The effect of standoff distance and surface roughness on biofilm disruption using cavitation

Role of immune dysregulation in peri-implantitis

Peri-implantitis, a complex condition that can lead to dental implant failure, is characterized by inflammatory destruction resulting from immune dysregulation. Oral microbial dysbiosis and foreign body stimulation are the main factors contributing to such dysregulation, impairing immune cell function and triggering an inflammatory response. Immune dysregulation plays a critical role in the pathophysiology of peri-implantitis, impacting the balance of T cell subsets, the production of inflammatory factors, and immune-related molecular signaling pathways. Understanding the relationship between immune dysregulation and peri-implantitis is crucial for developing targeted strategies for clinical diagnosis and individualized treatment planning. This review explores the similarities and differences in the immune microenvironment of oral bacterial infections and foreign body rejection, analyzes the relevant molecular signaling pathways, and identifies new key targets for developing innovative immunotherapeutic drugs and effective and personalized treatment modalities for peri-implantitis. Additionally, it addresses the challenges and potential directions for translating immunotherapy into clinical practice for peri-implantitis, offering insights that bridge the gaps in current literature and pave the way for future research.

Impact of Biofilms on Surface Properties of Polymethyl Methacrylate (PMMA) Resins

Poly(methyl methacrylate) (PMMA) resins are widely used in medical and dental applications. Their susceptibility to bacterial biofilm formation poses significant challenges related to material degradation and infection risk. This study investigated the effects of Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) biofilms on PMMA resin surface properties over a 45-day period at 35°C. The study examined various parameters including biofilm adhesion, morphology, surface roughness, hydrophobicity, solid fraction, and zeta potential. PMMA resin specimens were inoculated with bacteria and incubated for 45 days. Biofilm adhesion was visually assessed, while surface characterization was conducted using scanning electron microscopy (SEM), atomic force microscopy (AFM), roughness analysis, contact angle measurements, solid fraction determination, and zeta potential analysis. The P. aeruginosa and S. aureus isolates were selected based on their biofilm-positive characteristics, which were further confirmed using Congo red and biofilm formation assays through crystal violet staining and spectrophotometric analysis. The results demonstrated robust biofilm adhesion on PMMA surfaces. SEM and AFM imaging revealed textured surfaces with elevated structures and depressions within the biofilm matrix. Biofilm-exposed resins exhibited significantly increased roughness (Ra = 164.5 nm, Rq = 169.5 nm) and hydrophobicity (mean angle = 85.5°-90.5°) compared to control samples (Ra = 38-50 nm, angle = 55°). Solid fraction measurements indicated a denser biofilm matrix on exposed resins (0.908) compared to controls (0.65). Additionally, zeta potential values were more negative for biofilm-exposed resins (mean = -84.2 mV) than controls (-45.0 mV). These findings underscore the substantial alterations in PMMA resin surface properties induced by bacterial biofilms, emphasizing the critical need for strategies to prevent biofilm formation and mitigate associated risks in healthcare settings. Future research should focus on developing anti-biofilm coatings or treatments to preserve the integrity and functionality of PMMA materials.

Numerical investigation of cavitation in periodontal Pockets: Insights for enhancing cleaning efficiency

Ultrasonic dental scalers are indispensable instruments for efficient dental cleaning through the generation of cavitation. To gain valuable insights and enhance the cavitation cleaning effects, a numerical investigation is conducted using the finite element method via ABAQUS. Numerical results are compared with the experimental cavitation image for a scaler undergoes vibrations near a wall. We then analyse how the amplitude, frequency, and cross-sectional shape of the scaler affect cavitation generation. Numerical results indicate that cavitation is more pronounced for a scaler oscillating near a nearly rigid boundary than a soft boundary. It increases with the vibration amplitude because of higher ultrasonic energy transferring to the liquid and generating stronger pressure waves. The resonant frequency of the scaler coincides with the maximum cavitation and scaler tip amplitude. Reducing the dimension of the cross-section of the scaler in its oscillation direction increases both the scaler tip amplitude and the cavitation generated. This finding offers a potential design approach for enhancing the scaler cavitation and its cleaning effects. These insights provide practical guidance for optimising dental scaler settings, which can improve oral hygiene and prevent complications related to dental implants.

The evolution of cavitation in narrow soft-solid wedge geometry mimicking periodontal and peri-implant pockets

In periodontology and implantology, laser-induced cavitation has not yet been used to treat biofilm-related problems. In this study we have checked how soft tissue affects the evolution of cavitation in a wedge model representing periodontal and peri-implant pocket geometry. One side of the wedge model was composed of PDMS mimicking soft periodontal or peri-implant biological tissue, the other side was composed of glass mimicking hard tooth root or implant surface, which allowed observations of the cavitation dynamics with an ultrafast camera. Different laser pulse modalities, PDMS stiffness, and irrigants were tested for their effect on the evolution of cavitation in the narrow wedge geometry. The PDMS stiffness varied in a range that corresponds to severely inflamed, moderately inflamed, or healthy gingival tissue as determined by a panel of dentists. The results imply that deformation of the soft boundary has a major effect on the Er:YAG laser-induced cavitation. The softer the boundary, the less effective the cavitation. We show that in a stiffer gingival tissues model, photoacoustic energy can be guided and focused at the tip of the wedge model, where it enables generation of secondary cavitation and more effective microstreaming. The secondary cavitation was absent in severely inflamed gingival model tissue, but could be induced with a dual-pulse AutoSWEEPS laser modality. This should in principle increase cleaning efficiency in the narrow geometries such as those found in the periodontal and peri-implant pockets and may lead to more predictable treatment outcomes.

Cavitation in a periodontal pocket by an ultrasonic dental scaler: A numerical investigation

Periodontal pockets are spaces or holes surrounded by teeth under the gum line. These pockets can become filled with infection-causing bacteria resulting in tissue, bone, and tooth loss. Cavitation produced by the oscillating tip of dental ultrasonic scalers plays a significant role in routine periodontal therapy to clean these areas. Numerical studies were conducted for a scaler vibrating in a periodontal pocket which was simplified to a hole, using ABAQUS based on the finite element method. The simulations consider the three-dimensional, nonlinear, and transient interaction between the vibration and deformation of the scaler tip, the water flow around the scaler and the cavitation formation. The numerical model was validated by comparing results with experimental data for a scaler vibrating in an unbounded liquid, the displacement at the free end of the scaler and the cavitation pattern near the scaler tip displaying excellent agreement. A parametric study for a scaler vibrating in a hole has been carried out in terms of the volume of the hole, the taper ratio (the radius ratio between the circular opening and bottom of the hole), and the immersion depth of the scaler tip in the hole. The amount of cavitation generated is evaluated by the cavitation density (or the void fraction) which is the ratio of the volume of the cavitation occupied in the hole to the total volume of the hole. Numerical results indicate that the cavitation density in the hole increases with the decreasing hole volume and the increasing taper ratio. It is inferred that cleaning effects could be increased if some modifications to the scaler design could be made to increase the blocking effect of the hole during the cleaning process. Cavitation is observed in the hole even if the scaler is placed above the hole and increases with the immersion depth.

Acoustic frequency combs using gas bubble cluster oscillations in liquids: a proof of concept

We propose a new approach to the generation of acoustic frequency combs (AFC)-signals with spectra containing equidistant coherent peaks. AFCs are essential for a number of sensing and measurement applications, where the established technology of optical frequency combs suffers from fundamental physical limitations. Our proof-of-principle experiments demonstrate that nonlinear oscillations of a gas bubble cluster in water insonated by a low-pressure single-frequency ultrasound wave produce signals with spectra consisting of equally spaced peaks originating from the interaction of the driving ultrasound wave with the response of the bubble cluster at its natural frequency. The so-generated AFC posses essential characteristics of optical frequency combs and thus, similar to their optical counterparts, can be used to measure various physical, chemical and biological quantities.