Microbiological Effectiveness of Anti-Bacterial Agents Used Inside Implants

Research Article

J Dent & Oral Disord. 2017; 3(3): 1065.

Microbiological Effectiveness of Anti-Bacterial Agents Used Inside Implants

Pereira LM¹, Carneiro TAPN¹, Davi LR¹, Prudente MS¹, Martins CHG², Penatti MPA¹ and Neves FD¹*

¹School of Dentistry, Universidade Federal de Uberlândia, Brazil

²School of Dentistry, Universidade de Franca, Brazil

*Corresponding author: Flávio Domingues das Neves, School of Dentistry, Universidade Federal de Uberlândia, Brazil

Received: May 09, 2017; Accepted: June 16, 2017; Published: June 23, 2017


To prevent bacterial contamination between implant/abutment, different types of gels and ointments inside of implants are commonly used. This in vitro study aimed to evaluate, the anti-bacterial effectiveness of different concentrations of chlorhexidine and tetracycline gels; Neosporin® and Proheal® ointments. The anti-bacterial activity was determined by inhibition zones through agar diffusion method in plates previously inoculated with different bacteria: F. nucleatum, P. nigrescens, (obligatory anaerobic bacteria) and E.coli, S. sanguinis (Facultative anaerobic bacteria). The plates were prepared in triplicate for each type of bacteria. The diameter of microbial inhibition were measured (mm) and statistically analyzed (One-way ANOVA, a=0.05). The greatest inhibition halos against anaerobic bacteria were produced by Proheal® (85.69 mm) which was significantly greater than 2.5%, 2% and 1% tetracycline gels (63.09 mm), followed by 2.5%, 2%, 1% chlorhexidine gels and Neosporin® (19.72 mm). For aerobic bacteria the greatest halos were produced by 2.5% and 2% tetracycline (36.05 mm), which were significantly superior than 1% tetracycline (30.02 mm) followed by 2.5%, 2% and 1% chlorhexidine (17.75 mm), and these were statistically different from Neosporin® (10.98 mm) and Proheal® (6.22 mm). Although Proheal® presented the greatest halos of inhibition against anaerobic bacteria. Due to its effectiveness for all bacteria tested, the tetracycline gel seems to be the most indicated.

Keywords: Anti-Bacterial agents, Dental implant-abutment interface


It is already known that a microgap exists in the Implant/ Abutment interface (IAI) [1]. This misfit creates bacterial niches that may develop an inflammatory tissue near the IAI [2]. Micro movements caused during the loading of dental implants [3], loss of preload of abutment screws [4] and the misfit between the IAI provide bacterial microleakage between the components of the implanted prosthesis; being the main cause of a bone loss and inflamed tissue near the implant/Abutment junction [5]. Several antibacterial agents have been used within the implants in order to prevent bacterial microleakage, the most common antibacterial agents are tetracycline gel, chlorhexidine gel, Neosporin® ointment and Proheal® Ointment [6,7]. Koutouzis et al. (2013) analyzed the influence of Chlorhexidine 0.12% in the micro leakage through the IAI in Morse taper junction, however in this concentration the chlorhexidine cannot preclude that the cytokine leakage through IAI, in other study Paolantonio et al. (2008) found that the chlorhexidine can alleviate contamination and decrease the count of bacteria inside the implant.

Few studies have evaluated the efficiency of various antibacterial gels and its various concentrations. Therefore, this study aims to evaluate the antibacterial efficiency between gels with different concentrations of chlorhexidine and tetracycline and also the Neosporin® and ProHeal®. In this way, can determine which substance has the best antibacterial effect and which concentration should be used inside implants to avoid bacterial growth.

Materials and Methods

For this study, the following substances were analyzed: Chlorhexidine (Group Cl) and Tetracycline (Group Te) (Pharmus, Uberlândia, Brazil), at concentrations of 1%, 2% and 2.5%, and ProHeal® (Biomacmed ointments, Juiz de Fora, Brazil) (Ph group) and Neosporin® (Johnson & Johnson Consumer Companies, Inc., USA) (Ne group) and control group as the pure thickening gelnatrosol (GC group) (Table 1). These substances were selected with the different concentrations available on the market.