University of Oulu

Sarfraz S, Tamminen A-M, Leikola J, Salmi S, Kaakinen M, Sorsa T, Suojanen J, Reunanen J. High Adherence of Oral Streptococcus to Polylactic Acid Might Explain Implant Infections Associated with PLA Mesh Implantation. International Journal of Molecular Sciences. 2023; 24(11):9504.

High adherence of oral streptococcus to polylactic acid might explain implant infections associated with PLA mesh implantation

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Author: Sarfraz, Sonia1; Tamminen, Anni-Maria2; Leikola, Junnu3;
Organizations: 1Biocenter Oulu, Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland
2Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland
3Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland
4Oulu Centre for Cell-Matrix Research, Faculty of Biochemistry and Molecular Medicine, University of Oulu, 90220 Oulu, Finland
5Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, 00014 Helsinki, Finland
6Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.7 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2023
Publish Date: 2023-09-06


The aim of this study was to evaluate and compare the biofilm formation properties of common pathogens associated with implant-related infections on two different implant material types. Bacterial strains tested in this study were Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis, and Escherichia coli. Implant materials tested and compared were PLA Resorb × polymer of Poly DL-lactide (PDLLA) comprising 50% poly-L-lactic acid and 50% poly-D-lactic acid) and Ti grade 2 (tooled with a Planmeca CAD-CAM milling device). Biofilm assays were done with and without saliva treatment to evaluate the effect of saliva on bacterial adhesion and to mimic the intraoral and extraoral surgical routes of implant placement, respectively. Five specimens of each implant type were tested for each bacterial strain. Autoclaved material specimens were first treated with 1:1 saliva-PBS solution for 30 min, followed by washing of specimens and the addition of bacterial suspension. Specimens with bacterial suspension were incubated for 24 h at 37 °C for biofilm formation. After 24 h, non-adhered bacteria were removed, and specimens were washed, followed by removal and calculation of adhered bacterial biofilm. S. aureus and E. faecalis showed more attachment to Ti grade 2, whereas S. mutans showed higher adherence to PLA in a statistically significant manner. The salivary coating of specimens enhanced the bacterial attachment by all the bacterial strains tested. In conclusion, both implant materials showed significant levels of bacterial adhesion, but saliva treatment played a vital role in bacterial attachment, therefore, saliva contamination of the implant materials should be minimized and considered when placing implant materials inside the body.

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Series: International journal of molecular sciences
ISSN: 1661-6596
ISSN-E: 1422-0067
ISSN-L: 1661-6596
Volume: 24
Issue: 11
Article number: 9504
DOI: 10.3390/ijms24119504
Type of Publication: A1 Journal article – refereed
Field of Science: 318 Medical biotechnology
313 Dentistry
Funding: This study was funded by the Academy of Finland, project number 243032491 (J.R.), the Helsinki University Hospital Specific Catchment Area Research Funds, grant number 200230071 (J.S.), and the Päivikki and Sakari Sohlberg Foundation Research Grant (J.S.). Planmeca Ltd. provided titanium blocks free of charge. Open access funding provided by University of Helsinki.
Copyright information: © 2023 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 (