The effect of five mechanical instrumentation protocols on implant surface topography and roughness: A scanning electron microscope and confocal laser scanning microscope analysis

Abstract

Objective:To evaluate in vitro the changes in implant surface topography and roughness of commercial implants after instrumentation with five decontamination protocols.Material and methods: Seventy-two titanium implants with a sandblasted and acidetched (SLA) surface were placed 5 mm supra-crestally. Five groups of twelve implants were instrumented with the following protocols: a metal scaler tip (SCAL), a thermoplastic scaler tip (PEEK), a round titanium brush (RBRU), a tufted brush with titanium bristles (TNBRU), and a glycine-based air-powder abrasive (GLYC). A sixth group with untreated implants was used as control. Scanning electron microscope and confocal laser scanning microscope were utilized to evaluate the changes in the implant surfaces. Results:The SCAL caused pronounced macroscopic alterations and damage of the implant surface, the PEEK left remnants of the plastic tip in the implant surface, and both titanium brush groups flattened the thread profile, while minimal alterations were observed in the GLYC. When compared to the control group, the roughness parameters (Sa) in the buccal aspect increased in the thread area of SCAL, and a minor reduction was observed in the PEEK while in the other groups, these values remained unchanged. In the valley areas, however the RBRU, TNBRU, and GLYC experienced a significant reduction (smoothening) indicating different accessibility of the decontamination protocols to the thread and valley. Similarly, the buccal aspects had more pronounced changes than those in the palatal aspect. Conclusion:Within the limitations of this in vitro investigation, the tested protocols induced different macroscopic alterations and surface roughness changes that varied in the thread and valley area. K E Y W O R D Sconfocal microscope, dental implants, peri-implantitis, scanning electron microscope, surface decontamination, surface macrotopography, titanium | 579 CHA et Al.

In vitro surgical and non-surgical air-polishing efficacy for implant surface decontamination in three different defect configurations

“…A current review on the in vitro efficacy of air-polishing devices on titanium implant surface damages concludes that they are less damaging compared to harder and larger-sized powders such as sodium bicarbonate especially when using glycine-based powder types [41]. These results are confirmed by recent in vitro [26,27] and in vivo [28] studies. On the other hand, there are indications that coarser powder types can achieve a higher cleaning efficacy than finer ones [27].…”

“…The use of glycine-based powder, which is a human protein component, has the advantage of being absorbable and not remaining in a wound as a foreign body. On the other hand, scanning electron microscope (SEM) images have recently shown that glycine-based powder has a less abrasive effect on implant surfaces compared to sodium bicarbonate powder [26][27][28].…”

Supportive treatment following peri‐implantitis surgery: An RCT using titanium curettes or chitosan brushes

“…A recently published in vitro study assessed the surface changes at different parts of the implant threads when different mechanical decontamination tools were applied. The results indicated that certain parts of threaded implants were difficult to reach by the use of mechanical instrumentation (Cha et al., 2019). The inability for instruments to reach especially the “valley areas” and “apically facing” thread surfaces of the implant threads may hamper the efficiency of the mechanical debridement of the implants, making it difficult to eliminate bacterial biofilm formation (Cha et al., 2019; Steiger‐Ronay et al., 2017).…”

Pilot Study on the Use of a Laser-Structured Double Diamond Electrode (DDE) for Biofilm Removal from Dental Implant Surfaces

“…While it may be argued that alternative treatment strategies such as air powder abrasion [15] may have been more appropriate as control, it has to be kept in mind that simple, flat surfaces were considered here, which could be well accessed. This is in contrast to clinical reality, where access for removing biofilm due to surface roughness and the macrodesign of implants [25,27] as well as defect morphology [26] is critical. The double diamond electrodes were kept at a distance of 1 mm to the disc surfaces and despite that, they were at least as effective in biofilm removal as the use of curettes.…”

“…The major challenges in peri-implantitis therapy include the risk of changes in implant surface topography [25] due to instrumentation as well as limited access depending on the morphology of the peri-implant defect [26]. Two recent studies pointed out that the complete removal of biofilms from implant surfaces is not feasible due to the macrodesign of the implants [25,27]. As a result of these limitations, the removal of biofilms based on the electrolysis of water has been advocated [28] as an alternative.…”