University of Oulu

Sarfraz S, Mäntynen P-h, Laurila M, Suojanen J, Saarnio J, Rossi S, Horelli J, Kaakinen M, Leikola J, Reunanen J. Effect of Surface Tooling Techniques of Medical Titanium Implants on Bacterial Biofilm Formation In Vitro. Materials. 2022; 15(9):3228.

Effect of surface tooling techniques of medical titanium implants on bacterial biofilm formation in vitro

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Author: Sarfraz, Sonia1; Mäntynen, Pilvi-helinä2; Laurila, Marisa2;
Organizations: 1Biocenter Oulu & Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland
2Päijät-Häme Joint Authority for Health and Wellbeing, Lahti Central Hospital, Department of Oral and Maxillofacial Surgery, 15850 Lahti, Finland
3Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland
4Research Unit for Surgery, Anaesthesiology and Intensive Care, University of Oulu, 90014 Oulu, Finland
5Planmeca, 00880 Helsinki, Finland
6Oulu Centre for Cell-Matrix Research, Faculty of Biochemistry and Molecular Medicine, University of Oulu, 90220 Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 30.9 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2022
Publish Date: 2022-09-15


The aim of this study was to assess the biofilm formation of Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Escherichia coli on titanium implants with CAD-CAM tooling techniques. Twenty specimens of titanium were studied: Titanium grade 2 tooled with a Planmeca CAD-CAM milling device (TiGrade 2), Ti₆Al₄V grade 5 as it comes from CAD-DMLS device (computer aided design-direct metal laser sintering device) (TiGrade 5), Ti₆Al₄V grade 23 as it comes from a CAD-CAM milling device (TiGrade 23), and CAD-DMLS TiGrade 5 polished with an abrasive disc (TiGrade 5 polished). Bacterial adhesion on the implants was completed with and without saliva treatment to mimic both extraoral and intraoral surgical methods of implant placement. Five specimens/implant types were used in the bacterial adhesion experiments. Autoclaved implant specimens were placed in petri plates and immersed in saliva solution for 30 min at room temperature and then washed 3× with 1× PBS. Bacterial suspensions of each strain were made and added to the specimens after saliva treatment. Biofilm was allowed to form for 24 h at 37 °C and the adhered bacteria was calculated. Tooling techniques had an insignificant effect on the bacterial adhesion by all the bacterial strains studied. However, there was a significant difference in biofilm formation between the saliva-treated and non-saliva-treated implants. Saliva contamination enhanced S. mutans, S. aureus, and E. faecalis adhesion in all material types studied. S. aureus was found to be the most adherent strain in the saliva-treated group, whereas E. coli was the most adherent strain in the non-saliva-treated group. In conclusion, CAD-CAM tooling techniques have little effect on bacterial adhesion. Saliva coating enhances the biofilm formation; therefore, saliva contamination of the implant must be minimized during implant placement. Further extensive studies are needed to evaluate the effects of surface treatments of the titanium implant on soft tissue response and to prevent the factors causing implant infection and failure.

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Series: Materials
ISSN: 1996-1944
ISSN-E: 1996-1944
ISSN-L: 1996-1944
Volume: 15
Issue: 9
Article number: 3228
DOI: 10.3390/ma15093228
Type of Publication: A1 Journal article – refereed
Field of Science: 3111 Biomedicine
Funding: This study was funded by Academy of Finland project number 243032491 (J.R.), Helsinki University Hospital Specific Catchment Area Research Funds Grant number 200230071 (J.S.), Päivikki and Sakari Sohlberg Foundation Research Grant (J.S.). Planmeca Ltd. provided titanium blocks free of charge.
Copyright information: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (