title: Effect of cleansing of biofilm formed on titanium discs.
abstract: OBJECTIVE
  To study the combined effect of mechanical and chemical cleansing on a 4-day biofilm grown intra-orally on titanium discs with different surface characteristics.
  
  
  METHODS
  Twenty subjects used a splint with two metal plates in the upper jaw. Each plate was placed in the premolar-molar region and carried four titanium discs with four different surface characteristics (OsseoSpeed(™), TiOblast(™), experimental and turned surface). After 4 days of biofilm growth, the discs were cleaned mechanically and chemically with saline or chlorhexidine. Following cleansing, microbial samples were obtained and analysed by culture. The titanium discs were processed for scanning electron microscope (SEM) analysis. The experiment was repeated 3 days later using delmopinol or a mixture of essential oils during cleansing.
  
  
  RESULTS
  The combination of mechanical and chemical cleansing was ineffective in complete biofilm removal from all four titanium discs. The microbiological analysis did not reveal any statistically significant differences between surface types or between cleaning agents regarding logarithmic mean counts of CFU for specific bacteria, aerobes, anaerobes or the TVC. Aerobes were more numerous than anaerobes on all surface types. The SEM analysis disclosed that the remaining biofilm on moderately rough surfaces (OsseoSpeed(™), TiOblast(™) and experimental) was complex and firmly attached, while the biofilm on turned surface had a pattern of spread bacteria forming less clusters.
  
  
  CONCLUSIONS
  Cleansing may call for prolonged time of chemomechanical debridement and/or more effective disinfectants to suppress biofilms on dental implant surfaces.
authors.affiliation: Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Georgios
authors.initials: G
authors.lastname: Charalampakis
authors.affiliation: Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Ramberg
authors.affiliation: Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Dahlén
authors.affiliation: Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Tord
authors.initials: T
authors.lastname: Berglundh
authors.affiliation: Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Abrahamsson
mesh_terms: D000328:Adult; D018441:Biofilms / Q000254:growth & development*; D015169:Colony Count, Microbial; D018592:Cross-Over Studies; D003666:Decontamination / Q000379:methods*; D015921:Dental Implants / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D016037:Single-Blind Method; D013499:Surface Properties; D014025:Titanium
chemical_list: D015921:Dental Implants; D014025:Titanium
keywords: biofilm; culture; disinfectant; implant surface; in vivo experiment; titanium discs