Influence of titanium surface roughness on attachment of Streptococcus sanguis: an in vitro study.

The purpose of the present study was to investigate the efficacy of the decontamination protocol for bacterial removal in titanium surfaces with three different levels of roughness using a high-pressure sodium bicarbonate device for 1 minute under aseptic conditions. Group 1 was composed of 10 as-machined titanium sheets and Groups 2 and 3 of titanium sheets blasted with aluminum oxide (Al2O3, alumina) particles with different diameters: Group 2 was blasted with 65-microm particles and Group 3 with 250-microm particles. The titanium specimens were sterilized and incubated in tubes containing a suspension of Streptococcus sanguis. The colony-forming units were counted before and after the application of the decontamination protocol. The arithmetic mean roughness (R(a)) per group was: Group 1, 0.17 microm +/- 0.01; Group 2, 1.14 microm +/- 0.15; and Group 3, 3.17 microm +/- 0.23. After the contamination period, Group 1 remained with 49 x 10(3) bacterial cells, and the bacterial concentrations of Groups 2 and 3 were 11 x 10(4) and 35 x 10(5), respectively. After the application of the decontamination protocol, no viable bacteria were detected. With the increase of the surface roughness, an exponential increase in bacterial cells was observed. The results showed that the decontamination protocol treatment with a high-pressure sodium bicarbonate device efficiently removed all bacterial cells in all surfaces tested. This indicates that high-pressure sodium bicarbonate spray should be used in the maintenance phase of implant treatment.