Decontamination of Dental Implant Surfaces by the Er:YAG Laser Beam: A Comparative in Vitro Study of Various Protocols

Abstract

Oral rehabilitation with dental implants has revolutionized the field of dentistry and has been proven to be an effective procedure. However, the incidence of peri-implantitis has become an emerging concern. The efficacy of the decontamination of the implant surface, by means of lasers, is still controversial. Previous studies have revealed a reduction in osteoblast adhesion to carbon-contaminated implant surfaces. This in-vitro study aimed to evaluate the decontamination of failed implants by assessing the carbon proportion, after irradiation by low-energy erbium yttrium-aluminum-garnet laser (Er:YAG) (Fotona; 2940 nm, Ljubljana, Slovenia) for a single and for multiple passages, until getting a surface, free of organic matters; to find the appropriate procedure for dental-implant surface-decontamination. Ninety implants were used. Thirty sterile implants were kept as a negative control. Thirty failed implants were irradiated by the Er:YAG laser, for a single passage, and the other thirty, for multiple passages. The parameters used in our experiments were an irradiation energy of 50 mJ, frequency of 30 Hz, and an energy density of 3.76 J/cm2. A sapphire tip, with a length of 8 mm, was used with concomitant water spray irrigation, under air 6 and water spray 4. Super short pulse mode (SSP) was of 50 μs; irradiation speed being 2 mm/s. We used energy-dispersive X-ray spectroscopy (EDX) to evaluate the carbon proportion on the surfaces of the sterile implants, the contaminated, and the lased implants, with one (LX1) and with three passages (LX3). Statistical analysis was performed by ANOVA. Results showed mean difference between the three groups (contaminated, LX1, and LX3) with p < 0.0001, as between LX1 and Group A (p < 0.0001), while the difference between LX3 and the control group was not statistically significant. The decontamination of the implant surfaces with a low-energy Er:YAG laser with three passages, appeared to be an encouraging approach.

Q-Switch Nd:YAG Laser-Assisted Decontamination of Implant Surface

“…Unfortunately, the PDT allows germs destruction without any implant surface cleaning. On the other hand, Er:YAG (Erbium-doped yttrium aluminium garnet) laser (laser irradiation with several passages showed promising results in the cleaning of implant surfaces [17]. Though, the reduced flexibility of the Er:YAG laser fiber is a limitation of its use in the deep or complex periimplantitis pockets.…”

The Effects of Erbium-Doped Yttrium Aluminum Garnet Laser (Er: YAG) Irradiation on Sandblasted and Acid-Etched (SLA) Titanium, an In Vitro Study

“…These surface alterations were able to slow down the cellular proliferation, but did not alter the cellular differentiation. On the contrary, Wakim et al have found no significant alteration on SLA titanium surfaces after multiple Er: YAG treatments with irradiation energy 50 mJ, 30 Hz frequency, 1.5 W power output, and 3.76 J/cm 2 energy density, but in this protocol, a super short pulse of 50 us was applied [46]. As a result, reduction to surface micro-roughness could delay or prevent bone bacterial adhesion.…”

Changes in the surface topography and element proportion of clinically failed SLA implants after in vitro debridement by different methods

“…The bacteria‐cultivated titanium disk is a common in vitro experimental model for implant surface debridement in previous studies. Recently, clinical failed implants were used as a better alternative for the comparison of different decontamination protocols (Hakki et al., 2017; Nejem Wakim et al., 2018; Rosen et al., 2018), which provide a more similar contaminated situation in clinical practice, including the calculus, bone debris, soft tissue, residual proteinaceous material and dry stains (Esposito et al., 1999;; Shibli et al., 2004, 2005). However, as the major limitation of the present study, the biofilm deposits had not been evaluated in the methodological approaches utilized.…”