**Author details**

*Streptococcus sanguis Capnocytophaga* spp. *Streptococcus mitis Campylobacter rectus*

The surface characteristics of dental implants—roughness, wettability, surface free energy, and composition—play a crucial role in bacterial adhesion and colonization. The highest adhesion capacity is observed on rough Ti surfaces. Some authors have observed that mean roughness values below 0.088 microns significantly inhibit plaque adhesion and maturation [92]. Furthermore, decreasing the wettability of dental implants favors bacterial colonization. Some authors suggest that autoclave-sterilized Ti presents a higher rate of bacterial colonization,

Surface free energy is the sum of the forces of cohesion and adhesion that determine whether or not there is impregnation (the dispersion of the liquid over a surface). Decreasing surface free energy inhibits bacterial adhesion and biofilm formation on the surface of dental implants and abutments [93]. Thus, bacterial adherence is correlated with the presence of surface components with nonpolar or hydrophobic characteristics [93–95]. Finally, the type of metal and its composition also has an effect on bacterial adhesion and biofilm formation on its surface. Pure metals, especially Ti, nickel, iron, and vanadium, have some bacteriostatic

Some authors have concluded that ZnO and TiO2 reduce the adhesion of staphylococcal bacteria and increase the adhesion of osteoblasts [97]. The addition of silver compounds to increase antimicrobial action has also been studied [98]. Other authors have analyzed the behavior of Ti surfaces modified with vancomycin attached via covalent bonds and have reported a stable surface with a greater inhibition of bacterial adhesion than with Ti alone [99].

In this chapter, we have highlighted the important role of the macro- and micro-design of implants and their composition in the process of osseointegration. We have also stressed the significant influence of the surface characteristics of implants on the peri-implant microbiota. All in all, peri-implantitis is an important area for future research. It is extremely difficult to control the progress of an infection once it is established around an implant. The rough surfaces facilitate osseointegration, but also favor the adhesion of oral biofilm. Because of the multi‐ factorial nature of infectious peri-implant complications, studies should also take into account

*Aggregatibacter actonimycemetcomitans Spirochetes Porphyromonas gingivalis Veillonella parvula Prevotella intermedia Staphylococcus aureus Tannerella forsythia Fusobacterium* spp. *Treponema denticola Peptostreptococcus prevoti*

**Table 1.** List of bacterial species associated to dental implant biofilm.

118 Dental Implantology and Biomaterial

given the loss of surface wettability (**Figure 5**).

capacity [96].

**6. Conclusion**

Jaume Miranda-Rius1\*, Eduard Lahor-Soler1 , Lluís Brunet-Llobet2 , David de Dios3 and Francesc Xavier Gil4

\*Address all correspondence to: jmiranda-rius@ub.edu

1 Dental and Oral Department, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain

2 Division of Orthodontics and Paediatric Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain

3 Health Sciences Program, Autonomous University of Barcelona, Barcelona, Spain

4 Material Sciences Department, Bioengineering Research Center, Polytechnic University of Catalonia, Barcelona, Spain
