Journal of Periodontal and Implant Science

  • 제34권1호
  • /
  • Pages.71-81
  • /
  • 2004
  • /
  • 2093-2278(pISSN)
  • /
  • 2093-2286(eISSN)
대한치주과학회 (Korean Academy of Periodontology)
권호 표지

오염된 임프란트 표면의 해독 방법에 따른 내독소 제거 효과에 관한 연구

The Endotoxin Assay of Contaminated Titanium Implants following Various Techniques of Detoxification

  • 박중희 (단국대학교 치과대학 치주과학교실) ;
  • 임성빈 (단국대학교 치과대학 치주과학교실)
  • Park, Joong-Hee (Department of Periodontology, College of Dentistry, Dan-Kook University) ;
  • Lim, Sung-Bin (Department of Periodontology, College of Dentistry, Dan-Kook University)
  • 발행 : 2004.03.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.

키워드

참고문헌

  1. Adell R, Lekholm U, Rockler B and Branemark PI: A 15-year study of osseointegrated implants in the treatment of edentulous jaw. Int J Oral Surg, 1981, 10: 387-416
  2. Kent JN, Block MS, Finger IM, et al: Biointegrated hydrowyapatite-coated dental implants: 5-year clinical observations. J Am Dent Assoc. 1990, 121: 138-144
  3. Meffert RM, Block MS, Kent JN: What is osseointegration? Int J Periodont Rest Dent. 1987, 7: 9-21
  4. Newman MG, Flemmig TF: Periodontal considerations of implants and implant associated microbiota. J Dent Educ. 1988, 52: 737-744
  5. Arnim S, Hagerman D: The connective tissue fibers of the marginal gingiva. J Am Dent Assoc. 1953, 47: 271-281
  6. James R: The support systems and the perigingival defense mechanism of oral implants. J Oral Implantol. 1976, 6: 270-285
  7. Meffert RM: How to maintain the endosseous implant. Dent Today. 1991,10: 36, 38-39
  8. Kwan JY, Zablotsky MH: Peri-implantitis, the ailing implant. Implant Soc. 1991, 2: 6-9
  9. Apse P, Ellen RP, Overall CM, Zarb GA: Microbiota and crevicular fluid collagenase activity in the osseointegrated dental implant sulcus: a comparison of sites in edentulous and partially edentulous patients. J Periodont Res. 1989, 24: 96-105
  10. Quirynen M, Lisgarten MA: Distribution of bacterial morphotypes around natural teeth and titanium implants ad modum $Br{\"{a}}nemark$. Clin Oral Implant Res. 1990, 1: 8-12
  11. Mombelli A, van Oosten MAC, Sch ch E, Lang NP: The microbiota associated with successful or failing osseointegrated titanium implants: Oral Microbiology and Immunology. 1987, 2: 145-151
  12. Koka S, Razzong ME, Bloem TJ, Syed S: Microbial colonization of dental implants in partially edentulous subjects. J Prosthet Dent. 1993, 70: 141-144
  13. George K, Zafiropoulos GG, Murat Y, Hebertus S, Nisengard RJ: Clinical and microbiological statue of osseointegrated implants. J Periodontol. 1994, 65: 766-770
  14. Steinberg D, Sela MN, Klinger A, Kohavi D: Adhesion of periodontal bacteria to titanium and titanium alloy powders. Clin Oral Impl Res. 1998, 9: 67-72
  15. Alcoforado GAP, Feik D, Rams TE, Rosenberg ES, Slots J: Microbiology of failing osseointegrated dental implants. Abstract. 1989, ASM Annual Meeting
  16. Slots J, Bragd L, Wikstrom M, Dahlen G: The occurrence of Actinobacillus actinomycetem-comitans, Bacteroides gingivalis and Bacteroides intermedius in destructive periodontal desease in adults. J Clin Periodontol. 1986, 13: 570
  17. Palmisano DA, Mayo JA, Block MS, Lancaster DM: Subgingival bacteria associated with hydroxyapatite-coated dental implants. morpho-types and trypsin-like enzyme activity. Int J Oral Maxillofac Implants. 1991, 6: 313-318
  18. Savitt ED, Socransky SS: Distribution of certain subgingival microbial species in selected periodontal conditions. J Periodont Res. 1984, 19: 218-230
  19. Schwartz J, Stinson FJ, Parker RB: The passage of tritiated bacterial endotoxins across intact gingival crevicular epithelium. J Periodontol. 1972, 43: 270-276
  20. Simon BI, Goldman HM, Ruben MP, Baker E: The role of endotoxins in periodontal disease: I-a reproducible, quantitative method for determining the amount of endotoxin in human gingival exudate. J Periodontol. 1969, 40: 695-701
  21. Wilson M:Biological activities of lipopolysaccharides from oral bacteria and their relevance to the pathogenesis of chronic periodontitis. Sci Prog. 1995, 78: 19-34
  22. Reclaru L, Meyer JM: Study of corrosion between a titanium implant and dental alloys. J Dent. 1994, 22: 159-168
  23. Morrison DC, Kline LF: Activation of the classical, and properdin pathways of complement by bacteria lipopolysaccharides(LPS). J Immunol. 1977, 118: 361-368
  24. Wahl LM, Wahl SM, Mergenhagen SE, Martin GR: Collagenase production by endotoxin-activated macrophage. Proc Natl Acad Sci USA. 1974, 71: 3598-3601
  25. Hausman C, Weinfeld N, Miller W: Effect of lipopolysaccharides on bone resorption in tissue culture. Science. 1972, 168: 862-864
  26. Hausman E, Luderitiz O, Knox K, Weinfeld N: Structural requirements for bone resorption by endotoxins and lipoteichoic acid. J Dent Res. 1975, 54: 94-99
  27. Bom-van Noorloos AA, Van Der Meer JW, Van De Gevel JS et al: Bacteroides gingivalis stimulates bone resorption via interleukin-1 production by mononuclear cells: the relative role for B. gingivzlis. J Clin Periodontol. 1990, 17: 409-413
  28. Hatfield C, Baumhammer A: Cytotoxic effects of periodontally involved surfaces of human teeth. Arch Oral Biol. 1971, 16: 465-8
  29. DeRenzis FA, Chen S: Ultrastructural study of cultured human gingival fibroblasts exposed to endotoxins. J Periodontol. 1983, 9: 1-15
  30. Ogawa T: Immunobiological properties of chemically-defined lipid A from lipopolysaccharide of Porphyromonas(Bacteroides) gingvelis. Eur J Biochem. 1994, 219: 737-42
  31. Renvert S, Wikstrom M, Dahlen S, et al: Effect of root debridement on the elimination of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis from periodontal pockets. J Clin Periodontol. 1990, 17: 345
  32. Slots J, Listgarten MA: Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans in human periodontal diseases. J Clin Periodontol. 1988, 15: 85
  33. Knoernschild KL, Lefebvre CA, Schuster GS, Payant LM et al: Endotoxin adherence to and elusion from two casting alloys. Int J Prosthodont. 1994, 7: 22-29
  34. Robinson FG, Knoernschild KL, Sterrett JD, Tompkins GR: Porphyromonas gingivalis endotoxin affinity for dental ceramics. J Prosthet Dent. 1996, 75: 217-227
  35. Parham PL, Cobb CM, French AA, Love JW, Drisko CL, Killoy WJ: Effects of an air-powder abrasive system on plasma-sprayed titanium implant surfaces: An in vitro evaluation. J Oral Implantol. 1989, 15: 78-86
  36. Dennison DK, Huerzeler MB, Quinones C, Caffesse RG: Contaminated implant surfaces: An in vitro comparison of implant surface coating and treatment madalities for decontamination. J Periodontol. 1994, 65: 942-948
  37. Zablotsky MH, Diedrich DL, Meffert RM: Detoxification of endotoxin-contaminated titanium and hydroxyapatite-coated surfaces utilizing various Chemotherapeutic and mechanical modalities. Implant Dent. 1992, 1: 154-158
  38. Zablotsky MH, Diedrich DL, Meffert RM, Wittrig E: The abiliry of various chemotherapeutic agents to detoxify the endotoxin infected HA-coated implant surface. Int J Oral Implant. 1991, 8: 45-51
  39. Rapley JW, Swan RH, Hallmon WW, Mills MP: The surface characteristics produced by various oral hygiene instruments and materials on titanium implant abutments. Int J Oral Maxillofac Implants. 1990, 5: 47-52
  40. Chairay JP, Boulekbache H, Jean A, Soyer A, Bouchard P: Scanning electron microscopic evaluation of effects of an air-abrasive system on dental implants: A comparative in vitro study between machined and plasma-sprayed titanium surfaces. J Periodontol. 1997, 68: 1215-1222
  41. McCoy SA, Creamer HR, Kawanami M, Adams DF: The concentration of lipopolysaccaride of individual root surfaces at varying times following in vivo root planning. J Periodontol. 1987, 58: 393-399
  42. McCollum J, O'Neal RB, Brennan WA, Van Dyke TE, Homer JA: The effect of titanium implant abutment surface irregularities on plaque accumulation in vivo. J Periodontol. 1992, 63: 802-805