One-stage full-mouth disinfection to overcome intra-oral transmission of periodontopathogens

The oral cavity offers a range of different niches where periodontopathogens can adhere and survive (e.g. the mucosa, the tongue, the tonsils, the saliva and all intra-oral hard surfaces such as teeth, dentures, oral implants). Transmission of bacteria from one niche to another is likely to occur. Recent studies, for example, illustrated that initially sterile abutments of oral implants were rapidly colonized by bacteria from the subgingival environment around teeth. This transmission of bacteria can occur spontaneously via the saliva, or by means of oral hygiene aids and/or dental instruments. Such an intra-oral transmission, if it occurs at a high speed, could jeopardize the outcome of periodontal therapy. To overcome a bacterial transmission, a 'one-stage full-mouth disinfection' was recently introduced for the treatment of periodontal infections. This new treatment strategy resulted in significant clinical and microbiological improvements when compared, with the standard sequential treatment. (C) 1997 Academic Press

THE INFLUENCE OF SURFACE-FREE ENERGY ON SUPRAGINGIVAL AND SUBGINGIVAL PLAQUE MICROBIOLOGY - AN IN-VIVO STUDY ON IMPLANTS

THE INFLUENCE OF SURFACE FREE ENERGY on supra- and subgingival plaque microbiology was examined in 9 patients with functional fixed prostheses supported by endosseous titanium implants. Two abutments (trans-mucosal part of the 2 stage implant) were replaced by either a new titanium abutment or a fluor-ethylene-propylene (FEP) coated abutment per subject. After 3 months of habitual oral hygiene, plaque samples were taken. Supragingival plaque was examined by means of differential phase-contrast microscopy, whereas for the subgingivial plaque additional analyses (DNA probes analysis, culturing) were performed. The subgingival samples were taken by paper-points and by scraping of the subgingival abutment surface. Differential phase-contrast microscopy showed a significant difference in plaque composition, especially when supragingival plaque was considered (P = 0.05). FEP coated abutments frequently harbored more coccoid microorganisms, whereas spirochetes or motile organisms were only detected around titanium abutments. Subgingivally, the number of colony forming units (CFU) in paper-points was comparable for both types of abutments. If the to-the-abutment-adhering plaque was considered, the number of CFU was 5 times higher on the titanium abutments than on the FEP coated abutments. However, this difference did not reach a statistical level of significance (P = 0.38). The DNA probe analysis of the subgingival plaque collected with paper-points showed a slightly higher frequency and concentration of perio-pathogens around the titanium abutments. However, the inter-substratum differences were smaller than the inter-subject differences. The latter seemed to be related to patient's dental status. These results indicate that lowering the surface-free energy of intra-oral hard surfaces results in a reduction in bacterial colonization and in a retardation in its maturation in the supragingival area. For the subgingival area, the influence of this surface characteristic is not as obvious