Soft tissue integration versus early biofilm formation on different dental implant materials

Bingran Zhao, Henderina van der Mei, Guruprakash Subbiahdoss, Joop de Vries, Minie Rustema-Abbing, Roel Kuijer, Henk J. Busscher, Yijin Qu-Ren

Research output: Contribution to journalArticleAcademicpeer-review

105 Citations (Scopus)

Abstract

OBJECTIVE: Dental implants anchor in bone through a tight fit and osseo-integratable properties of the implant surfaces, while a protective soft tissue seal around the implants neck is needed to prevent bacterial destruction of the bone-implant interface. This tissue seal needs to form in the unsterile, oral environment. We aim to identify surface properties of dental implant materials (titanium, titanium-zirconium alloy and zirconium-oxides) that determine the outcome of this "race-for-the-surface" between human-gingival-fibroblasts and different supra-gingival bacterial strains.

METHODS: Biofilms of three streptococcal species or a Staphylococcus aureus strain were grown in mono-cultures on the different implant materials in a parallel-plate-flow-chamber and their biovolume evaluated using confocal-scanning-laser-microscopy. Similarly, adhesion, spreading and growth of human-gingival-fibroblasts were evaluated. Co-culture experiments with bacteria and human-gingival-fibroblasts were carried out to evaluate tissue interaction with bacterially contaminated implant surfaces. Implant surfaces were characterized by their hydrophobicity, roughness and elemental composition.

RESULTS: Biofilm formation occurred on all implant materials, and neither roughness nor hydrophobicity had a decisive influence on biofilm formation. Zirconium-oxide attracted most biofilm. All implant materials were covered by human-gingival-fibroblasts for 80-90% of their surface areas. Human-gingival-fibroblasts lost the race-for-the-surface against all bacterial strains on nearly all implant materials, except on the smoothest titanium variants.

SIGNIFICANCE: Smooth titanium implant surfaces provide the best opportunities for a soft tissue seal to form on bacterially contaminated implant surfaces. This conclusion could only be reached in co-culture studies and coincides with the results from the few clinical studies carried out to this end.

Original languageEnglish
Pages (from-to)716-727
Number of pages12
JournalDENTAL MATERIALS
Volume30
Issue number7
DOIs
Publication statusPublished - Jul-2014

Keywords

  • Titanium-zirconium alloy
  • Zirconia
  • Osseo-integratable
  • Surface roughness
  • Supra-gingival bacteria
  • IN-VIVO
  • SURFACE-ROUGHNESS
  • TITANIUM SURFACES
  • PLAQUE-FORMATION
  • ADHESION
  • CELLS
  • COLONIZATION
  • BIOMATERIALS
  • FIBROBLASTS
  • TOPOGRAPHY

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