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      Biofilm and dental implant: The microbial link

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          Abstract

          Mouth provides a congenial environment for the growth of the microorganisms as compared to any other part of the human body by exhibiting an ideal nonshedding surface. Dental plaque happens to be a diverse community of the microorganisms found on the tooth surface. Periodontal disease and the peri-implant disease are specific infections that are originating from these resident microbial species when the balance between the host and the microbial pathogenicity gets disrupted. This review discusses the biofilms in relation to the peri-implant region, factors affecting its presence, and the associated treatment to manage this complex microbial colony. Search Methodology: Electronic search of the medline was done with the search words: Implants and biofilms/dental biofilm formation/microbiology at implant abutment interface/surface free energy/roughness and implant, periimplantitis/local drug delivery and dental implant. Hand search across the journals – clinical oral implant research, implant dentistry, journal of dental research, international journal of oral implantology, journal of prosthetic dentistry, perioodntology 2000, journal of periodontology were performed. The articles included in the review comprised of in vivo studies, in vivo (animal and human) studies, abstracts, review articles.

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          Effect of material characteristics and/or surface topography on biofilm development.

          Wim Teughels, Nele Van Assche, Isabelle Sliepen … (2006)
          From an ecological viewpoint, the oral cavity, in fact the oro-pharynx, is an 'open growth system'. It undergoes an uninterrupted introduction and removal of both microorganisms and nutrients. In order to survive within the oro-pharyngeal area, bacteria need to adhere either to the soft or hard tissues in order to resist shear forces. The fast turn-over of the oral lining epithelia (shedding 3 x/day) is an efficient defence mechanism as it prevents the accumulation of large masses of microorganisms. Teeth, dentures, or endosseous implants, however, providing non-shedding surfaces, allow the formation of thick biofilms. In general, the established biofilm maintains an equilibrium with the host. An uncontrolled accumulation and/or metabolism of bacteria on the hard surfaces forms, however, the primary cause of dental caries, gingivitis, periodontitis, peri-implantitis, and stomatitis. This systematic review aimed to evaluate critically the impact of surface characteristics (free energy, roughness, chemistry) on the de novo biofilm formation, especially in the supragingival and to a lesser extent in the subgingival areas. An electronic Medline search (from 1966 until July 2005) was conducted applying the following search items: 'biofilm formation and dental/oral implants/surface characteristics', 'surface characteristics and implants', 'biofilm formation and oral', 'plaque/biofilm and roughness', 'plaque/biofilm and surface free energy', and 'plaque formation and implants'. Only clinical studies within the oro-pharyngeal area were included. From a series of split-mouth studies, it could be concluded that both an increase in surface roughness above the R(a) threshold of 0.2 microm and/or of the surface-free energy facilitates biofilm formation on restorative materials. When both surface characteristics interact with each other, surface roughness was found to be predominant. The biofilm formation is also influenced by the type (chemical composition) of biomaterial or the type of coating. Direct comparisons in biofilm formation on different transmucosal implant surfaces are scars. Extrapolation of data from studies on different restorative materials seems to indicate that transmucosal implant surfaces with a higher surface roughness/surface free energy facilitate biofilm formation.
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            Bacterial interactions and successions during plaque development.

            Paul Kolenbrander, Robert J Palmer, Alexander Rickard … (2006)
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              Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs.

              D Buser, R Schenk, S. Steinemann … (1991)
              The purpose of the present study was to evaluate the influence of different surface characteristics on bone integration of titanium implants. Hollow-cylinder implants with six different surfaces were placed in the metaphyses of the tibia and femur in six miniature pigs. After 3 and 6 weeks, the implants with surrounding bone were removed and analyzed in undecalcified transverse sections. The histologic examination revealed direct bone-implant contact for all implants. However, the morphometric analyses demonstrated significant differences in the percentage of bone-implant contact, when measured in cancellous bone. Electropolished as well as the sandblasted and acid pickled (medium grit; HF/HNO3) implant surfaces had the lowest percentage of bone contact with mean values ranging between 20 and 25%. Sandblasted implants with a large grit and titanium plasma-sprayed implants demonstrated 30-40% mean bone contact. The highest extent of bone-implant interface was observed in sandblasted and acid attacked surfaces (large grit; HCl/H2SO4) with mean values of 50-60%, and hydroxylapatite (HA)-coated implants with 60-70%. However, the HA coating consistently revealed signs of resorption. It can be concluded that the extent of bone-implant interface is positively correlated with an increasing roughness of the implant surface.
              Article 0 comments Cited 197 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Indian Soc Periodontol
                Journal ID (iso-abbrev): J Indian Soc Periodontol
                Journal ID (publisher-id): JISP
                Title: Journal of Indian Society of Periodontology
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0972-124X
                ISSN (Electronic): 0975-1580
                Publication date (Print): Jan-Feb 2013
                Volume: 17
                Issue: 1
                Pages: 5-11
                Affiliations
                [1] Department of Periodontology and Oral Implantology, Sudha Rustagi College of Dental Sciences and Research, Kheri More, Bhopani, Faridabad, Haryana, India
                Author notes
                Address for correspondence: Dr. Sangeeta Dhir, 1079/17 Faridabad, Haryana - 121 002, India. E-mail: dhirsangeeta@ 123456hotmail.com
                Article
                Publisher ID: JISP-17-5
                DOI: 10.4103/0972-124X.107466
                PMC ID: 3636945
                PubMed ID: 23633764
                SO-VID: 8eb11f08-717c-4323-a6fb-f8c54491f3d7
                Copyright © Copyright: © Journal of Indian Society of Periodontology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 June 2011
                Date accepted : 12 September 2012
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Dentistry
                Keywords: biofilms,dental implants,peri-implantitis,plaque microbiology
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: biofilms, dental implants, peri-implantitis, plaque microbiology

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