Evaluation of different implant surface decontamination techniques on bacterial load and surface integrity: an in-vitro study.

Abstract

This study aimed to evaluate the effects of different decontamination techniques on titanium discs contaminated with Staphylococcus aureus biofilms focusing on bacterial removal efficacy and preservation of surface chemistry and topography.Two hundred twenty titanium discs, either contaminated with Staphylococcus aureus biofilms or kept sterile, were allocated to five decontamination protocols: titanium curette (TC), Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet (Er, Cr: YSGG) laser at 1.5 W (LI1) and 2 W (LI2), air-abrasion with glycine powder (AGP), and erythritol powder with chlorhexidine (AEP). Microbial reduction was assessed by colony-forming unit (CFU) counts, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM); surface alterations were evaluated using SEM, X-ray photoelectron spectroscopy (XPS), and profilometry. Statistical analysis included ANOVA, Kruskal-Wallis, and Pearson correlation tests. All methods significantly reduced CFU counts (p < 0.05), with LI2 achieving the highest log reduction. CLSM and SEM confirmed substantial reductions in viable biomass for LI2, TC, and AEP (p < 0.05), while AGP was least effective (p > 0.05). XPS analysis revealed that LI2 and AEP significantly increased surface oxygen (p < 0.05) and altered elemental composition with minimal damage. TC caused notable surface scratches, and AGP/AEP left powder residues. Only the TC group showed a significant increase in surface roughness (p < 0.05). None of the techniques completely removed biofilm; however, Er, Cr: YSGG laser at 2 W showed the most favorable balance between microbial reduction and surface preservation. Optimized laser parameters and chlorhexidine-enriched fine powders appear to be effective and safe options. Although titanium curettes achieved considerable biofilm removal, they induced significant alterations in surface morphology.