Verwijdering van biofilm op titaniumoppervlakken

NTvT 29 november 2011


De kolonisatie van bacteriƫn op de abutments van implantaten verschilt niet van de bacteriesamenstelling op natuurlijke gebitselementen. Accumulatie van plaque met paropathogenen kan echter wel periimplantaire mucositis veroorzaken, met een vergrote kans op uiteindelijk verlies van het implantaat.
In een in vitro-onderzoek bleek citroenzuur het meest effectief voor reiniging van besmette titatiumoppervlakken.

Abstract
Objective: To assess the effectiveness of different chemotherapeutic agents on biofilm-contaminated titanium surfaces.
Material and Methods: This study used a recently described biofilm model. In experiment 1, Streptococcus mutans biofilms grown on titanium discs were treated with (1) EDTA, (2) citric acid (CA), (3) cetylpyridium chloride, (4) Ardox-X, (5) hydrogen peroxide (H2O2), (6) chlorhexidine (CHX) and (7) water. In experiment 2, polymicrobial biofilms were treated with (1) CA, (2) Ardox-X, (3) H2O2, (4) Ardox-X followed by CA, (5) H2O2 followed by CA, (6) CHX and (7) water. Aliquots of the suspendedbiofilms were plated and incubated anaerobically to enable counts of the total remaining viable bacteria, which were expressed as CFUs. Following incubation, the amount of protein remaining in the treated Streptococcus mutans biofilms was quantified to assess the removal potency of each treatment agent.
Results: H2O2, Ardox-X and CA killed significantly more Streptococcus mutans compared with the other treatments. H2O2 and CA removed significantly more protein than water. CA and the combination treatments were significantly more effective against the polymicrobial biofilms than CHX, H2O2 and Ardox-X. The difference in the killing efficacy between CA alone and the combination treatments was not statistically significant.
Conclusion: Among the chemicals tested, CA demonstrated the greatest decontamination capacity with respect to both the killing and the removal of biofilm cells. This combination of effects is clinically desirable because it promotes biocompatibility and healing around a previously contaminated implant surface.

Bron
Ntrouka V, Hoogenkamp M, Zaura E, Weijden F van der. The effect of chemotherapeutic agents on titanium-adherent biofilms. Clin Oral Impl Res 22; 2011: 1227-1234. doi: 10.1111/j.1600-0501.2010.02085.x.

Klinische relevantie
Binnen de beperkingen van dit in vitro-onderzoek bleek citroenzuur het best in staat micro-organismen te doden en cellen van de biofilm te verwijderen van titanium implantaatoppervlakken. Onder voorwaarde dat in vivo-onderzoeken deze goede eigenschappen bevestigen, is citroenzuur in potentie geschikt voor professionele reiniging van blootliggende titanium implantaatoppervlakken.

Verwijdering van biofilm op titaniumoppervlakken

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