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- Title
Bacterial colonization patterns of percutaneous abutment surfaces in relation to skin integration.
- Authors
van Hoof, M.; Kapsokalyvas, D.; Wigren, S.; Budding, A. E.; Savelkoul, P. H. M.; van Zandvoort, M. A. M. J.; Ramaekers, F. C. S.; Stokroos, R. J.
- Abstract
Objective: Peri-abutment dermatitis is thought to relate to bacterial infection of pockets around the patient's abutment. It is yet unknown how bacteria colonize the abutment surface. Molecular microbiology techniques allow for selective microbiota profiling to approximate bacterial migration patterns. Bacteria are in direct competition with the host's ability to control the abutment surface ( "race for the surface" Gristina 1987). Upon integration of the host to the abutment, competitive bacteria are hypothesized to be prevented from colonizing it. Evidence for skin integration has been shown before for hydroxyapatite(HA)-abutments, but without elucidating the attachment mechanisms behind it. Therefore the objective of two investigations was to study the relationships between the microbiota on and around the titanium abutment and to investigate skin-integration on HA-coated abutments. Study design: Observational case series featuring 3D imaging and molecular microbiology. Patients: Sixteen subjects with and without peri-abutment dermatitis were included for the microbiology case-control study. Four subjects with a HA-coated and one subject with a titanium abutment were included for an ex vivo cell investigation of skin integration. Methods: Molecular bacterial profiling was performed using IS-pro (IS-Diagnostics LtD) on the retrieved abutment of a subject, the skin surrounding it, and the contra-lateral side (control). Scanning electron microscopy was performed for biofilm assessment. Two-photon microscopy was performed on retrieved HA-coated abutments using fluorescent labeling of adhesion proteins, nuclei, and dermal collagen. Results: The microbiota on and around the titanium abutment is diverse and distinct from the contralateral control skin, in health and disease. A multitude of different microbes including yeast and bacterial (sub)species belonging to different phyla on and around the BCHI titanium abutment were found in planktonic form or biofilm, in subjects with and without inflammation. The HA-coated abutments without infection show evidence of integration by means of hemidesmosomes, basal keratinocytes, and/ or the presence of vascularization. Conclusion: The differences in the three microbiota per individual for subjects with and without inflammation suggests that the composition and complex interplay (i.e mutualism, parasitism, commensalism and/or coaggregation) of those microbiota might be a determinant for the difference between health and disease. Previously hypothesized skin integration markers were found on the HA-coated abutment.
- Subjects
BELGIUM; CONFERENCES &; conventions; COCHLEAR implants; HOST-bacteria relationships; SKIN
- Publication
Journal of Hearing Science, 2018, Vol 8, Issue 2, p279
- ISSN
2083-389X
- Publication type
Article