Removal of Dental Biofilms with an Ultrasonically Activated Water Stream

Abstract

Acidogenic bacteria within dental plaque biofilms are the causative agents of caries. Consequently, maintenance of a healthy oral environment with efficient biofilm removal strategies is important to limit caries, as well as halt progression to gingivitis and periodontitis. Recently, a novel cleaning device has been described using an ultrasonically activated stream (UAS) to generate a cavitation cloud of bubbles in a freely flowing water stream that has demonstrated the capacity to be effective at biofilm removal. In this study, UAS was evaluated for its ability to remove biofilms of the cariogenic pathogen Streptococcus mutans UA159, as well as Actinomyces naeslundii ATCC 12104 and Streptococcus oralis ATCC 9811, grown on machine-etched glass slides to generate a reproducible complex surface and artificial teeth from a typodont training model. Biofilm removal was assessed both visually and microscopically using high-speed videography, confocal scanning laser microscopy (CSLM), and scanning electron microscopy (SEM). Analysis by CSLM demonstrated a statistically significant 99.9% removal of S. mutans biofilms exposed to the UAS for 10 s, relative to both untreated control biofilms and biofilms exposed to the water stream alone without ultrasonic activation (P < 0.05). The water stream alone showed no statistically significant difference in removal compared with the untreated control (P = 0.24). High-speed videography demonstrated a rapid rate (151 mm(2) in 1 s) of biofilm removal. The UAS was also highly effective at S. mutans, A. naeslundii, and S. oralis biofilm removal from machine-etched glass and S. mutans from typodont surfaces with complex topography. Consequently, UAS technology represents a potentially effective method for biofilm removal and improved oral hygiene.

In vitro evaluation of the effects of Ultrasound Tongue Scraper on bacteria and biofilm formation

“…16 A similar study demonstrated significant decrease in level of Escherichia coli in biofilms formed around medical implants by using gentamicin (72 hours) and ultrasound (48 hours) together. 24 Howlin et al 25 used an ultrasonically activated water stream to remove Streptococcus mutans biofilm and the results revealed that it was very effective as compared with regular water stream alone. However, to date, there is no report on the use of UTS for inhibition of red complex bacteria biofilm, except the present study.…”

Effects of Ultrasonic Debridement on Oral Hygiene Status

“…Therefore, it should be performed with ultrasonic instruments, utilising the effects of cavitation 6,13) . This has been shown to be effective in removing biofilms and improving oral hygiene status 8) . …”

The acoustic bubble: Oceanic bubble acoustics and ultrasonic cleaning

“…This UAS method has already demonstrated its efficacy in removing dental bacterial biofilms, and cleaning bone, skin models, and removing brain tissue from surgical steel [46][47][48]. Here a range of other applications are shown.…”