Effect of Surface Tooling Techniques of Medical Titanium Implants on Bacterial Biofilm Formation In Vitro

Abstract

The aim of this study was to assess the biofilm formation of Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Escherichia coli on titanium implants with CAD-CAM tooling techniques. Twenty specimens of titanium were studied: Titanium grade 2 tooled with a Planmeca CAD-CAM milling device (TiGrade 2), Ti6Al4V grade 5 as it comes from CAD-DMLS device (computer aided design-direct metal laser sintering device) (TiGrade 5), Ti6Al4V grade 23 as it comes from a CAD-CAM milling device (TiGrade 23), and CAD-DMLS TiGrade 5 polished with an abrasive disc (TiGrade 5 polished). Bacterial adhesion on the implants was completed with and without saliva treatment to mimic both extraoral and intraoral surgical methods of implant placement. Five specimens/implant types were used in the bacterial adhesion experiments. Autoclaved implant specimens were placed in petri plates and immersed in saliva solution for 30 min at room temperature and then washed 3×with 1 ×PBS. Bacterial suspensions of each strain were made and added to the specimens after saliva treatment. Biofilm was allowed to form for 24 h at 37 °C and the adhered bacteria was calculated. Tooling techniques had an insignificant effect on the bacterial adhesion by all the bacterial strains studied. However, there was a significant difference in biofilm formation between the saliva-treated and non-saliva-treated implants. Saliva contamination enhanced S. mutans, S. aureus, and E. faecalis adhesion in all material types studied. S. aureus was found to be the most adherent strain in the saliva-treated group, whereas E. coli was the most adherent strain in the non-saliva-treated group. In conclusion, CAD-CAM tooling techniques have little effect on bacterial adhesion. Saliva coating enhances the biofilm formation; therefore, saliva contamination of the implant must be minimized during implant placement. Further extensive studies are needed to evaluate the effects of surface treatments of the titanium implant on soft tissue response and to prevent the factors causing implant infection and failure.

High Adherence of Oral Streptococcus to Polylactic Acid Might Explain Implant Infections Associated with PLA Mesh Implantation

“…This study finds that the biofilm formation of S. mutans favors PLA over titanium, whereas S. aureus binds more strongly to titanium. Another major result was that salivary coating increased biofilm formation on both implant materials tested by all four bacterial strains in a statistically significant manner, which is in accordance with our previous studies [15,16]. Another study has also reported high bacterial adherence to implant material with saliva contamination [17], which might be because the presence of salivary pellicles on the implant surface reduces the chemical charge and make it more hydrophilic to favor the attachment of bacteria.…”

Comparison of Titanium and PEEK Medical Plastic Implant Materials for Their Bacterial Biofilm Formation Properties

“…All implants were manufactured as 20 mm discs, sterilized, and destained in a similar way as normally provided for the needs of the patients. The implant types studied were PEEK, titanium grade 2, and titanium grade 5 [14].…”

Global Trends in Orthopedic Biofilm Research: A Bibliometric Analysis of 1994-2022

“…Nevertheless, studies have shown that the surface structure of commonly used titanium implant materials is relatively rough, which promotes the formation of biofilm. 38–40 As a result, research has been conducted on modifying the properties of implant materials by optimizing wettability, topography, and pattern size to prevent biofilm formation. 41 Several studies have utilized nanoimprint lithography as a patterning technique to create hierarchically patterned samples.…”