Antibacterial effect of hydrogen peroxide-titanium dioxide suspensions in the decontamination of rough titanium surfaces

Abstract

The chemical decontamination of infected dental implants is essential for the successful treatment of peri-implantitis. The aim of this study was to assess the antibacterial effect of a hydrogen peroxide-titanium dioxide (H₂O₂–TiO₂) suspension against Staphylococcus epidermidis biofilms. Titanium (Ti) coins were inoculated with a bioluminescent S. epidermidis strain for 8 h and subsequently exposed to H₂O₂ with and without TiO₂ nanoparticles or chlorhexidine (CHX). Bacterial regrowth, bacterial load and viability after decontamination were analyzed by continuous luminescence monitoring, live/dead staining and scanning electron microscopy. Bacterial regrowth was delayed on surfaces treated with H₂O₂–TiO₂ compared to H₂O₂. H₂O₂-based treatments resulted in a lower bacterial load compared to CHX. Few viable bacteria were found on surfaces treated with H₂O₂ and H₂O₂–TiO₂, which contrasted with a uniform layer of dead bacteria for surfaces treated with CHX. H₂O₂–TiO₂ suspensions could therefore be considered an alternative approach in the decontamination of dental implants.

Keywords:

• Titanium dioxide
• hydrogen peroxide
• antibacterial agent
• implant surface
• biofilm
• Staphylococcus

Acknowledgments

The authors thank Heidi A. Åmdal (Department of Oral Biology, University of Oslo) for technical laboratory assistance and Michael Otto for kindly providing them with S. epidermidis Xen 43 at no charge.