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Biological Film

In the field of implantology and oral surgery, the term biological film encompasses distinct clinical realities. Sometimes a vector of infectious complications, sometimes a support for healing, the biological film represents a major factor in the success of surgical procedures. This article reviews the various forms of biological films encountered in clinical practice, along with recommendations for controlling or leveraging them for the patient’s benefit.

1. The microbial biofilm: a silent enemy of implants

The biofilm is an organized structure of microorganisms—mainly bacteria—embedded in an extracellular matrix they produce. This film forms rapidly on the surface of any biomaterial exposed to the oral environment, especially dental implants.

Formation mechanisms

Initial colonization occurs within hours after implant placement, with adhesion of commensal bacteria. If the biofilm is not controlled, it may evolve into a pathogenic anaerobic flora responsible for mucositis and peri-implantitis.

Clinical consequences

Persistent gingival inflammation

Peri-implant bone resorption

Failure of osseointegration

Risk of systemic dissemination (depending on patient health)

Prevention and control

Controlling biofilm involves:

Rigorous preoperative antisepsis (e.g., chlorhexidine)

Optimized sterilization protocol for instruments and surgical field

Customized postoperative implant maintenance

2. The biological film as a regenerative support

In a completely different context, biological film can also refer to a surgical membrane, often collagen-based, used in regenerative surgery.

Functions of biological membranes

Promote guided bone regeneration (GBR) or guided tissue regeneration (GTR)

Create a physical barrier between connective tissue and the bone regeneration site

Stabilize the blood clot and support angiogenesis

Types of membranes

Membrane type

Resorption

Origin

Indications

Collagen

Resorbable

Human or animal

Bone augmentation, socket preservation

PTFE (ePTFE, dPTFE)

Non-resorbable

Synthetic

Complex defects, sinus lifts

Selection criteria

Biocompatibility

Resorption time suited to healing period

Mechanical strength

Ease of handling

3. Biological residues and sterilization: beware the organic film

The biological film can also refer to organic residues (blood, proteins, tissues) that adhere to reusable medical devices during reprocessing.

Associated risks

Reduced sterilization effectiveness (biofilm protects bacteria)

Risk of cross-contamination between patients

Premature degradation of instruments

Best practices

Immediate post-use cleaning (enzymatic bath)

Use of non-abrasive brushes

Visual inspection and cleanliness tests (e.g., ATP or methylene blue test)

Validation of the sterilization cycle (class B autoclave)

Conclusion

The biological film is a multifaceted concept in implantology—sometimes an infectious issue to manage, other times a valuable therapeutic tool to integrate into treatment plans. Understanding its formation mechanisms, applications, and impacts is essential to optimize clinical outcomes and ensure patient safety.