Two Biofilm-related infections in medical devices
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Biofilms on dental implants
Regensburg University Medical Center, Regensburg, Germany
From a very oversimplified point of view, a dental implant is equivalent to an artificial root inserted into the bone of toothless areas of the upper or lower jaw for the replacement of missing teeth. As the loss of teeth has always involved functional and esthetic constraints, the first implantological attempts date back to the ancient Egyptians, who inserted shells into the osseous sockets of missing teeth. Since then, countless approaches have been undertaken to develop implant systems, with differences in shape and designed, material, insertion mode (subperiostal vs. endosseous), or prosthetic construction. However, the first commercially successful dental implant system manufactured from titanium has been introduced by the Swedish orthopedic surgeon Per-Ingvar Branemark as late as in the 1980s. Dental implantology has since become one of the fastest growing fields in contemporary dentistry and the enormous number of international groups researching in this field indicates that the demand for oral implan- tology is still growing. In 2006, the American Academy of Implant Dentistry numer- alized the number of implants inserted by US dentists at approximately 5.5 million (http://www.aaid.com/about/press_room/dental_implants_faq.html, 01.09.2015), and the German SocietyforlmplantDentistry(DGI) estimates that—onlyin Germany—aboutone million dental implants are inserted every year (https://www.dginet.de/web/dgi/warum, 01.09.2015)—data that underline the enormous relevance of implantology in contemporary dentistry. However, coinciding with the number of implants inserted, the frequency of biomaterial-associated biological complications increases. Although no exact epidemiological data have so far been published, researchers estimate that biofilm-induced periimplant infections affect around 10% of implants and 20% of patients after 5-10 years of clinical service (Mombelli et al., 2012); however, due to the limited scientific evidence available, some researchers estimate that the incidence of periimplant infections is even higher (Holmberg et al., 2013).