Antibacterial effect of hydrogen peroxide-titanium dioxide suspensions in the decontamination of rough titanium surfaces

The chemical decontamination of infected dental implants is essential for the successful treatment of peri-implantitis. The aim of this study was to assess the antibacterial effect of a hydrogen peroxide-titanium dioxide (H2O2–TiO2) suspension against Staphylococcus epidermidis biofilms. Titanium (Ti) coins were inoculated with a bioluminescent S. epidermidis strain for 8 h and subsequently exposed to H2O2 with and without TiO2 nanoparticles or chlorhexidine (CHX). Bacterial regrowth, bacterial load and viability after decontamination were analyzed by continuous luminescence monitoring, live/dead staining and scanning electron microscopy. Bacterial regrowth was delayed on surfaces treated with H2O2–TiO2 compared to H2O2. H2O2-based treatments resulted in a lower bacterial load compared to CHX. Few viable bacteria were found on surfaces treated with H2O2 and H2O2–TiO2, which contrasted with a uniform layer of dead bacteria for surfaces treated with CHX. H2O2–TiO2 suspensions could therefore be considered an alternative approach in the decontamination of dental implants.