Project: Combined antibacterial debridement strategy for infected permanent bone implants as peri-implantitis treatment
Aim of the project_x000D_To develop a gel formulation that allows for a more effective removal of biofilms on bone implant surfaces to successfully treat peri-implantitis. The treatment will involve a combination of chemo-mechanical debridement and a light device that is able to re-activate the implant surface. Thus the aim is to bring two products on the market that amplify each others abilities._x000D__x000D_Peri-implantitis is caused by bacteria that colonize the surfaces of permanent dental implants. It is an inflammatory process affecting the tissues around osseointegrated implants resulting in loss of supporting bone and ultimately leading to implant failure. _x000D_To-date, peri-implant bony defects are treated with either nonsurgical or surgical techniques. Bone regeneration is possible in selected peri-implant bony defects if appropriate surgical techniques are used, implant surface preparation is achieved, and the cause is eradicated. Debridement is an important part of the treatment process for healing of peri-implant bone loss. In medicine, debridement refers to the removal of necrotic, damaged, or infected tissue to improve the healing potential of the reCOing healthy tissue. In dentistry, debridement also refers to the removal of plaque and calculus that have accumulated on teeth or any other surface in the oral cavity._x000D__x000D_Despite their favorable survival rates, 28-56 % of patients with osseo-integrated titanium (Ti) implants develop peri-implantitis caused by bacterial biofilms (Algraffee et al. 2012). The most important development that drives the present-day marked of dental implants for tooth replacement is the use of micro- and nanorough surfaces for improved osseointegration; examples here are the OsseoSpeed implant from AtraTech, NanoTi from Biomet 3i, and SLActive from Institut Straumann AG. Micro- and nanorough implant surfaces on screw-shaped implants yield a favorable surface for bone cells, but also for bacteria. In addition they make debridement more demanding and increase the need of an appropriate tool. Once established, treatment involves mechanical cleaning for moderate cases and mechanical removal of the biofilm plus systemic antibiotics for severe cases. A wide range of debridement strategies have been suggested to reduce biofilm, e.g. curettes made of carbon fibre, plastic or Ti, ultrasound, carbon dioxide (CO2) laser irradiation, or hydrogen peroxide (H2O2) - but without systematic investigation. A common concern for all commercially available instruments is the difficulty in getting sufficient access to the surfaces between the treads of the contaminated fixtures to thoroughly clean the entire surface structure in situ. We propose to develop a new debridement gel that, together with our TiBrush™ (Institute Straumann AG) invention will lead to more effective biofilm eradication. This will prepare for re-osseointegration and thus reduce the need of implant removal._x000D_It is important to find a methodology, which will decontaminate dental implants but at the same time leave the original surface structure intact, not obstructing the potential for re-osseointegration. Using carbon fibre curettes has been reported to leave remnants of carbon fibre on the implant surface. These material residues often trigger a foreign body response and are generally not well accepted by the human body. Similarly the utilization of dental lasers has been reported to burnish the surface, which may have a negative effect on the potential for the implant to re-osseointegrate. None of the methods currently in use remove a satisfactory amount of bacteria (Schmage et al. 2012). In addition, with the number of multi-resistant bacterial strains rising, alternative strategies towards antibacterial treatments are urgently needed. _x000D_In order to avoid the mentioned damaging risk, a cleaning tool in the form of a brush comprising soft bristles should be utilized cleaning metallic medical implants having delicate surfaces. One example of such a brush for cleaning a dental implant is disclosed in US 6,345,406, another example is given in WO 2009/083281 , which discloses the implant cleaning/debridement tool TiBrush™._x000D_Further, if the Ti implant surfaces can be re-activated with light irradiation after cleaning to favor bone adhesion, an additional positive effect can be achieved to help re-osseointegration._x000D_
|
Acronym
|
NuGel
(Reference Number: 8320)
|
|
Duration
|
01/08/2013 - 30/07/2016
|
|
Project Topic
|
We aim for removal of bacterial biofilms from dental implants to eliminate peri-implantitis and thus to prepare for bone tissue regrowth around the implant. The system will combine bactericidal gel to enhance the cleansing effect in combination with a light device.
|
|
Network
|
Eurostars
|
|
Call
|
Eurostars Cut-Off 10
|
Project partner
