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Delucchi F, Ingegnieros L, Pesce P, Baldi D, Canullo L, Bagnasco F, Zunino P, Menini M. Efficacy and safety of erythritol air-polishing in implant dentistry: A systematic review. Int J Dent Hyg 2024. [PMID: 38825804 DOI: 10.1111/idh.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVES Professional oral hygiene is essential to prevent peri-implant disease. Appropriate instruments should be employed for implant-supported restorations: they should effectively remove deposits without damaging dental implant surface. The aim of the present systematic review is to investigate the efficacy and safety of erythritol air-polishing in implant-supported rehabilitations, compared to alternative hygienic techniques. MATERIALS AND METHODS The guidelines reported in the indications of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were employed for this systematic review. The focused question was: 'what is the effect of erythritol air-polishing on dental implant surfaces regarding its cleansing efficacy and/or safety?' The final online search was conducted on 13 August 2023; MEDLINE-PubMed, Scopus and Cochrane Library were employed. Comparative in vitro or in vivo original studies were included. RESULTS The initial database search yielded 128 entries; the final selection comprised 15 articles. The risk of bias was evaluated using the Newcastle Ottawa scale (NOS), the Cochrane Handbook for Systematic Reviews of Interventions, GRADE method. Ultrasonic scaling with PEEK tips, glycine air-polishing and cold atmospheric plasma were the devices most frequently compared to erythritol powder in the included studies. Erythritol air-polishing appeared to be significantly more effective in reducing biofilm compared to other treatments, without causing any significant damage to the implant surface and peri-implant tissues, promoting a good biological response. CONCLUSION Erythritol air-polishing showed promising results for professional oral hygiene in implant-supported restorations. According to this systematic review, it is effective and safe for removing biofilm from titanium dental implants.
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Affiliation(s)
- F Delucchi
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - L Ingegnieros
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - P Pesce
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - D Baldi
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - L Canullo
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - F Bagnasco
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - P Zunino
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - M Menini
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
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Chuchulska B, Dimitrova M, Vlahova A, Hristov I, Tomova Z, Kazakova R. Comparative Analysis of the Mechanical Properties and Biocompatibility between CAD/CAM and Conventional Polymers Applied in Prosthetic Dentistry. Polymers (Basel) 2024; 16:877. [PMID: 38611135 PMCID: PMC11013798 DOI: 10.3390/polym16070877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Modern media often portray CAD/CAM technology as widely utilized in the fabrication of dental prosthetics. This study presents a comparative analysis of the mechanical properties and biocompatibility of CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) polymers and conventional polymers commonly utilized in prosthetic dentistry. With the increasing adoption of CAD/CAM technology in dental laboratories and practices, understanding the differences in material properties is crucial for informed decision-making in prosthodontic treatment planning. Through a narrative review of the literature and empirical data, this study evaluates the mechanical strength, durability, esthetics, and biocompatibility of CAD/CAM polymers in comparison to traditional polymers. Furthermore, it examines the implications of these findings on the clinical outcomes and long-term success of prosthetic restorations. The results provide valuable insights into the advantages and limitations of CAD/CAM polymers, informing clinicians and researchers about their suitability for various dental prosthetic applications. This study underscores the considerable advantages of CAD/CAM polymers over conventional ones in terms of mechanical properties, biocompatibility, and esthetics for prosthetic dentistry. CAD/CAM technology offers improved mechanical strength and durability, potentially enhancing the long-term performance of dental prosthetics, while the biocompatibility of these polymers makes them suitable for a broad patient demographic, reducing the risk of adverse reactions. The practical implications of these findings for dental technicians and dentists are significant, as understanding these material differences enables tailored treatment planning to meet individual patient needs and preferences. Integration of CAD/CAM technology into dental practices can lead to more predictable outcomes and heightened patient satisfaction with prosthetic restorations.
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Affiliation(s)
- Bozhana Chuchulska
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (I.H.); (Z.T.); (R.K.)
| | - Mariya Dimitrova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (I.H.); (Z.T.); (R.K.)
| | - Angelina Vlahova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (I.H.); (Z.T.); (R.K.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Ilian Hristov
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (I.H.); (Z.T.); (R.K.)
| | - Zlatina Tomova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (I.H.); (Z.T.); (R.K.)
| | - Rada Kazakova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (I.H.); (Z.T.); (R.K.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
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Chen A, Ghaffar H, Taib H, Hassan A. A Review of Bacterial Colonization on Dental Implants With Various Hygiene Instruments. Cureus 2023; 15:e47483. [PMID: 38021779 PMCID: PMC10663103 DOI: 10.7759/cureus.47483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Peri-implant diseases can still develop despite oral hygiene practices being maintained. Consequently, regular debridement must be carried out to ensure the implant is sustained. This review evaluated bacterial colonization on implants following the use of different hygiene instruments. A literature search was conducted in PubMed, ScienceDirect, and Scopus databases for articles published from 2012 to 2022. A total of 19 full-text papers were selected. The number of bacteria colonized was most commonly evaluated with a scanning electron microscope (SEM) or by colony-forming unit (CFU) counts, crystal violet assays, plaque index, probing depth, bleeding on probing, turbidity test, and live-dead assays. Rubber cup polishing with an abrasive paste showed a significantly greater reduction in biofilm formation compared with air abrasion with glycine powder, while the air abrasion treatment was found to be more efficient than piezoelectric, carbon, and stainless steel scalers. Surface treatment with Er, Cr: YSGG laser, and Er: YAG laser resulted in statistically significant superior dental biofilm removal compared with titanium curettes and photodynamic therapy. Air abrasion, plastic curette, titanium curette, and ultrasonic scaler showed no significant differences in bacterial colonization, but air abrasion and plastic curette were safer for zirconia implant decontamination. Furthermore, the titanium brush showed better results in decontaminating the implant surface than the Er: YAG laser. Although no single instrument or method could be considered as offering a gold standard in treating peri-implant diseases, the use of air abrasion with glycine powder, laser therapies, rubber cup polishing with an abrasive paste, and a titanium brush had high levels of cleaning efficacy and acceptance by patients.
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Affiliation(s)
- Ashmita Chen
- School of Dental Sciences, Universiti Sains Malaysia, Kelantan, MYS
| | - Hareem Ghaffar
- School of Dental Sciences, Universiti Sains Malaysia, Kelantan, MYS
| | - Haslina Taib
- School of Dental Sciences, Universiti Sains Malaysia, Kelantan, MYS
| | - Akram Hassan
- School of Dental Sciences, Universiti Sains Malaysia, Kelantan, MYS
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Chuchulska B, Hristov I, Dochev B, Raychev R. Changes in the Surface Texture of Thermoplastic (Monomer-Free) Dental Materials Due to Some Minor Alterations in the Laboratory Protocol-Preliminary Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6633. [PMID: 36233975 PMCID: PMC9570521 DOI: 10.3390/ma15196633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Contemporary thermoplastic monomer-free prosthetic materials are widely used nowadays, and there are a great variety available on the market. These materials are of interest in terms of the improvement of the quality features of the removable dentures. The aim of this study is to establish how minimal changes in the laboratory protocol of polyamide prosthetic base materials influence the surface texture. Two polyamide materials intended for the fabrication of removable dentures bases were used-Perflex Biosens (BS) and VertexTM ThermoSens (TS). A total number of 20 coin-shaped samples were prepared. They were injected under two different modes-regular, as provided by the manufacturer, and modified, proposed by the authors of this study. Scanning electronic microscopy (SEM) under four magnifications-×1000, ×3000, ×5000, and ×10,000-was conducted. With minimal alterations to the melting temperature (5 °C) and the pressure (0.5 Bar), in Biosens, no changes in terms of surface improvement were found, whereas in ThermoSens, the surface roughness of the material significantly changed in terms of roughness reduction. By modifying the technological mode during injection molding, a smoother surface was achieved in one of the studied materials.
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Affiliation(s)
- Bozhana Chuchulska
- Department of Prosthetic Dental Medicine, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Ilian Hristov
- Department of Prosthetic Dental Medicine, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Boyan Dochev
- Department of Mechanics, Faculty of Mechanical Engineering, Technical University of Sofia, Branch Plovdiv, 4000 Plovdiv, Bulgaria
| | - Raycho Raychev
- Department of Mechanics, Faculty of Mechanical Engineering, Technical University of Sofia, Branch Plovdiv, 4000 Plovdiv, Bulgaria
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Tan NCP, Miller CM, Antunes E, Sharma D. Impact of physical decontamination methods on zirconia implant surface and subsequent bacterial adhesion: An in-vitro study. Clin Exp Dent Res 2021; 8:313-321. [PMID: 34599862 PMCID: PMC8874065 DOI: 10.1002/cre2.486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the effect of routinely used physical decontamination methods on the surface characteristics of zirconia implants and subsequent ability of bacteria to adhere in vitro. Background Physical decontamination methods commonly used in peri‐implantitis therapy and routine implant maintenance can potentially alter zirconia implant surfaces. Methods Acid‐etched zirconia discs were instrumented with titanium curette (TC), plastic curette, air abrasive device, ultrasonic scaler (US) with stainless steel tip. Following instrumentation, surface topography, and surface elemental composition was analyzed using 3D‐laser scanning microscopy and energy‐dispersive X‐ray spectroscopy, respectively. Subsequently, plaque biofilm was cultured on zirconia discs for 48 h and bacterial adhesion assessed using a turbidity test and scanning electron microscopy. Results A significant difference in surface roughness was observed between the US and control group (p < 0.05). The US and TC caused gray surface discolouration on zirconia discs due to deposition of metallic residue as confirmed by X‐ray spectroscopy. No significant difference in bacterial adhesion was noted among all treatment groups (p > 0.05). Conclusion TC and US with stainless steel tips should be used with caution due to deposition of metallic residue on the surface. Air abrasive devices and plastic curettes caused minimal surface alterations and are, therefore, safer for zirconia implant decontamination.
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Affiliation(s)
- Nathan Chiang Ping Tan
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, Australia
| | - Catherine M Miller
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Queensland, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Queensland, Australia
| | - Elsa Antunes
- College of Science and Engineering, James Cook University, Townsville, Queensland, Australia
| | - Dileep Sharma
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Queensland, Australia
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Tan NCP, Khan A, Antunes E, Miller CM, Sharma D. The effects of physical decontamination methods on zirconia implant surfaces: a systematic review. J Periodontal Implant Sci 2021; 51:298-315. [PMID: 34713992 PMCID: PMC8558004 DOI: 10.5051/jpis.2005080254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/25/2021] [Accepted: 03/05/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Peri-implantitis therapy and implant maintenance are fundamental practices to enhance the longevity of zirconia implants. However, the use of physical decontamination methods, including hand instruments, polishing devices, ultrasonic scalers, and laser systems, might damage the implant surfaces. The aim of this systematic review was to evaluate the effects of physical decontamination methods on zirconia implant surfaces. METHODS A systematic search was conducted using 5 electronic databases: Ovid MEDLINE, PubMed, Scopus, Web of Science, and Cochrane. Hand searching of the OpenGrey database, reference lists, and 6 selected dental journals was also performed to identify relevant studies satisfying the eligibility criteria. RESULTS Overall, 1049 unique studies were identified, of which 11 studies were deemed suitable for final review. Air-abrasive devices with glycine powder, prophylaxis cups, and ultrasonic scalers with non-metal tips were found to cause minimal to no damage to implant-grade zirconia surfaces. However, hand instruments and ultrasonic scalers with metal tips have the potential to cause major damage to zirconia surfaces. In terms of laser systems, diode lasers appear to be the most promising, as no surface alterations were reported following their use. CONCLUSION Air-abrasive devices and prophylaxis cups are safe for zirconia implant decontamination due to preservation of the implant surface integrity. In contrast, hand instruments and ultrasonic scalers with metal tips should be used with caution. Recommendations for the use of laser systems could not be fully established due to significant heterogeneity among included studies, but diode lasers may be the best-suited system. Further research-specifically, randomised controlled trials-would further confirm the effects of physical decontamination methods in a clinical setting.
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Affiliation(s)
| | - Ahsen Khan
- College of Medicine and Dentistry, James Cook University, Smithfield, Australia
| | - Elsa Antunes
- College of Science and Engineering, James Cook University, Smithfield, Australia
| | - Catherine M Miller
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Australia
| | - Dileep Sharma
- College of Medicine and Dentistry, James Cook University, Smithfield, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Australia.
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Kligman S, Ren Z, Chung CH, Perillo MA, Chang YC, Koo H, Zheng Z, Li C. The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation. J Clin Med 2021; 10:1641. [PMID: 33921531 PMCID: PMC8070594 DOI: 10.3390/jcm10081641] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant's surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.
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Affiliation(s)
- Stefanie Kligman
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Zhi Ren
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Michael Angelo Perillo
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Yu-Cheng Chang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Hyun Koo
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
- Center for Innovation & Precision Dentistry, School of Dental Medicine and School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhong Zheng
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
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Sahrmann P, Winkler S, Gubler A, Attin T. Assessment of implant surface and instrument insert changes due to instrumentation with different tips for ultrasonic-driven debridement. BMC Oral Health 2021; 21:25. [PMID: 33413296 PMCID: PMC7791805 DOI: 10.1186/s12903-020-01384-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/23/2020] [Indexed: 12/04/2022] Open
Abstract
Background To assess the changes of implant surfaces of different roughness after instrumentation with ultrasonic-driven scaler tips of different materials. Methods Experiments were performed on two moderately rough surfaces (I—Inicell® and II—SLA®), one surface without pre-treatment (III) and one smooth machined surface (IV). Scaler tips made of steel (A), PEEK (B), titanium (C), carbon (D) and resin (E) were used for instrumentation with a standardized pressure of 100 g for ten seconds and under continuous automatic motion. Each combination of scaler tip and implant surface was performed three times on 8 titanium discs. After instrumentation roughness was assessed by profilometry, morphological changes were assessed by scanning electron microscopy, and element distribution on the utmost surface by energy dispersive X-ray spectroscopy. Results The surface roughness of discs I and II were significantly reduced by instrumentation with all tips except E. For disc III and IV roughness was enhanced by tip A and C and, only for IV, by tip D. Instrumentation with tips B, D and E left extensive residuals on surface I, II and III. The element analysis of these deposits proved consistent with the elemental composition of the respective tip materials. Conclusion All ultrasonic instruments led to microscopic alterations of all types of implants surfaces assessed in the present study. The least change of implant surfaces might result from resin or carbon tips on machined surfaces.
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Affiliation(s)
- Philipp Sahrmann
- Clinic of Conservative and Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Sophie Winkler
- Clinic of Conservative and Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Andrea Gubler
- Clinic of Conservative and Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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In vitro surgical and non-surgical air-polishing efficacy for implant surface decontamination in three different defect configurations. Clin Oral Investig 2020; 25:1743-1754. [PMID: 32813077 PMCID: PMC7966646 DOI: 10.1007/s00784-020-03476-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/24/2020] [Indexed: 12/12/2022]
Abstract
Objectives Evaluation of surgical and non-surgical air-polishing in vitro efficacy for implant surface decontamination. Material and methods One hundred eighty implants were distributed to three differently angulated bone defect models (30°, 60°, 90°). Biofilm was imitated using indelible red color. Sixty implants were used for each defect, 20 of which were air-polished with three different types of glycine air powder abrasion (GAPA1–3) combinations. Within 20 equally air-polished implants, a surgical and non-surgical (with/without mucosa mask) procedure were simulated. All implants were photographed to determine the uncleaned surface. Changes in surface morphology were assessed using scanning electron micrographs (SEM). Results Cleaning efficacy did not show any significant differences between GAPA1–3 for surgical and non-surgical application. Within a cleaning method significant (p < 0.001) differences for GAPA2 between 30° (11.77 ± 2.73%) and 90° (7.25 ± 1.42%) in the non-surgical and 30° (8.26 ± 1.02%) and 60° (5.02 ± 0.84%) in the surgical simulation occurred. The surgical use of air-polishing (6.68 ± 1.66%) was significantly superior (p < 0.001) to the non-surgical (10.13 ± 2.75%). SEM micrographs showed no surface damages after use of GAPA. Conclusions Air-polishing is an efficient, surface protective method for surgical and non-surgical implant surface decontamination in this in vitro model. No method resulted in a complete cleaning of the implant surface. Clinical relevance Air-polishing appears to be promising for implant surface decontamination regardless of the device.
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