The Effects of Ultrasonic Scaling and Air-Abrasive Powders on the Decontamination of 9 Implant-Abutment Surfaces: Scanning Electron Analysis and In Vitro Study

Key topographic parameters driving surface adhesion of Porphyromonas gingivalis

Dental implant failure is primarily due to peri-implantitis, a consequence of bacterial biofilm formation. Bacterial adhesion is strongly linked to micro-/nano-topographies of a surface; thus an assessment of surface texture parameters is essential to understand bacterial adhesion. In this study, mirror polished titanium samples (Ti6Al4V) were irradiated with a femtosecond laser (fs-L) at a wavelength of 1030 nm (infrared) with variable laser parameters (laser beam polarization, number, spacing and organization of the impacts). Images of 3-D topographies were obtained by focal variation microscopy and analyzed with MountainsMap software to measure surface parameters. From bacteria associated with peri-implantitis, we selected Porphyromonas gingivalis to evaluate its adhesion on Ti6Al4V surfaces in an in vitro study. Correlations between various surface parameters and P. gingivalis adhesion were investigated. We discovered that Sa value, a common measure of surface roughness, was not sufficient in describing the complexity of these fs-L treated surfaces and their bacterial interaction. We found that Sku, density and mean depths of the furrows, were the most accurate parameters for this purpose. These results provide important information that could help anticipate the bacterial adhesive properties of a surface based on its topographic parameters, thus the development of promising laser designed biofunctional implants.

The efficacy of different implant surface decontamination methods using spectrophotometric analysis: an in vitro study

PURPOSE

Various methods have been proposed to achieve the nearly complete decontamination of the surface of implants affected by peri-implantitis. We investigated the in vitro debridement efficiency of multiple decontamination methods (Gracey curettes [GC], glycine air-polishing [G-Air], erythritol air-polishing [E-Air] and titanium brushes [TiB]) using a novel spectrophotometric ink-model in 3 different bone defect settings (30°, 60°, and 90°).

METHODS

Forty-five dental implants were stained with indelible ink and mounted in resin models, which simulated standardised peri-implantitis defects with different bone defect angulations (30°, 60°, and 90°). After each run of instrumentation, the implants were removed from the resin model, and the ink was dissolved in ethanol (97%). A spectrophotometric analysis was performed to detect colour remnants in order to measure the cumulative uncleaned surface area of the implants. Scanning electron microscopy images were taken to assess micromorphological surface changes.

RESULTS

Generally, the 60° bone defects were the easiest to debride, and the 30° defects were the most difficult (ink absorption peak: 0.26±0.04 for 60° defects; 0.32±0.06 for 30° defects; 0.27±0.04 for 90° defects). The most effective debridement method was TiB, independently of the bone defect type (TiB vs. GC: P<0.0001; TiB vs. G-Air: P=0.0017; TiB vs. GE-Air: P=0.0007). GE-Air appeared to be the least efficient method for biofilm debridement.

CONCLUSIONS

T-brushes seem to be a promising decontamination method compared to the other techniques, whereas G-Air was less aggressive on the implant surface. The use of a spectrophotometric model was shown to be a novel but promising assessment method for in vitro ink studies.

New Implant Materials

In the last forty years, dental implantology has become a widespread worldwide clinical practice in medicine, able to rehabilitate partial or full human edentulism of the jaw and highly successful over the long term [...].

Dental Materials Design and Innovative Treatment Approach

In recent years, technological innovation has had exponential growth, resulting in positive implications in dentistry [...]

Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report

Implantology represents the gold standard in oral rehabilitation. Unfortunately, a new pathology begins to show itself to clinicians that no longer affects only and solely the supporting tissues of the tooth but also dental implants and peri-implantitis. In this study, we present a case report regarding a tissue regeneration maneuver involving dental implants. The clinical and radiographic results are encouraging, regarding the use of these techniques on implant surfaces. Surely, the advent of new biomaterials and surgical techniques will make this practice safe and predictable.