Effect of implantoplasty on fracture resistance and surface roughness of standard diameter dental implants

Abstract

Objective: To assess the effect of implantoplasty on the fracture resistance, surface roughness, and macroscopic morphology of standard diameter (4.1 mm) external connection dental implants. Materials and methods:An in vitro study was conducted in 20 screw-shaped titanium dental implants with an external connection. In 10 implants, the threads and surface were removed and polished with high-speed burs (implantoplasty), while the remaining 10 implants were used as controls. The final implant dimensions were recorded.The newly polished surface quality was assessed by scanning electron microscopy (SEM) and by 3D surface roughness analysis using a confocal laser microscope. Finally, all the implants were subjected to a mechanical pressure resistance test. A descriptive analysis of the data was made. Also, Student's t tests were employed to detect differences regarding the compression tests.Results: Implantoplasty was carried out for a mean time of 10 min and 48 s (standard deviation (SD) of 1 min 22 s). Macroscopically, the resulting surface had a smooth appearance, although small titanium shavings and silicon debris were present. The final surface roughness (S a values 0.1 ± 0.02 μm) was significantly lower than that of the original (0.75 ± 0.08 μm S a ) (p = .005). There was minimal reduction in the implant's inner body diameter (0.19 ± 0.03 mm), and no statistically significant differences were found between the test and control implants regarding the maximum resistance force (896 vs 880 N, respectively).Conclusions: Implantoplasty, although technically demanding and time-consuming, does not seem to significantly alter fracture resistance of standard diameter external connection implants. A smooth surface with S a values below 0.1 μm can be obtained through the use of silicon polishers. A larger sample is required to confirm that implantoplasty does not significantly affect the maximum resistance force of standard diameter external connection implants.

Mechanical and biological complications after implantoplasty—A systematic review

“…Implantoplasty did not affect significantly implant strength and resistance to fracture of wide diameter implants (i.e., 4.7 mm diameter; Chan et al, ). In contrast, variable results were reported for narrow/regular diameter implants (i.e., 3.75–4.1 mm diameter); in one study, a minimal reduction (i.e., 0.2 mm) in the core diameter of the implant did not significantly affect implant strength (Costa‐Berenguer et al, ), while average strength reduction of about 17%–40%—depending on implant platform/connection design—was observed in two other studies (Chan et al, ; Gehrke et al, ). In a finite element analysis (Tribst et al, ), implantoplasty resulted in a stress increase on the implant body of 44%–85%, more or less independent of the extent of simulated bone loss height, thus also of the extent—in height—of implant grinding; implantoplasty did not affect bone micro‐strain, which depended on the extent of simulated bone loss and was critical when the endo‐osseous portion of the implant was smaller than the exposed portion.…”

“…Kappa scores regarding agreement on the articles to be included in the full‐text analysis and those finally chosen were 0.91 and 0.95, respectively ( p < 0.001). Out of a total of 391 records assessed, 26 publications were finally included: six laboratory (Chan et al, ; Costa‐Berenguer et al, ; Gehrke, Aramburú Júnior, Dedavid, & Shibli, ; Sharon, Shapira, Wilensky, Abu‐Hatoum, & Smidt, ; de Souza Júnior et al, ; Tribst, Piva, Shibli, Borges, & Tango, ), two preclinical in vivo (Schwarz, Mihatovic, Golubovic, Becker, & Sager, ; Schwarz, Sahm, Mihatovic, Golubovic, & Becker, ), and 18 clinical publications (Englezos, Cosyn, Koole, Jacquet, & De Bruyn, ; Geremias et al, ; Matarasso et al, ; Nart, de Tapia, Pujol, Pascual, & Valles, ; Pommer et al, ; Ramanauskaite, Becker, Juodzbalys, & Schwarz, ; Romeo et al, ; Sapata, de Souza, Sukekava, Villar, & Neto, ; Schwarz et al, ; Schwarz, John, & Becker, ; Schwarz, John, Mainusch, Sahm, & Becker, ; Schwarz, John, Sahm, & Becker, ; Schwarz, John, Schmucker, Sahm, & Becker, ; Schwarz, Sahm, & Becker, ; Schwarz, Sahm, Iglhaut, et al, ; Suh, Simon, Jeon, Choi, & Kim, ; Thierbach & Eger, ). The two preclinical in vivo publications (Schwarz, Mihatovic, et al, ; Schwarz, Sahm, Mihatovic, et al, ) and the clinical of Romeo et al () and Romeo et al () publications reported on different aspects basically of the same study population.…”

“…While the complications during the procedure might be avoidable, if care is taken, the late complications might not be able to control, as they are depended on the altered (weakened) mechanical properties of the implant. Indeed, the laboratory studies included in this review have indicated that narrow/standard—but not wide—diameter implants suffer from a variable, mostly significant, extent of weakening due to implantoplasty (Chan et al, ; Costa‐Berenguer et al, ; Gehrke et al, ). In this context, the information regarding the clinical performance of implants subjected to implantoplasty is based on relatively limited numbers, with short‐ to medium‐term follow‐up, which may be considered as limitation of the current review.…”

Two to six‐year disease resolution and marginal bone stability rates of a modified resective‐implantoplasty therapy in 32 peri‐implantitis cases

“…19,[25][26][27] Studies have reported that the clinical prognosis of peri-implantitis resective therapy could be influenced by pre-surgical initial probing depths of more than 7mm. 20,37 Even though, various studies claim that implatoplasty may or may not induce implant fracture, 16 F I G U R E 3 Distribution of implants for follow-up time and implant failure rate implantoplasty technique could be a "promising" surgical therapy for peri-implantitis resolution. This gently reduction of the implant diameter, associated with the bone recontouring, will allow to separate the supracrestal area from the intra-bony area like in a platform switch format, counteracting possibly future MBL.…”

“…12 This approach pursuits to reduce biofilm accumulation in the rough exposed implant surfaces, since it has been reported by numerous studies that a rough surface can protect biofilm from shear forces executed by mechanical debridement, 13,14 allowing its growth and persistence as a local factor for progressive PI disease. 12,15 Nevertheless, implantoplasty has been criticized since it is a demanding technique that could increase the implant susceptibility to fracture 16,17 and the released titanium particles could induce an inflammatory process of the adjacent tissues. in vitro studies have also reported that a smooth surface enhances fibroblast adherence and consequently can help to recuperate peri-implant soft tissue health.…”