Biofilm Formation on Three High-Performance Polymeric CAD/CAM Composites: An In Vitro Study

Reinforced polymeric materials are investigated as novel non-metal alternatives for prosthetic frameworks. This study examined the adherence of Streptococcus mutans to three high-performance polymeric (HPP) composites focusing on their microstructural composition, wettability, and surface roughness. Three CAD/CAM HPP composites [two fiber-reinforced composites, CarboCad (CC) and TRINIA (TR), and one ceramic-reinforced polyether ether ketone, DentoPEEK (PK)], were sectioned into ten beam- and ten plate-shaped specimens from each material. Surface properties (n = 10) were analyzed by water wettability and roughness measurements (Ra and Rz). The biofilm adherence was determined by calculating the number of S. mutans through colony-forming units (CFUs). Representative images were obtained using a confocal laser scanning microscope (CLSM) and scanning electron microscopy (SEM). The data were analyzed using Welch one-way ANOVA and Dunnett T3 post hoc tests. The results showed significant differences in roughness (Ra) across the materials, ranked from highest to lowest as follows: TR, 0.231 µm; CC, 0.194 µm; and PK, 0.161 µm (p = 0.0001). The contact angle averages varied from 51.36° to 91.03°, with PK exhibiting the highest wettability (p = 0.0012). However, S. mutans adherence was markedly reduced in PK (1.96 CFU/mm², p = 0.0001) in comparison to TR and CC (2.86 and 2.98 CFU/mm², respectively). Consequently, the fiber-reinforced composites (CC and TR), despite their low wettability, exhibited greater susceptibility for bacterial adherence than the smoother and more wettable PK, highlighting the substantial impact of their surface roughness and microstructural variability.