title: Effect of chemical and mechanical debridement techniques on bacterial re-growth on rough titanium surfaces: an in vitro study.
abstract: OBJECTIVE
  The aim of this in vitro study was to compare the effect of combined chemical and mechanical debridement of titanium (Ti) surfaces inoculated with Staphylococcus epidermidis, compared with the effect of chemical debridement alone.
  
  
  METHODS
  Different Ti surfaces were characterized with respect to roughness and subsequently inoculated with S. epidermidis. NaCl (0.9 vol.%), EDTA (12 vol.%), H₂O₂ (3 vol.%) or H₂O₂ + TiO₂ nanoparticles served as chemical debridement agents, while TiBrush was used as the mechanical debridement tool. Safranin staining assessed biomass still attached to surfaces after debridement. Biofilm viability was assessed after re-incubation of the debrided samples. SEM analysis was performed before and after the cleaning process.
  
  
  RESULTS
  Surface average roughness (Sa ) of the samples was measured at 2.22 ± 0.19 μm for group A, 0.19 ± 0.02 μm for group B, and 1.99 ± 0.10 μm for group C. When chemical debridement agents were used alone, H₂O₂-containing products were most efficient in reducing the biomass load. The surface roughness did not affect the outcome of chemical debridement. However, when combining chemical and mechanical debridement, a further reduction of biofilm load and viability was observed with best effect on the smoothest surface.
  
  
  CONCLUSIONS
  Combining H₂O₂-containing chemical agents with mechanical debridement (TiBrush) provided best reduction in biofilm mass and re-growth, when studied in vitro.
authors.affiliation: Department for Prosthodontics, Institute for Clinical Dentistry, University of Oslo, Oslo, Norway.
authors.forename: Eva
authors.initials: E
authors.lastname: Gustumhaugen
authors.forename: Jessica
authors.initials: J
authors.lastname: Lönn-Stensrud
authors.forename: Anne A
authors.initials: AA
authors.lastname: Scheie
authors.forename: S P
authors.initials: SP
authors.lastname: Lyngstadaas
authors.forename: Anders
authors.initials: A
authors.lastname: Ekfeldt
authors.forename: Sébastien
authors.initials: S
authors.lastname: Taxt-Lamolle
mesh_terms: D018441:Biofilms; D003646:Debridement / Q000379:methods*; D004492:Edetic Acid / Q000494:pharmacology; D006861:Hydrogen Peroxide / Q000494:pharmacology; D066298:In Vitro Techniques; D053758:Nanoparticles; D012965:Sodium Chloride / Q000494:pharmacology; D013212:Staphylococcus epidermidis / Q000254:growth & development*; D013499:Surface Properties; D014025:Titanium / Q000494:pharmacology
chemical_list: C009495:titanium dioxide; D012965:Sodium Chloride; D004492:Edetic Acid; D006861:Hydrogen Peroxide; D014025:Titanium
keywords: biofilm; debridement; rough implant surfaces