the students' learning experience.

Amplification of oral streptococcal DNA from human incisors and bite marks.

Challenges to the evidentiary value of morphometric determinations have led to a requirement for scientifically substantiated approaches to the forensic analysis of bite marks. Human teeth support genotypically distinctive populations of bacteria that could be exploited for forensic purposes. This study explored the feasibility of directly amplifying bacterial DNA from bite marks for comparison with that from teeth. Samples from self-inflicted experimental bite marks (n = 24) and human incisors were amplified by PCR using primers specific for streptococcal 16S ribosomal DNA. Amplicon profiles (resolved by denaturing gradient gel electrophoresis) from bite mark samples aligned significantly more closely with profiles generated from the teeth responsible than with those from other teeth. Streptococcal amplicons were generated from dental samples applied to excised porcine skin for up to 48 h. These findings indicate that streptococcal DNA can be amplified directly from bite marks, and have potential application in bite mark analysis.

Alkaline Tolerance and Biofilm Formation of Root Canal Isolates of Enterococcus faecalis: An In Vitro Study.

INTRODUCTION: The aim of this study was to compare the effects of glucose and glycerol (provided as principal fermentable supplements) on alkaline tolerance and biofilm-forming capabilities of root canal-derived strains of Enterococcus faecalis and those from other environments. METHODS: The planktonic growth kinetics and the biofilm-forming capabilities of E. faecalis isolates (identified by 16S ribosomal DNA sequencing) were compared when supplied with glucose and glycerol at pH levels of 8 and 11 in a microtiter plate. The metabolic activity of the biofilms plate that formed at a neutral pH level (supplied with either glucose or glycerol) was measured after subsequent adjustment to a pH level of 11. RESULTS: Ten isolates (7 from root canals and 3 from other sources) were examined. The lag phase and the doubling time increased under elevated alkalinity irrespective of either the fermentable supplement (glucose or glycerol) or the origin of the isolate. Biofilm formation and metabolic activity varied among strains, but neither was related to the source of isolation. In general, biofilm formation was enhanced when grown in glucose compared with glycerol and at a pH of 8 compared with a pH of 11 (irrespective of the fermentable supplement). The provision of glycerol did not increase either the planktonic growth rate or biofilm development compared with glucose but significantly increased the metabolic activity of biofilms, especially at a pH of 11 compared with a pH of 8. CONCLUSIONS: In the nutrient-deprived environment of a necrotic or root-filled root canal, glycerol may be an alternative energy source that can promote increased metabolic activity of E. faecalis under alkaline treatment conditions.

AgNP/Alginate Nanocomposite hydrogel for antimicrobial and antibiofilm applications.

The synthesis and specific surface functionalization of antimicrobial silver nanoparticles (AgNPs) and their incorporation into an alginate hydrogel is described. Divalent cation-mediated ionic crosslinking was used to disperse the AgNPs throughout the gel, made possible by -COO- cross-linking sites provided by the surface-enhanced nanoparticles, inspired by the classic egg-box model crosslinking of calcium alginate. An AgNP concentration, 10-20 µg g-1 increased hygrogel elasticity, viscosity, and shear resistance by 45, 30, and 31% respectively. Cryo-TEM revealed evenly distributed AgNP assemblies of discrete AgNPs throughout the gel matrices. FTIR-ATR indicated AgNPs were involved in alginate carboxylate-Ca2+-COO-AgNP crossbridging, which was not achieved through mixing of AgNPs into preformed gels. Live/dead fluorometric assays determined a minimal bactericidal concentration of 25 µg g-1 Ag for 6 microorganisms. Anti-biofilm assays showed species-dependent cell death of 44 -61%, with limited silver ion release of 0.41% and 1.1% after 7 days for Gram positive and negative bacteria, respectively.

PCR-based detection of salivary bacteria as a marker of expirated blood.

Distinguishing between bloodstains caused by a spatter pattern or by expirated blood may be crucial to a forensic investigation. Expirated blood is likely to be contaminated with saliva but current techniques have limited sensitivity, especially with small bloodstains. We report that a PCR assay, designed to detect salivary bacteria, can amplify streptococcal DNA from saliva stains applied to fabrics for at least 62 days after seeding. Bacterial DNA was detected when 0.01 microl of saliva was present in the stain and the amplification was not affected by contamination with blood. These findings indicate that PCR amplification of salivary microbial DNA may have application in the identification of expirated bloodstains in forensic case-work.

Reusing Titanium Healing Abutments: Comparison of Two Decontamination Methods.

PURPOSE: To assess the amount of contamination remaining on used healing abutments after autoclaving and to compare the effectiveness of two additional decontamination methods. MATERIALS AND METHODS: After autoclaving, a total of 120 used healing abutments were divided equally into three groups: used healing abutments after autoclaving only (group 1); used healing abutments after autoclaving and air-flow polishing (Master Piezon, EMS) using erythritol powder (AIR-FLOW PLUS, EMS) (group 2); and used healing abutments after autoclaving and sodium hypochlorite (NaOCl; 25 g/L) treatment (group 3). Residual contaminants were stained using Phloxine B (400 g/mL), and healing abutments were photographed using a light microscope with digital capture system (Nikon SMZ800). The proportion of stained (ie, contaminated) areas on each healing abutment was then measured using imaging software (ImageJ). The healing abutments were also examined using scanning electron microscopy (SEM). RESULTS: Mean proportion of surface area affected by residual contaminants on the body, top (screwdriver-engaging), and bottom (implant-abutment interface) surfaces for group 1 was 38.2% ± 28.34%, 30.0% ± 19.55%, and 18.7% ± 17.87%, respectively; group 2 showed 3.5% ± 4.90%, 5.3% ± 3.74%, and 5.4% ± 8.49%, respectively; and group 3 showed 0.3% ± 0.16%, 1.9% ± 2.14%, and 0.7% ± 1.02%, respectively. Autoclaving alone was insufficient for successful decontamination, while additional decontamination procedures significantly reduced remaining contaminants. NaOCl was significantly more effective than air polishing. SEM analysis showed no detectable differences in the surface appearance of titanium healing abutments. CONCLUSION: The results show that decontamination of used healing abutments is achievable, thus strengthening the feasibility of reusing healing abutments.

Antimicrobial activity of chemomechanical gingival retraction products.

BACKGROUND: Application of astringent hemostatic agents is the most widely used technique for gingival retraction, and a variety of products are offered commercially. However, these products may have additional unintended yet clinically beneficial properties. The authors assessed the antimicrobial activities of marketed retraction products against plaque-associated bacteria in both planktonic and biofilm assays, in vitro. METHODS: The authors assessed hemostatic solutions, gels, pellets, retraction cords, pastes, and their listed active agents against a collection of microorganisms by means of conventional agar diffusion and minimum bacteriostatic and bactericidal concentration determinations. The authors then tested the most active products against monospecies biofilms grown on hydroxyapatite disks. RESULTS: All of the tested retraction products exhibited some antimicrobial activity. The results of the most active products were comparable with those of a marketed mouthwash. The listed retraction-active agents displayed relatively little activity when tested in pure form. At 10% dilution, some products evidenced inhibitory activity against most tested bacteria within 3 minutes of exposure, whereas others displayed variable effects after 10 minutes. The most active agents reduced, but did not completely prevent, the metabolic activity of a monospecies biofilm. CONCLUSIONS: Commercial gingival retraction products exhibit antimicrobial effects to various degrees in vitro. Some products display rapid bactericidal activity. The antimicrobial activity is not owing to the retraction-active agents. Biofilm bacteria are less sensitive to the antimicrobial effects of the agents. PRACTICAL IMPLICATIONS: The rapidity of killing by some hemostatic agents suggests an antimicrobial effect that may be efficacious during clinical placement. The results of this in vitro study suggest that clinicians should be aware of the potential antimicrobial effects of some hemostatic agents, but more research is needed to confirm these observations in clinical use.

Surface Characteristics and Biofilm Development on Selected Dental Ceramic Materials.

BACKGROUND: Intraoral adjustment and polishing of dental ceramics often affect their surface characteristics, promoting increased roughness and consequent biofilm growth. This study correlated surface roughness to biofilm development with four commercially available ceramic materials. METHODS: Four ceramic materials (Vita Enamic®, Lava™ Ultimate, Vitablocs Mark II, and Wieland Reflex®) were prepared as per manufacturer instructions. Seventeen specimens of each material were adjusted and polished to simulate clinical intraoral procedures and another seventeen remained unaltered. Specimens were analysed by SEM imaging, confocal microscopy, and crystal violet assay. RESULTS: SEM images showed more irregular surface topography in adjusted specimens than their respective controls. Surface roughness (Ra ) values were greater in all materials following adjustments. All adjusted materials with the exception of Vitablocs Mark II promoted significantly greater biofilm growth relative to controls. CONCLUSION: Simulated intraoral polishing methods resulted in greater surface roughness and increased biofilm accumulation.

Antibacterial properties of root canal lubricants: a comparison with commonly used irrigants.

The aim was to assess in vitro the antibacterial activity of 10 root canal lubricants. K-Y Jelly personal lubricant, RC-Prep, File-Eze, File-Rite, EndoPrep Gel, Endosure Prep Crème 15%, Prep-Rite, Glyde, SlickGel ES and Alpha Glide were selected and compared in their antimicrobial properties to seven irrigants. Serial dilutions of each agent in tryptic soy broth were inoculated with either Enterococcus faecalis or Pseudomonas aeruginosa and incubated at 37C for 24 h. During incubation bacterial growth was measured by optical density (A(600)), and samples removed for cultivation on tryptic soy broth agar. Against both test bacteria after 1 h incubation, six lubricants recorded minimum bactericidal concentrations ranging from 1/10 to 1/80, whereas the inhibitory activity of the irrigants ranged from 1/20 to 1/640. Under these conditions, several lubricants exhibited antimicrobial activity comparable with some irrigants. Three irrigants, Consepsis (containing chlorhexidine), Endosure EDTA/C (containing cetrimide) and EndoPrep Solution (containing cetrimide), showed superior antibacterial action to lubricants against both species. The irrigants containing ethylenediamine tetraacetic acid and cetrimide were the most effective against both bacterial species at all time intervals. Antimicrobial activity of the lubricants did not correlate to pH values, which ranged from 2.9 to 10.3. Root canal lubricants have antibacterial properties that may help to disinfect canals.

The butterfly effect: an investigation of sectioned roots.

INTRODUCTION: The butterfly effect is an optical phenomenon seen in some sections of tooth roots. The aim of this work was to investigate the density of dentinal tubules in mesiodistal and buccolingual cross-sections of roots exhibiting the butterfly effect and to determine if the effect is featured throughout the length of roots and is age related. METHODS: Thirty extracted single-rooted teeth were allocated to the following groups according to patient age: group 1: 15-24 years, group 2: 25-44 years, and group 3: 45 years and over. The teeth were decoronated, and their roots were embedded in acrylic and cut into ten 1 mm-thick cross-sections. Sections were viewed under a light microscope and coded (1 or 2) according to presence or absence of the butterfly effect. A root scored 20 when all levels exhibited the butterfly appearance. The 2 teeth with the highest score from each group and 2 control teeth with the minimum score (of 10) were selected. Two adjacent, consecutive cross-sections were chosen with the most coronal cut mesiodistally and the other buccolingually. Scanning electron micrographs (×850) were taken of the central portion of their canal lumina and the density of the dentinal tubules determined. RESULTS: The butterfly effect was found at all levels in the roots of the affected teeth. The tubule density was highest in the buccolingual root sections (45,348 mm(-2)) and lowest mesiodistally (12,605 mm(-2)), a significant difference (P = .02). This trend was found across all age groups. CONCLUSIONS: Root sections with the butterfly effect have a lower density of dentinal tubules mesiodistally corresponding to the wings of the butterfly. The pattern was observed in teeth from all age groups and was absent in controls.

Infection of apical dentin and root-end cavity disinfection.

INTRODUCTION: The purpose of this study was to assess Enterococcus faecalis penetration into the dentin of the apical 3 mm and bacterial death after the application of either chlorhexidine or laser to root-end cavities. METHODS: Root canals of 60 single-rooted teeth were prepared. In part 1, cementum was removed semicircumferentially from 21 roots, and the smear layer was removed from 15 roots using 17% EDTA/cetrimide. Teeth were inoculated and incubated with E. faecalis for 10 days, rinsed, and live/dead stained. The effect of cementum and smear on bacterial penetration was assessed by confocal laser scanning microscopy (CLSM). In part 2, 39 teeth had root ends resected and cavities ultrasonically prepared. Inoculated roots were assigned to 1 of the following 3 groups: (1) root-end cavities irrigated with 0.2 % chlorhexidine, (2) root-end cavities irradiated with a laser for 20 seconds at 1.5 W, or (3) root-end cavities that received no treatment. Roots were live/dead stained, sectioned, and examined by CLSM. The depth of the bacterial penetration and bacterial survival were compared using the Mann-Whitney U test. RESULTS: The presence of a smear layer and/or cementum did not significantly affect bacterial penetration. In root-end cavities, chlorhexidine was more effective than laser (P < .001), reducing bacterial viability by 93% versus 70% with a laser. CONCLUSIONS: E. faecalis invaded the entire width of dentin in the apical 3 mm irrespective of the smear layer and/or cementum. Chlorhexidine was more effective than laser in disinfecting root-end cavities.

Microbial analysis of bite marks by sequence comparison of streptococcal DNA.

Bite mark injuries often feature in violent crimes. Conventional morphometric methods for the forensic analysis of bite marks involve elements of subjective interpretation that threaten the credibility of this field. Human DNA recovered from bite marks has the highest evidentiary value, however recovery can be compromised by salivary components. This study assessed the feasibility of matching bacterial DNA sequences amplified from experimental bite marks to those obtained from the teeth responsible, with the aim of evaluating the capability of three genomic regions of streptococcal DNA to discriminate between participant samples. Bite mark and teeth swabs were collected from 16 participants. Bacterial DNA was extracted to provide the template for PCR primers specific for streptococcal 16S ribosomal RNA (16S rRNA) gene, 16S-23S intergenic spacer (ITS) and RNA polymerase beta subunit (rpoB). High throughput sequencing (GS FLX 454), followed by stringent quality filtering, generated reads from bite marks for comparison to those generated from teeth samples. For all three regions, the greatest overlaps of identical reads were between bite mark samples and the corresponding teeth samples. The average proportions of reads identical between bite mark and corresponding teeth samples were 0.31, 0.41 and 0.31, and for non-corresponding samples were 0.11, 0.20 and 0.016, for 16S rRNA, ITS and rpoB, respectively. The probabilities of correctly distinguishing matching and non-matching teeth samples were 0.92 for ITS, 0.99 for 16S rRNA and 1.0 for rpoB. These findings strongly support the tenet that bacterial DNA amplified from bite marks and teeth can provide corroborating information in the identification of assailants.

Bacterial viability determination in a dentinal tubule infection model by confocal laser scanning microscopy.

Dentinal tubule invasion protects bacteria from chemo-mechanical disinfection and frequently results in root canal treatment failures. Enterococcus faecalis is a primary causative agent, particularly in persistent, asymptomatic, and chronic apical periodontitis. In order to assess and compare the efficacies of endodontic antimicrobial agents and application strategies, we have developed a convenient and robust method to measure bacterial viability and assess distribution in an ex vivo tubule infection model. Following infection and antimicrobial treatment of prepared ex vivo roots, the tubule bacteria are exposed to nucleic acid-binding fluorescent stains (LIVE/DEAD BacLight stain), sectioned, and examined by confocal laser scanning microscopy. The proportion of red-fluorescing (dead) and green-fluorescing (live) bacteria is then visualized in situ and quantified with image analysis software.

Bacterial colonization of titanium discs: a pilot study for evaluating implant surface deterioration

Background: Bacterial colonization of dental implant surfaces is considered the main aetiological factor in peri-implant diseases. Aim: To devise a protocol that will yield a consistent and viable biofilm on titanium specimens for the purpose of in vitro experimental investigation of microbially-induced surface deterioration and potential peri-implant therapy efficacy. Materials and Methods: Twelve Southern Implants grade 4 titanium discs, six with machined and six with moderately roughened surfaces were used in this study. Six discs were inoculated with Streptococcus oralis and incubated in brain- heart infusion under anaerobic conditions at 37o C 1, 2 and 3-days. Specimen surface characteristics were evaluated by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Energy dispersive x-ray analysis quantified the surface elemental composition of the discs. Qualitative and quantitative SEM analyses evaluated colonisation and consistency of biofilm formation. The pH of the media was determined following each incubation period. Results: There were significant differences in surface roughness between machined (Ra = 0.27μm, Sa = 1.01μm) and moderately roughened (Ra = 2.14μm, Sa= 1.34μm) surfaces. SEM revealed widespread surface irregularities (spikes, valleys and grooves) on the moderately roughened surfaces compared to the machined surfaces. pH measurements of the medium indicated an acidic level (pH = 4.4) after an initially neutral value (pH = 7.0). Colonisation of the disc surface was evident after 24 hours as a multilayered biofilm for both titanium surfaces. Conclusions: A protocol capable of yielding a consistent viable biofilm on titanium specimens has been devised. This can be used in future studies to investigate the effect of bacterial accumulation and the efficacy of peri-implant therapy on bacterial colonization on implant surfaces

Laser therapy: the future of peri-implantitis management?

Background: Peri-implantitis is an inflammatory process that leads to a loss of supporting bone around an osseointegrated implant. Currently, there is no standard of care for the treatment of peri-implantitis and clinicians are faced with a myriad of treatment choices. Aim: To evaluate articles from the previous ten years that have investigated the use of lasers in the treatment of peri-implantitis. Materials and Methods: The Pubmed electronic database of the US National Library of Medicine was used to search for articles relating to the use of lasers in the treatment of peri implantitis. Results were limited to ten years, and English articles only. Results: Ten articles were selected for review. These studies demonstrated positive treatment outcomes after 6 months with CO2 and Er:YAG lasers, however studies with follow-up of greater than 6 months showed that initial positive outcomes were not maintained throughout the observation period, coinciding with raised plaque index and bleeding scores. Conclusion: The short-term value of laser treatment has been documented, however the authors would like to see in vivo case studies demonstrating Er:YAG, CO2 and diode laser treatment of peri-implantitis with follow-up of at least 12 months, and regular observation periods.