The effect of Er:YAG laser treatment on biofilm formation on titanium and zirconia disc surfaces

Abstract

Background Lasers represent a promising method for implant decontamination, but evidence on implant surface changes and subsequent biofilm formation is limited. This study aimed to assess the effect of erbium‐doped yttrium aluminum garnet (Er:YAG) laser treatment on zirconia and titanium discs, and the differences in biofilm formation as a result of surface alterations. Methods A two‐stage (in vitro and in vivo) experiment utilizing Er:YAG laser on titanium and zirconia discs was performed. In vitro, surface alterations, roughness, and elemental‐material weight differences following laser treatment were assessed using scanning electron microscopy and atomic force microscopy. In vivo, four participants wore custom‐made intra‐oral stents, embedded with laser‐treated and untreated titanium and zirconia discs overnight. Biofilm‐coated discs were stained using nucleic acid fluorescence dye and visualized using multiphoton confocal laser scanning microscopy. Biofilm 3D structure, biomass, thickness, and live‐to‐dead bacteria ratio were assessed. Results Both titanium and zirconia discs treated with Er:YAG laser resulted in visual surface alterations, but showed no significant change in average surface roughness (titanium P = 0.53, zirconia P = 0.34) or elemental‐material‐weight (titanium, P = 0.98), (zirconia, P = 0.96). No significant differences in biofilm biomass, average thickness, and live‐to‐dead bacteria ratio of laser‐treated titanium and zirconia discs were identified compared to untreated groups (titanium P > 0.05, zirconia P > 0.05). Generally, zirconia discs presented with a lower live‐to‐dead bacteria ratio compared to titanium discs, regardless of laser treatment. Conclusion Er:YAG laser treatment of titanium and zirconia implant surfaces does not significantly affect surface roughness, elemental material weight, or early biofilm formation in the oral cavity.

In vitro efficacy of non‐surgical and surgical implant surface decontamination methods in three different defect configurations in the presence or absence of a suprastructure

“…were not examined in this study. 31,32,39 The decontamination methods were originally chosen because they represent the usual methods from subgingival instrumentation around teeth and probably reflect the standard in general dental practices. 17 To maintain the comparability of the in vitro studies, 16 the decontamination methods were not changed.…”

“…For clinical use, air‐polishing devices are superior to rigid instruments like CUR and SOSC at all defect angles and in both surgical and non‐surgical procedures 16,17,19,20 . However, the surgical application of air‐polishing devices represents an off‐label use, and there are other decontamination methods (e.g., titanium brush, laser) that were not examined in this study 31,32,39 . The decontamination methods were originally chosen because they represent the usual methods from subgingival instrumentation around teeth and probably reflect the standard in general dental practices 17 .…”