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Comparação in vitro entre quatro métodos de descontaminação em implantes contaminados com pseudomonas aeruginosa
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Abstract(s)
Introdução: Atualmente, os implantes dentários são o método de escolha para substituir os dentes perdidos. A saúde dos tecidos peri-implantares deve ser preservada para que os implantes sejam estáveis a longo prazo.
Objetivo: O objetivo deste estudo piloto in vitro foi comparar a eficácia entre o sistema de jato de eritritol (PerioFlow®), o protocolo de descontaminação eletrolítico (Galvosurge®) e dois modelos de escovas de titânio (R-Brush® e i-Brush®) na remoção de biofilmes de Pseudomonas aeruginosa de implantes, e verificar se estas metodologias alteram a superfície do implante.
Métodos: Implantes de titânio (N=40) com diferentes superfícies (Nano, SLA e SMA) foram contaminados com P. aeruginosa e depois submetidos a um dos seguintes procedimentos: descontaminação electrolítica (ED), descontaminação com jato de eritritol (JE), desbridamento mecânico com R-Brush® (RB), desbridamento com i-Brush® (IB) ou ausência de tratamento (grupo controlo). Após o tratamento, a descontaminação da superfície dos implantes foi examinada de forma qualitativa por microscopia eletrónica de varrimento (MEV) e de forma quantitativa por contagem de unidades formadoras de colónias (UFC/cm2).
Resultados: Obteve-se uma redução significativa no número de bactérias após todos os tipos de tratamento em comparação com os implantes não tratados. Contudo, nenhum dos métodos de descontaminação conseguiu remover todas as bactérias dos implantes. Por outro lado, foi possível observar uma alteração notória da superfície dos implantes tratados com i-Brush® e R-Brush®.
Conclusão: Os métodos de descontaminação analisados neste estudo removeram um número significativo de bactérias dos implantes, mas nenhum alcançou a sua total descontaminação. Os resultados sugerem que o sistema JE é o melhor método de descontaminação bacteriana de implantes. A descontaminação com escovas de titânio altera a estrutura superficial dos implantes.
Introduction: Nowadays, dental implants are the method of choice for replacing lost teeth. The health of the peri-implant tissues must be preserved for implants to be stable in the long term. Objectives: The aim of this pilot in vitro study was to compare the effectiveness between the erythritol jet system (PerioFlow®), the electrolytic decontamination protocol (Galvosurge®) and two titanium brush designs (R-Brush® and i-Brush®) in removing Pseudomonas aeruginosa biofilms from implants, and to verify whether these methodologies alter the implant surface. Methods: Titanium implants (N=40) with different surfaces (Nano, SLA and SMA) were contaminated with P. aeruginosa and then subjected to one of the following procedures: electrolytic decontamination (ED), erythritol jet decontamination (EJ), mechanical debridement with R-Brush® (RB), debridement with i-Brush® (IB) or no treatment (control group). After treatment, decontamination of the implant surface was examined qualitatively by scanning electron microscopy (SEM) and quantitatively by counting colony forming units (CFU/cm2). Results: A significant reduction in the number of bacteria was obtained after all types of treatment compared to untreated implants. However, none of the decontamination methods was able to remove all bacteria from the implants. On the other hand, a noticeable change of the surface of implants treated with i-Brush® and R-Brush® could be observed. Conclusion: The decontamination methods reviewed in this study removed a significant number of bacteria from implants, but none has achieved complete decontamination. The results suggest that the EJ system is the best method for bacterial decontamination of implants. Decontamination with titanium brushes alters the surface structure of implants.
Introduction: Nowadays, dental implants are the method of choice for replacing lost teeth. The health of the peri-implant tissues must be preserved for implants to be stable in the long term. Objectives: The aim of this pilot in vitro study was to compare the effectiveness between the erythritol jet system (PerioFlow®), the electrolytic decontamination protocol (Galvosurge®) and two titanium brush designs (R-Brush® and i-Brush®) in removing Pseudomonas aeruginosa biofilms from implants, and to verify whether these methodologies alter the implant surface. Methods: Titanium implants (N=40) with different surfaces (Nano, SLA and SMA) were contaminated with P. aeruginosa and then subjected to one of the following procedures: electrolytic decontamination (ED), erythritol jet decontamination (EJ), mechanical debridement with R-Brush® (RB), debridement with i-Brush® (IB) or no treatment (control group). After treatment, decontamination of the implant surface was examined qualitatively by scanning electron microscopy (SEM) and quantitatively by counting colony forming units (CFU/cm2). Results: A significant reduction in the number of bacteria was obtained after all types of treatment compared to untreated implants. However, none of the decontamination methods was able to remove all bacteria from the implants. On the other hand, a noticeable change of the surface of implants treated with i-Brush® and R-Brush® could be observed. Conclusion: The decontamination methods reviewed in this study removed a significant number of bacteria from implants, but none has achieved complete decontamination. The results suggest that the EJ system is the best method for bacterial decontamination of implants. Decontamination with titanium brushes alters the surface structure of implants.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Peri-implantite Implantes Sistemas de descontaminação mecânica Pseudomonas aeruginosa