Effect of implant cleaning on titanium particle dissolution and cytocompatibility

Abstract

Background Peri‐implantitis treatments are mainly based on protocols for teeth but have not shown favorable outcomes for implants. The potential role of titanium dissolution products in peri‐implantitis necessitate the consideration of material properties in devising treatment protocols. We assessed implant cleaning interventions on (1) bacterial removal from Ti‐bound biofilms, (2) Ti surface alterations and related Ti particle dissolution, and (3) cytocompatibility. Methods Acid‐etched Ti discs were inoculated with human peri‐implant plaque biofilms and mechanical antimicrobial interventions were applied on the Ti‐bound biofilms for 30 seconds each: (1) rotary nylon brush; (2) Ti brush; (3) water‐jet on high and (4) low, and compared to sterile, untreated and Chlorhexidine‐treated controls. We assessed colony forming units (CFU) counts, biofilm removal, surface changes via scanning electron microscopy (SEM) and atomic force microscopy (AFM), and Ti dissolution via light microscopy and Inductively‐coupled Mass Spectrometry (ICP‐MS). Biological effects of Ti particles and surfaces changes were assessed using NIH/3T3 fibroblasts and MG‐63 osteoblastic cell lines, respectively. Results Sequencing revealed that the human biofilm model supported a diverse biofilm including known peri‐implant pathogens. WJ and Nylon brush were most effective in reducing CFU counts (P < 0.01 versus control), whereas Chlorhexidine was least effective; biofilm imaging results were confirmatory. Ti brushes led to visible streaks on the treated surfaces, reduced corrosion resistance and increased Ti dissolution over 30 days of material aging as compared to controls, which increase was amplified in the presence of bacteria (all P‐val < 0.05). Ti particles exerted cytotoxic effects against fibroblasts, whereas surfaces altered by Ti brushes exhibited reduced osteoconductivity versus controls (P < 0.05). Conclusions Present findings support that mechanical treatment strategies selected for implant biofilm removal may lead to Ti dissolution. Ti dissolution should become an important consideration in the clinical selection of peri‐implantitis treatments and a necessary criterion for the regulatory approval of instruments for implant hygiene.

Study on the immunopathological effect of titanium particles in peri‐implantitis granulation tissue: A case–control study

“…TPs seemingly represent a common finding in peri‐implant tissues that may originate from drilling, friction and instrumental manipulation during routine dental procedures (Kister et al, 2017; Kotsakis et al, 2020; Suárez‐López Del Amo et al, 2018). Moreover, a bacterially contaminated microenvironment and the use of corrosive antiseptics may facilitate the process of TPs detachment (Kotsakis et al, 2016; Mombelli et al, 2018).…”

Bio-Tribocorrosion of Titanium Dental Implants and Its Toxicological Implications: A Scoping Review

“…ere were 26 in-vitro studies [8-27, 29, 30, 32, 33, 35, 39], 3 ex-vivo studies [5,28,38], 3 observational in-vivo studies [31,34,36], 1 case-control study [37], and 1 case report [40]. Eighteen studies reported the factors responsible for biotribocorrosion [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], while 16 reported the toxic effects of the released metal ions [5,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. e review results are summarized as follows:…”

Análise físico-química da superfície de titânio após tratamento químico de descontaminação com clorexidina: estudo in vitro

“…Devido à característica da técnica de EDS, que é apenas de análise de elementos químicos, não é possível afirmar que foi gerada uma fase cristalina de óxido de titânio (TiO 2 ) após a aplicação do agente descontaminante. Estudos mostram que a ocorrência da formação de TiO 2 é importante, podendo inclusive influenciar na desestabilização molecular bacteriana 12,16 .…”

“…Os discos de titânio foram fixados, com o auxílio de anteparo plástico esterilizado, na tampa da placa. Fechando a placa com a tampa contendo os discos, estes ficaram submersos no inóculo e então foram incubados em condição de aerobiose a 37 °C por 24 horas 15,16 .…”