新型高强度聚焦超声清创钛质牙种植体附着的变形链球菌生物膜

Novel High Intensity Focused Ultrasound in Debriding Ti Dental Implant-Attached Streptococcus mutans Biofilms.

作者信息

Tran Minh Dien, Hubbard Alysia, Rinaldi Catherine A, Ngo Hien, Rajan Sheetal Maria, Fawzy Amr

机构信息

Biomaterials and Dental Technology Research Team, UWA Dental School, the University of Western Australia, WA, Australia.

Centre for Microscopy, Characterisation and Analysis, the University of Western Australia, WA, Australia.

出版信息

Int Dent J. 2025 Sep 18;75(6):103905. doi: 10.1016/j.identj.2025.103905.

DOI:10.1016/j.identj.2025.103905

PMID:40972477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12477924/

Abstract

INTRODUCTION AND AIMS

Effective management of PI depends on removing the colonised microbial biofilms to preserve osseointegration, yet thorough debridement remains difficult. HIFU offers a novel, non-invasive approach that uses contact-free acoustic energy while minimising aerosol and debris. This in vitro study evaluates the effectiveness of HIFU in removing Streptococcus mutans biofilms from titanium implants. Biofilm reduction was visualised via DCLSM and quantified using FCM.

METHODS

Two Ti dental implants were characterised via SEM. S. mutans biofilms were grown over 10 days on the coronal 5mm section of another 18 implants. Implants in the test group (n = 6) were treated with optimised HIFU through a glass beaker in water-based medium for 2 minutes. Residual biofilms were stained and visualised under DCLSM at 4×, 10×, and 20× magnifications and quantified using FCM for live/dead bacterial images and counts. The data from the test and the control samples (untreated and Airflow® treated) were subjected to ANOVA followed by post-hoc Tukey's test to determine the statistical differences between the groups.

RESULTS

DCLSM Z-stacks using a 10× objective and 512-pixel resolution yielded the optimal balance between image clarity and field coverage. HIFU-treated implants showed scattered bacterial clusters with surrounding biofilm-free zones, while Airflow®-treated samples retained a thin, continuous biofilm primarily along thread walls and root junctions. Both Airflow® and HIFU significantly reduced total bacterial loads compared to untreated controls (p < .05). (Airflow: 40,021 ± 17,253; HIFU: 254,000 ± 124,000; control: 731,000 ± 211,000).

CONCLUSION AND CLINICAL RELEVANCE

HIFU acoustic waves were uniquely able to penetrate a solid (glass) barrier and create localised biofilm-free regions. HIFU shows potential as a physical method for biofilm disruption; however, further studies - including multispecies, in vivo, and pre-clinical models - are required to evaluate its clinical applicability.

摘要

引言与目的

种植体周围炎的有效管理依赖于清除定植的微生物生物膜以维持骨整合，但彻底清创仍然困难。高强度聚焦超声（HIFU）提供了一种新颖的非侵入性方法，它使用非接触式声能，同时将气溶胶和碎屑降至最低。这项体外研究评估了HIFU从钛种植体上去除变形链球菌生物膜的有效性。通过双光子激光扫描显微镜（DCLSM）观察生物膜减少情况，并使用流式细胞仪（FCM）进行定量分析。

方法

通过扫描电子显微镜（SEM）对两个钛牙科种植体进行表征。在另外18个种植体的冠状面5mm部分上培养变形链球菌生物膜10天。测试组（n = 6）的种植体在水基介质中通过玻璃烧杯用优化的HIFU处理2分钟。对残留生物膜进行染色，并在DCLSM下以4倍、10倍和20倍放大倍数观察，使用FCM对活/死细菌图像和计数进行定量分析。将测试样品和对照样品（未处理和经Airflow®处理）的数据进行方差分析（ANOVA），然后进行事后Tukey检验，以确定组间的统计学差异。

结果

使用10倍物镜和512像素分辨率的DCLSM Z轴堆叠在图像清晰度和视野覆盖范围之间实现了最佳平衡。经HIFU处理的种植体显示出分散的细菌簇，周围有无生物膜区域，而经Airflow®处理的样品主要沿螺纹壁和牙根交界处保留了一层薄而连续的生物膜。与未处理的对照组相比，Airflow®和HIFU均显著降低了总细菌载量（p < 0.05）。（Airflow：40,021 ± 17,253；HIFU：254,000 ± 124,000；对照组：731,000 ± 211,000）。