Influence of eight debridement techniques on three different titanium surfaces: A laboratory study

Abstract

Objectives: Debridement methods may damage implant surfaces. This in vitro study investigated eight debridement protocols across three implant surfaces to assess both biofilm removal and surface alterations. Material and Methods:One hundred sixty commercially pure titanium discs were treated to simulate commercially available titanium implant surfaces-smooth, abraded and abraded and etched. Following inoculation with whole human saliva to create a mixed species biofilm, the surfaces were treated with eight debridement methods currently used for clinical peri-implantitis (n = 10). This included air abrasion using powders of glycine, sodium bicarbonate and calcium carbonate; conventional mechanical methods-piezoelectric scaler, carbon and stainless steel scalers; and a chemical protocol using 40% citric acid. Following treatment, remaining biofilm was analysed using scanning electron microscopy and crystal violet assays. For statistical analysis, ANOVA was applied (p < 0.05).Results: All debridement techniques resulted in greater than 80% reduction in biofilm compared with baseline, irrespective of the surface type. Glycine powder delivered through an air polishing system eliminated the most biofilm. Mechanical instruments were the least effective at eliminating biofilm across all surfaces and caused the greatest surface alterations. Citric acid was comparable with mechanical debridement instruments in terms of biofilm removal efficacy. Titanium surfaces were least affected by air abrasion protocols and most affected by mechanical methods.Conclusions: Mechanical protocols for non-surgical debridement should be approached with caution. Glycine powder in an air polisher and 40% citric acid application both gave minimal alterations across all implant surfaces, with glycine the superior method in terms of biofilm removal.

A Review of Bacterial Colonization on Dental Implants With Various Hygiene Instruments

“…Most of the studies supported the use of air polishing with glycine powder since it showed significant differences in terms of the effective removal of bacteria on implant surfaces [8,18,19,25]. One study revealed that titanium disks treated with Perioflow demonstrated less Streptococcus gordonii adhesion than the untreated surface, probably due to the difference in surface profiles observed using SEM.…”

“…Meanwhile, another study showed varied effectiveness of sodium bicarbonate air polishing with different titanium surfaces. It was ranked as the third most effective for sandblasted, large grit, acid-etched (SLA) surfaces but was considered the least effective for both abraded and polished titanium surfaces [19].…”