Antimicrobial efficiency and cytocompatibility of different decontamination methods on titanium and zirconium surfaces

Clinical Oral Implants Research, vol. 34, pp. 20–32

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.

Authors 8

1. Jamal M. Stein corresponding Aachen Operative Dentistry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Operative Dentistry, Periodontology and Preventive Dentistry University Hospital (RWTH) Aachen Germany

   Private Practice Aachen Germany

   Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany

   Private Practice, Aachen, Germany

2. Georg Conrads Aachen Division of Oral Microbiology and Immunology Department of Operative Dentistry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry Rheinisch‐Westfälische Technische Hochschule (RWTH) Aachen University Hospital Aachen Germany

3. Mohamed M. H. Abdelbary Aachen Division of Oral Microbiology and Immunology Department of Operative Dentistry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry Rheinisch‐Westfälische Technische Hochschule (RWTH) Aachen University Hospital Aachen Germany

4. Sareh Said Yekta Aachen Department of Orthodontics

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Orthodontics RWTH Aachen University Hospital Aachen Germany

   Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany

5. Patricia Buttler Aachen Operative Dentistry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Operative Dentistry, Periodontology and Preventive Dentistry University Hospital (RWTH) Aachen Germany

   Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany

6. Joanna Glock Aachen Operative Dentistry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Operative Dentistry, Periodontology and Preventive Dentistry University Hospital (RWTH) Aachen Germany

   Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany

7. Gelareh Sadvandi Aachen Operative Dentistry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Operative Dentistry, Periodontology and Preventive Dentistry University Hospital (RWTH) Aachen Germany

   Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital (RWTH), Aachen, Germany

8. Christian Apel Aachen Department of Biohybrid and Medical Textiles (BioTex) Institute of Applied Medical Engineering

   RWTH Aachen University

   Affiliation as printed

   Department of Biohybrid & Medical Textiles (BioTex), Institute of Applied Medical Engineering RWTH Aachen University & Hospital Germany