Bacterial colonisation of interior implant threads with and without sealing
2006
Premature loss of dental implants is due, apart from mechanical factors, to germrelated
inflammation. Gaps and hollow spaces within the implant system, for
example the gap between implant and abutment in the two-part implant system,
may provide a bacterial reservoir causing or maintaining inflammation. The
bacterial spectrum involved is similar to that found in periodontitis.
This in vitro study aimed to scrutinise the capability of Porphyromonas gingivalis
(DSM 20709), the bacterium blamed for inducing peri-implantitis, to pass the
implant/abutment gap in titanium implant systems used for orthodontic anchorage
and to remain vital in the interior. Additionally, the in vitro effectiveness of
gutta percha for gap sealing was examined. Twelve titanium implants (Straumann
®, diameter: 3.3 mm, length 5.5 mm) were provided with abutments at
a defined torque (20 Ncm), six of which were sealed with gutta percha before
screwing in the abutment. Subsequently the implants were placed in a nutrient
solution (thioglycolate boullion with haemin-menadione solution) that contained
Porphyromonas gingivalis . Microbiological specimens were sampled from the
implant interiors after 24 and 72 hours and analysed using culture methods.
There was evidence that penetration of the periodontal pathogen Porphyromonas
gingivalis to the implant interior may occur as early as after 24 hours. Microbes
were also detected in the interior of implants sealed with gutta percha.
The abutment/implant interface in vitro provides a microbiological leakage for
the prospective peri-implantitis-inducing bacterium Porphyromonas gingivalis .
Survival of the bacterium is possible in the interior, so that development of
a bacterial reservoir is assumed. This in vitro trial produced no evidence that
sealing with gutta percha is an effective means to prevent secondary bacterial
colonisation in the implant interior.
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