Trehalose powder air-polishing of implants in a biofilm model

Objectives: Objectives: Subgingival air-polishing devices are reported to reduce bacterial biofilms and have been shown to be clinically effective in treatment of peri-implantitis. The aim of the present study was to evaluate the efficiency of a novel trehalose powder for air-polishing to remove pathogenic bacteria in a biofilm model.
Methods: Methods: Sixty dental implants (Ankylos D3.5, Dentsply Implants, Mannheim, Germany) were inserted in silicone molds with a circular space of 1mm and treated with a subgingival air polishing device (Air-Flow, EMS, Nyon, Switzerland) in six groups: (I) glycine-based powder (Air-Flow Perio, EMS), (II) trehalose-based powder (Lunos Prophy Powder Perio Combi, Duerr Dental, Bietigheim-Bissingen, Germany), (III) only water, (IV) 445nm laser irradiation (SiroLaser Blue, Sirona Dentsply, Bensheim, Germany) 0.6W continuous wave mode, 320μm tip, 60s, (V) 970nm laser irradiation (SiroLaser Blue, Sirona Dentsply) 1.5W, 10Hz pulse mode, duty cycle 50%, 320μm tip, 60s. Prior to air-polishing, implants were inoculated with an artificial biofilm containing periopathogenic bacteria such as Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Parvimonas micra, Campylobacter rectus, Eikenella corrodens, Aggregatibacter actinomycetemcomitans and Prevotella intermedia. An additional group (VI) of inoculated but untreated implants was used as control. After air-polishing, remaining bacteria were evaluated microbiologically using real-time PCR.
Results: Results: The amount of remaining bacteria after air-polishing was dependent on the treatment procedure with the lowest number of total bacteria in groups (I) (median: 1.47E5 CFU, min: 4.51E4, max: 7.13E6) and (II) (median: 7.39E5 CFU, min: 4.14E4, max: 6.07E6) with a statistically significant lower total bacterial load compared to both the untreated control (median: 2.93E8 CFU, min: 1.13E8, max: 3.88E8) and group (III) with only water (p<0.05). Both laser devices showed a statistically significant lower bacterial reduction than air-polishing (p<0.05).
Conclusions: Conclusion: Both subgingival air-polishing powders under study can reduce periopathogenic bacteria and thus support antimicrobial treatment approaches of peri-implant infections.