Comparison of the Intensity of Biofilm Production by Oral Microflora and Its Adhesion on the Surface of Zirconia Produced in Additive and Subtractive Technology: An In Vitro Study

Background: This in vitro study set out to find out how well oral cavity-dwelling bacteria can form biofilms and adhere on the surfaces of zirconium oxide samples created by 3D printing and milling technologies. Methods: 5 strains of microorganisms were used for the study, and 40 zirconium oxide samples were prepared, which were divided into two groups (n = 20)-20 samples produced using removal technology comprised the control group, while 20 samples produced by 3D printing technology comprised the test group. The prepared samples were placed in culture media of bacteria and fungi that naturally occur in the oral cavity. Then, the intensity of biofilm build-up on the samples was determined using qualitative and quantitative methods. The results for both materials were compared with each other. Results: No variations in the degree of biofilm deposition on zirconium oxide samples were found for the microorganisms Streptococcus mutans, Pseudomonas aeruginosa, Enterococcus faecalis, and Staphylococcus aureus. For Candida albicans fungi, more intense biofilm deposition was observed on samples made using 3D printing technology, but these differences were not statistically significant. Conclusion: The biofilm accumulation intensity of ceramics produced by additive technology is comparable to that of milled zirconium oxide, which supports the material's broader use in clinical practice from a microbiological perspective. This ceramic has demonstrated its ability to compete with zirconium oxide produced by milling techniques in in vitro experiments, but sadly, no in vivo tests have yet been found to determine how this material will function in a patient's oral cavity.