RESUMO
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
Assuntos
Implantação Dentária , Infecções , Placa Dentária , TitânioRESUMO
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.