Biofilms in Implantology ( Posted by Komagal )

Biofilms are fascinating structures and may be found virtually anywhere. Biofilm consist of one or more communities of microorganisms, embedded in a glycocalyx, that are attached to a solid surface. The function of biofilms depend on the ability of bacteria and microcolonies within the biofilm to communicate with one another( Quarun sensing) The oral environment is unique because it is the only area of the body where biomaterials are routinely placed for long-term use in nonsterile environment. Colonization or oral biomaterials by various microorganism is inevitable.

Dental implants are root analogues that are surgically placed into the jaw bone and used to support crowns, bridges and dentures. The use of dental implant is now widespread. The excellent biocompatibility of implant material results mainly from it’s surface characteristics. Surface roughness and modifications, surface free energy, chemical composition of surface, implant abutment fit are vital properties of surface characteristics of implant prosthesis that creates an impact on the biofilm formation on implant biomaterial.

Periimplantitis is an inflammatory process affecting the tissues around an osseointegrated implant, resulting in the loss of supporting bone leading to implant failure. The factors associated with peri-implantitis appear to be related to the composition of the bacterial environment around an implant and the ability of bacteria to adhere to implant material.

Hence the importance of biofilm in implant prosthetics is a field to facilitate the development of new biologically based rational for treatment modalities in dentistry.

the possible conclusion of this topic.....

CONCLUSION

Osseointegrated dental implant play an important role in field of dentistry. Biofilm formation may cause inflammatory reactions around the implant (peri-implantitis) leading to implant failure. Hence it is very important to develop implant surfaces (around transmucosal portion) that reduce the number of initially adhering bacteria, which minimizes biofilm formation and subsequent inflammation of the soft tissues.
Implant material surface characteristic play a vital role in effecting the biofilm formation and maturation.

Micro roughness has been suggested to be appropriate for dental implants. (Bollen et al 1997)Because surfaces below Ra 0.2 μm doesn’t promote bacterial adherence due to larger size of most micro organisms. Vise-versa surface roughness above 150 nm didn’t enhance adherence of microorganisms. Hence importantly commercially available Branemark-type dental implants display a range of surface roughness(350-2500nm) to reduce bacterial adhesion. Materials with surface energy of 20-30 dynes cm exhibit minimal biologic adhesiveness, where as higher surface energy support bioadhersion. Hence, smooth surface with low surface energy is demanded to minimize biofilm formation. Modifications are also made chemically changing the surface to increase the antimicrobial capacity of titanium. Bacterial leakage influenced by implant-abutment fit results in an inflammatory cell infiltration(called abutment ICT) in periimplant mucosa at borderline between abutment and implant.

Future of prosthodontics research will be in development of scientific methods to evaluate both biomaterials and treatment designs based on desired biological outcomes. Physical and chemical composition are not end points but begins in the evaluvation of biocompatible material. Future understanding of pellicle formation as a function of surface composition, microbial adhesion to biomaterials, and cell reaction to implant biomaterials is not only necessary but essential.