Surface Decontamination of Titanium Dental Implants Subjected to Implantoplasty by Treatment with Citric Acid Solutions

Implantoplasty is one of the most common techniques to remove peri-implantitis from the surface of dental implants. It is a process of mechanization of the titanium surface, causing the loss of the roughness of the dental implant, which leads to difficulty in tissue regeneration. The aim of this research is to apply a decontaminant based on citric acid and add collagen and magnesium cations to promote tissue formation and have a bactericidal character. Eighty commercially pure grade 3 titanium discs were used to perform the implantoplasty protocol, like the one used in dental clinics. They were treated with four different solutions: 25% citric acid, 25% citric acid with the addition of collagen 0.25 g/L, 25% citric acid with the addition of 0.50 g/L and the latter with the addition of 1% Mg (NO3)2. The roughness was determined by confocal microscopy, the contact angle, adhesion and proliferation of HFFs fibroblasts, proliferation of SaOS-2 osteoblasts and bactericidal behavior by culturing very common bacteria in the oral cavity, Gram-positive Streptococcus sanguinis and gordonii and as Gram-negative Pseudomonas aeruginosa. The results showed that the treatment with citric acid slightly increases the roughness and decreases the contact angle from 78 to 13 degrees, making the surface superhydrophilic. Fibroblast proliferation studies show a very significant increase at 24 h, the most favorable solution being the one containing 0.50 g/L of collagen with the presence of magnesium in a 25% citric acid solution. This same solution shows the highest cytocompatibility and osteoblastic proliferation with statistically significant differences with respect to the control and the rest of the solutions. Microbiological studies show a bactericidal effect due to the presence of citric acid, which is especially effective on Gram-positive bacteria. The results allow us to have mouthwashes that can be applied in the patient's mouth, which will help the regeneration of tissues and avoid new bacterial colonization.