In Vitro Evaluation of Implant Surface Decontamination Methods Based on Removal and Regrowth of Microorganisms

The efficiency of bacterial removal using mechanical and chemical methods and recurrence rates was evaluated based on infected implant surface removal modalities.

The study comprises two main parts: in vitro bacterial removal (n = 49) and regrowth (n = 42) suppression tests on implant surfaces. Microorganisms were attached to each implant, and various methods were applied to clean the infected implants. The groups were allocated as follows: (1) no treatment, (2) cotton + saline, (3) brush, (4) scaler, (5) brush + scaler, (6) cotton + 3% H₂O₂, and (7) brush + 3% H₂O₂. All groups were further divided into two subgroups of mechanical treatment (3, 4, 5) vs mechanical + chemical treatment (2, 6, 7). After treatment for each group, immunofluorescence analysis and measurement using an ultraviolet-visible light spectrophotometer were performed.

In the mechanical treatment group, the brush, scaler, and brush + scaler groups, all of which had strong polishing abilities, exhibited superior removal efficiency compared with the other groups (P < .001). In the regrowth experiment, 3% H₂O₂ effectively restrained biofilm formation. In particular, the brush + 3% H₂O₂ group exhibited significant differences from the mechanical treatment group (vs brush: P < .001, vs scaler: P = .023, vs brush + scaler: P = .005).

Mechanical methods, including brushes and scalers, effectively removed bacteria. Biofilm formation was effectively restrained by H₂O₂. In particular, the brush + H₂O₂ group exhibited a superior ability to suppress bacterial regrowth compared with the other groups.