Scanning electron microscopic analysis of adherent bacterial biofilms associated with peri-implantitis

The Role of Implant Coronal Surface Properties on Early Adhesion of Streptococcus Oralis-An In Vitro Comparative Study

Dental implant coronal surfaces designed with the primary goal of maintaining crestal bone levels may also promote bacterial adhesion, leading to soft tissue inflammation and peri-implant bone loss. Achieving an optimal surface roughness that minimizes bacterial adhesion while preserving crestal bone is crucial. It is hypothesized that a specific threshold surface roughness value may exist below which, and above which, initial bacterial adhesion does not statistically change. This study evaluated 12 commercially available and 2 custom-designed implant surfaces for their physicochemical properties and initial bacterial adhesion, as represented by Streptococcus oralis (S. oralis) the dominant initial colonizer of the successive waves of bacterial consortia that result in plaque and biofilm formation. Implants were immersed in a S. oralis suspension for 4 h, after which microbial viability was assessed. Marked differences were observed in surface roughness, chemical composition, and wettability, and S. oralis adhesion. Surfaces with Sa > 1 μm had significantly more adherent bacteria after 4 h compared to those with Sa < 1 μm, despite complexity. Adding nanotopography to dual-acid etched surfaces further reduced bacterial adhesion compared to surfaces without these features. The role of chemical composition and wettability was less influential than roughness. In conclusion, there is a cut-off threshold roughness around Sa = 1 μm, above which the adhesion of bacteria increases significantly to a plateau level; while below which, bacterial adhesion is equivalent to a machined surface despite the surface texture of the implant collar.

Effect of Air Polishing on the Treatment of Peri-Implant Diseases: A Systematic Review and Meta-Analysis

Peri-implant diseases have become one of the notable biological complications of postrehabilitation with implant-supported restorations. Effective modalities for decontamination of biofilm deposits around implant surfaces are critical for resolution of the inflammation. Air polishing is one of the recommended clinical methods for treating peri-implant diseases. This systematic review assessed clinical evidence on efficacy of using air polishing technology for the management of peri-implant diseases, including peri-implant mucositis and peri-implantitis. Four electronic databases from January 1990 to December 2022 were searched to identify the relative human randomized clinical trials that applied air polishing for nonsurgical and surgical treatment of peri-implant mucositis and peri-implantitis. Twelve articles were selected. For treating peri-implant mucositis, air polishing showed a comparable effect to ultrasonic scaling in the reduction of bleeding on probing (BOP) and probing pocket depth (PPD). The nonsurgical approach of air polishing in treating peri-implantitis varied in the reduction of BOP, PPD, and clinical attachment level (CAL) in evaluated studies. Air polishing in the surgical treatment of peri-implantitis was comparable to mechanical cleaning, implantoplasty, and the use of Ti-brush, in regards to the significant reduction of BOP, PPD, and CAL, as well as the improvement of the bone level between baseline and follow-ups. The standardized mean difference with a 95% confidence interval of the studied parameters was estimated using the random effect model; however, statistical differences were not detected between air polishing and comparative modalities in the treatment of peri-implantitis. Within the limitations of this review, the application of air polishing did not result in more favorable outcomes in the treatment of peri-implant diseases compared to other modalities.