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Three-dimensional analysis of initial biofilm formation on polytetrafluoroethylene in the oral cavity

Dreidimensionale Analyse der initialen intraoralen Biofilmbildung auf Polytetrafluorethylen

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Aim

There is published evidence that polytetrafluoroethylene (PTFE) exhibits beneficial surface characteristics by means of long-term biofilm accumulation. The purpose of this study was to investigate and compare early biofilm formation on polytetrafluoroethylene, ceramic-reinforced polytetrafluoroethylene and as the control group, stainless steel.

Materials and methods

This study comprised 10 healthy volunteers (5 females and 5 males) with a mean age of 27.3±3.7 years. Three different slabs (two PTFE coatings: one pure and one ceramic-reinforced polytetrafluoroethylene, and stainless steel) were placed in random order on a splint in the mandibular molar region. Intraoral splints were inserted for 48 h. After 48 h, we removed the slabs from the splints and stained the biofilm with a two-color fluorescence assay for bacterial viability (LIVE/DEAD BacLight—Bacterial Viability Kit 7012, Invitrogen, Mount Waverley, Australia). The amount of biofilm accumulation was assessed using confocal laser scanning microscopy (CLSM).

Results

The biofilm surface coverage was 55.8±39.8% on pure PTFE-coated probes, 55.9±35.0% on ceramic-reinforced PTFE-coated probes, and 33.3±37.8% on stainless steel. The differences among the three groups were not significant (p=0.301). Biofilm depth was 5.6±5.4 μm on pure PTFE-coated probes, 5.2±3.8 μm on ceramic-reinforced PTFE-coated probes, and 2.4±2.9 μm on stainless steel. The Friedman test revealed a significant difference in biofilm depth (p=0.002). Pairwise comparison of biofilm accumulation yielded a significant difference between pure PTFE and ceramic-reinforced PTFE compared to stainless steel (p=0.017; p=0.005).

Conclusion

Our results indicate that the beneficial surface characteristics of PTFE coatings by reducing long-term biofilm are not a result of inhibiting initial bacterial adhesion.

Zusammenfassung

Zielsetzung

Im Vergleich zu konventionellen kieferorthopädischen Materialien weist Polytetrafluorethylen (PTFE) eine erheblich reduzierte intraorale Langzeitbiofilmakkumulation auf. Ziel der vorgestellten Untersuchung war es, eine konventionelle und eine mechanisch optimierte PTFE-Beschichtung hinsichtlich der initialen Biofilmbildung unter In-vivo-Bedingungen zu vergleichen. Zusätzlich wurde eine Kontrollgruppe eingeführt, die den Materialeigenschaften von konventionell eingesetzten Stahlbrackets entsprach.

Material und Methodik

Drei Probekörper (reines PTFE, keramikverstärktes PTFE und Stahl) wurden in randomisierter Reihenfolge auf einer Miniplastschiene in der Molarenregion befestigt. Die Schienen wurden für einen Zeitraum von 48 h bei insgesamt zehn parodontal gesunden Probanden (5 Frauen und 5 Männer) mit einem Durchschnittsalter von 27,3±3,7 Jahren eingegliedert. Anschließend erfolgten eine Fluoreszenzmarkierung des Biofilms und die dreidimensionale Analyse des Biofilms mittels der konfokalen Laser-Scanning-Mikroskopie (CLSM).

Ergebnisse

Die prozentuale Biofilmbelegung betrug auf reinem PTFE 55,8±39,8%, auf keramikverstärktem PTFE 55,9±35,0% und auf Stahl 33,3±37,8%. Der globale Test zeigte für die prozentuale Biofilmbedeckung keine signifikanten Unterschiede (p=0,301). Die durchschnittliche Höhe des Biofilms betrug auf reinem PTFE 5,6±5,4 μm, auf keramikverstärktem PTFE 5,2±3,8 μm und auf Stahl 2,4±2,9 μm. Die Unterschiede erwiesen sich als statistisch signifikant (p=0,002). Der paarweise Vergleich zeigte eine signifikant geringere Höhe der Biofilmbildung auf den Stahlproben verglichen mit reinem und keramikverstärktem PTFE (p=0,0017; p=0,005).

Schlussfolgerungen

Im Hinblick auf die initiale Kolonisation scheint PTFE gegenüber Stahl eine erhöhte bakterielle Affinität aufzuweisen. Die in der Literatur beschriebene reduzierte Langzeitbiofilmbildung auf PTFE scheint daher nicht auf einer verminderten initialen bakteriellen Adhäsion zu beruhen.

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Acknowledgments

We wish to thank Professor Hartmut Hecker for his assistance with the statistical data analysis.

Danksagung

Die Autoren danken Prof. Dr. Hartmut Hecker für die Hilfe bei der statistischen Analyse der Daten.

Conflict of interest

C. Fuchslocher Hellemann, S. Grade, W. Heuer, M.P. Dittmer, M. Stiesch, R. Schwestka-Polly, and A.P. Demling state that there are no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

Interessenkonflikt

C. Fuchslocher Hellemann, S. Grade, W. Heuer, M.P. Dittmer, M. Stiesch, R. Schwestka-Polly und A.P. Demling geben an, dass kein Interessenkonflikt besteht. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Department of Orthodontics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    C. Fuchslocher Hellemann, R. Schwestka-Polly &  A.P. Demling

  2. Department of Dental Prosthodontics and Biomedical Materials, Hannover Medical School, Hannover, Germany

    S. Grade, W. Heuer & M. Stiesch

  3. Center of Dentistry, Oral and Maxillofacial Science, Hannover Medical School, Hannover, Germany

    M.P. Dittmer

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  1. C. Fuchslocher Hellemann
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Correspondence to A.P. Demling.

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Fuchslocher Hellemann, C., Grade, S., Heuer, W. et al. Three-dimensional analysis of initial biofilm formation on polytetrafluoroethylene in the oral cavity. J Orofac Orthop 74, 458–467 (2013). https://doi.org/10.1007/s00056-013-0174-8

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