Figure 7

Battles occurring on the osseointegratable part of a dental implant between an existing layer of adhering U2OS osteoblasts and challenging periodontopathogens (left panel) and on the neck of an implant between gingival fibroblasts and contaminating oral bacteria adhering to the implant surface (right panel). Left panel: a comparison of the surface coverage by U2OS cells on dental implant materials grown prior to (coloured bars) and after (black bars) of a challenge by sub-gingival, oral bacterial strains. Data represent averages over P. intermedia ATCC 49046 and P. gingivalis ATCC 33277. On TiZr alloys and ZrO₂ variants, adhering osteoblasts withstand a challenge by sub-gingival bacteria more effectively than on Ti variants, regardless of surface roughness (green coloured, well-spread cell versus red cell), making TiZr alloys and ZrO₂ variants most suitable for the osseointegratable part of an implant. Right panel: a comparison of the surface coverage by human gingival fibroblasts on dental implant materials grown in absence (coloured bars) and presence (black bars) of contamination by adhering supra-gingival, oral bacteria (Streptococcus oralis J22, Streptococcus mitis BMS, Streptococcus salivarius HB and Staphylococcus aureus ATCC 25923). Data represent averages over the four strains indicated (data taken with permission from Zhao et al.¹¹). Displacement of contaminating supra-gingival bacteria from smooth Ti variants (green coloured, well-spread cell versus red, rounded-up cell) is easier than from the other implant materials included in this study, making smooth Ti variants most suitable for the neck of an implant. #These materials on average perform better than the other materials with respect to a bacterial challenge of an existing cellular layer or integration of a material in the presence of contaminating bacteria.