Abdulkareem, EH; (2013) Development of an in vitro model of peri-implantitis. Doctoral thesis (PhD), UCL (University College London).

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Abstract

Introduction Peri-implantitis is a bacterially induced inflammatory reaction surrounding dental implants leading to loss of supporting bone. Microbial biofilm development seems to play an important role in altering the biocompatibility of the implant surface leading to loss of the implant. Aims The aim of this study was to develop an in vitro model of peri-implantitis. Material and Methods Microcosm biofilms were grown on titanium discs in a constant depth film fermentor (CDFF). Artificial saliva and peri-implant sulcular fluid (PISF) were delivered to simulate three communities associated with dental implants (health, peri-implant mucositis and peri-implantitis). The intact biofilms were visualised by confocal laser scanning microscope (CLSM) at different time points. Biofilms were cultured on non-selective and selective media. PCR-cloning and comparative sequencing of the 16S rRNA gene was carried out to determine bacterial richness. To quantify bacterial species, multiplex qPCR was used for a range of important oral species; qPCR probes were designed, tested and used to quantify Capnocytophaga in the communities. Evaluation of current and novel treatment modalities, to eliminate the microcosm biofilm, on commercial titanium surfaces (polished, SLA and SLActive surfaces) was carried out. Furthermore, novel antimicrobial surfaces were prepared and initial biofilm formation assessed by cultural analysis and CLSM. Results The biofilms shifted from coccid dense communities, to those dominated by rods and long filaments. The clones shifted from healthy to mixed pathogens. The qPCR revealed significant differences between a healthy and disease conditions. The combined treatment (mechanical and chemical) revealed the greatest reduction of biofilm on all surfaces tested. The antibacterial surfaces showed promotion towards a healthy community on old mature biofilm. Discussion/Conclusion The CDFF allowed successful growth of microbial communities and the ability to monitor the bacterial shifts between three communities associated with dental implants. In addition, it has allowed the testing of a range of titanium surfaces and treatment modalities. This model will allow further understanding of the microbiology of peri-implantitis and provide appropriate biofilm communities for testing surfaces infection and treatments.

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