Osteostimulative calcium phosphosilicate biomaterials partially restore the cytocompatibility of decontaminated titanium surfaces in a peri‐implantitis model

Abstract

Bacterial peri-implant biofilms, and the chemotherapeutics for their removal alter titanium surface cytocompatibility. In this study we aimed to assess the adjunctive use of an osteostimulative biomaterial utilizing a peri-implantitis model under the hypothesis that it will increase cell migration towards treated titanium surfaces. Acid-etched titanium surfaces were inoculated with a multi-species biofilm model and treated with 1.5% NaOCl in a previously characterized in vitro peri-implantitis model. Cell migration of MG63 cells towards the treated titanium surface (CTRL) was significantly reduced following inoculation with biofilm and chemotherapeutic treatment as compared to sterile controls. Addition of a tricalcium phosphate biomaterial (TCP) as a control for Ca had a small non-significant effect, while BG significantly increased MG63 chemotaxis to titanium to levels comparable to sterile (STE). Similarly, cell viability at 5 days was increased in BG and TCP as compared to CTRL. SEM imaging confirmed the improved cytocompatibility of BG and TCP surfaces as compared to CTRL. Osteostimulative BG exhibited a strong chemotactic effect to osteoblasts, which was stronger than what was expected due to the chemotactic effect of Ca alone (TCP). In addition, substantially increased cell attachment and viability was found on treated implant surfaces as compared to CTRL. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2645-2652, 2018.

Effect of implant cleaning on titanium particle dissolution and cytocompatibility

“…To test our hypotheses while ascertaining a high translational potential we used a clinically relevant peri‐implantitis model, which employs acid‐etched microrough Ti grade V surfaces as substrates and multi species human plaque biofilms, as previously described 8,10 . In the present investigation we further improved retention from clinical samples using SHI medium for biofilm growth, which combines the ingredients of several selected media that can support different subpopulations from direct clinical oral samples to better sustain the original oral microbial diversity 25 .…”

“…However, the application of antimicrobial agents on implants may have adverse effects on physicochemical characteristics of the decontaminated surfaces 8 . Chemotherapeutic agents that are clinically employed to reduce peri‐implant bacterial burden are adsorbed by Ti surfaces and, as in the case of chlorhexidine (CHX), may adversely compromise cellular re‐attachment to the implant surface 5,8‐10 . Less is known regarding mechanical cleaning aids and instruments used for peri‐implant plaque biofilm removal in the context of prevention, or peri‐implantitis therapy.…”

The effect of different surface topographies of titanium implants on bacterial biofilm: a systematic review

“…For example, one study focused on Avantblast ® , a thermal treatment surface that combines an increment in the surface roughness by chemical etching with an increased thickness and crystallinity of the titanium oxide layer [50]. A different study focused on anti-bacterial bioactive glass, which is composed of silica (SiO 2 ), calcium (Ca), sodium (Na), and phosphorus (P) [30]. This forms a silica-rich hydroxyl carbonated apatite that resembles hydroxyapatite of a bone when in contact with biological fluids [30].…”

“…A different study focused on anti-bacterial bioactive glass, which is composed of silica (SiO 2 ), calcium (Ca), sodium (Na), and phosphorus (P) [30]. This forms a silica-rich hydroxyl carbonated apatite that resembles hydroxyapatite of a bone when in contact with biological fluids [30]. In another investigation, titanium oxide (TiO 2 ) as a coating of the titanium, was also able to produce a surface with grain size textures to allow improved osseointegration [55].…”

Hydroxyl radicals generated by hydrogen peroxide photolysis recondition biofilm-contaminated titanium surfaces for subsequent osteoblastic cell proliferation

“…Contaminants such as hydrocarbons left on titanium surfaces may reduce osteoblast attachment to the surface because proteins associated with cell adhesion cannot attach to such sites 16 , 17 . Moreover, some antiseptics alter the physical and/or chemical properties of titanium surfaces, resulting in less favourable conditions for osteoblast proliferation and re-osseointegration 15 , 18 , 19 . A systematic review suggested that data on the efficacy of chemotherapeutic agents on biofilm-contaminated titanium are scarce and that a definitive conclusion is unattainable 20 .…”