Titanium Surfaces and Detoxification : Effects of Bacterial Biofilm and Critic Acid on Oxide Layer Behavior

Dental implants have been highly successful in restoring teeth function and improving patient quality of life. However, many implant failures have been reported every year, the major reason for it being bacterial infiltration and development of peri-implantitis. Peri-implantitis is a pathological condition around the implant that results in soft tissue inflammation and marginal bone loss. With increasing number of implants being placed every year in the US and worldwide, there is a substantial increase in the number of peri-implantitis cases being reported as well. A number of treatment methods for peri-implantitis have been reported and citric acid has been a widely used chemical for the surface debridement of titanium implants. The effect of this treatment on the implant surface characteristics, specifically on the protective surface oxide layer, are relatively unknown. The ability of these surfaces that are generally used for implant body to repassivate and re-osseointegrate after being placed back into the implant pocket post-treatment is not well explored. The inability of a surface to provide conditions for implant re-osseointegration will further lead to bacterial infiltration ultimately leading to implant loosening/failure. The goal of this study was to understand the effects of detoxification on titanium surface oxide and its stability. This further enables the understanding of whether the titanium surfaces have the ability to function as efficiently after detoxification with acidic chemicals such as citric acid in terms of corrosion resistance and osseointegration. Further the efficiency of these treatments for the removal oral biofilm could also be addressed.