Smile Specialists Suite, Newcastle, NSW, Australia.
Formerly, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
Clin Oral Investig. 2021 Dec;25(12):6633-6642. doi: 10.1007/s00784-021-03949-x. Epub 2021 Apr 24.
Treatment of implants with peri-implantitis is often unsuccessful due to residual microbial biofilm hindering re-osseointegration. The aim of this study was to treat biofilm-grown titanium (Ti) implants with different modalities involving air abrasion (AA) and cold atmospheric plasma (CAP) to compare the effectiveness in surface decontamination and the alteration/preservation of surface topography.
Saliva collected from a peri-implantitis patient was used to in vitro develop human biofilm over 35 implants with moderately rough surface. The implants were then mounted onto standardized acrylic blocks simulating peri-implantitis defects and treated with AA (erythritol powder), CAP in a liquid medium, or a combination (COM) of both modalities. The remaining biofilm was measured by crystal violet (CV). Surface features and roughness before and after treatment were assessed by scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis followed by Tukey's multiple comparison test.
In the present peri-implantitis model, the human complex biofilm growth was successful as indicated by the statistical significance between the negative and positive controls. All the treatment groups resulted in a remarkable implant surface decontamination, with values very close to the negative control for AA and COM. Indeed, statistically significant differences in the comparison between the positive control vs. all the treatment groups were found. SEM analysis showed no post-treatment alterations on the implant surface in all the groups.
Decontamination with AA delivering erythritol with or without CAP in liquid medium demonstrated compelling efficacy in the removal of biofilm from implants. All the tested treatments did not cause qualitative alterations to the Ti surface features. No specific effects of the CAP were observed, although further studies are necessary to assess its potential as monotherapy with different settings or in combination with other decontamination procedures.
CAP is a promising option in the treatment of peri-implantitis because it has potential to improve the elimination of bacterial plaque from implant surfaces, in inaccessible pockets or during open-flap debridement, and should stimulate the process of the re-osseointegration of affected dental implants by not altering surface features and roughness.
由于残留微生物生物膜阻碍再骨整合，种植体周围炎的治疗往往不成功。本研究的目的是用不同的模式（包括喷砂和冷等离体等离子体）治疗生物膜生长的钛（Ti）种植体，以比较表面去污的效果以及表面形貌的改变/保持。
从一名种植体周围炎患者的唾液中提取，在具有中度粗糙表面的 35 个种植体上体外培养人生物膜。然后将这些种植体安装在标准化的丙烯酸块上，模拟种植体周围炎缺损，并分别用喷砂（赤藓糖醇粉末）、液体介质中的冷等离体等离子体或两者联合（COM）进行处理。用结晶紫（CV）测量剩余的生物膜。用扫描电子显微镜（SEM）评估处理前后的表面特征和粗糙度。使用 Kruskal-Wallis 检验 followed by Tukey 的多重比较检验对数据进行统计学分析。
在本种植体周围炎模型中，成功地实现了人复杂生物膜的生长，这表明阴性和阳性对照之间存在统计学意义。所有治疗组均使种植体表面得到了显著的去污，与阴性对照相比，AA 和 COM 的数值非常接近。事实上，在阳性对照与所有治疗组之间的比较中，发现了统计学上的显著差异。SEM 分析显示，所有组的种植体表面在处理后均无改变。
用 AA 输送赤藓糖醇，或用液体介质中的 CAP 进行的去污处理在去除种植体上的生物膜方面显示出了强大的功效。所有测试的处理方法都没有对 Ti 表面特性造成定性改变。虽然需要进一步的研究来评估其作为单一疗法的潜力以及与其他去污程序联合应用的潜力，但未观察到 CAP 的特定作用。
CAP 是治疗种植体周围炎的一种有前途的选择，因为它有可能改善种植体表面细菌菌斑的消除，在难以到达的口袋或开放式翻瓣清创术中，并且不改变表面特性和粗糙度，应刺激受影响的种植体再骨整合的过程。
