Instrumentation With Ultrasonic Scalers Facilitates Cleaning of the Sandblasted and Acid-Etched Titanium Implants

Abstract

Mechanical instrumentation is widely used to debride dental implants, but this may alter the surface properties of titanium, which in turn may influence bacterial adhesion and make it more difficult to remove the biofilm. This in vitro study was performed (1) to assess the amount of biofilm formation on a sand-blasted and acid-etched titanium fixture treated with ultrasonic scalers with metal, plastic, and carbon tips and (2) to evaluate how this treatment of titanium surfaces affects implant cleaning by brushing with dentifrice. The titanium fixtures were treated with various ultrasonic scaler tips, and surface roughness parameters were measured by confocal microscopy. Biofilm was formed on the treated fixtures by using pooled saliva from 10 subjects, and the quantity of the adherent bacteria was compared with crystal violet assay. The fixture surfaces with biofilm were brushed for total of 30 seconds with a toothbrush with dentifrice. The bacteria remaining on the brushed fixture surfaces were quantified by scanning electron microscopy. Surface changes were evident, and the changes of the surfaces were more discernible when metal tips were used. A statistically significant decrease in roughness value (arithmetic mean height of the surface) was seen in the 2 metal-tip groups and the single plastic-tip group. After brushing with dentifrice, the treated surfaces in all the treatment groups showed significantly fewer bacteria compared with the untreated surfaces in the control group, and the parts of the surfaces left untreated in the test groups. Within the limits of this study, treatment of titanium fixture surfaces with ultrasonic metal, plastic, or carbon tips significantly enhanced the bacterial removal efficacy of brushing. Thorough instrumentation that smooths the whole exposed surface may facilitate maintenance of the implants.

Post‐treatment supportive care for the natural dentition and dental implants

“…Therefore, instruments made of materials softer than titanium have been used. Several in vitro studies have been conducted to investigate the effects of different types of instruments on the roughness of implant surfaces .…”

Decontamination methods to restore the biocompatibility of contaminated titanium surfaces

“…Although the results vary depending on the instrument, many studies have investigated topographical changes of titanium surfaces after instrumentation [1920]. Altered surface topography may adversely affect cell proliferation and cell response.…”

Microbial Biofilm Decontamination on Dental Implant Surfaces: A Mini Review

“…Out of 116 studies, some studies did not use discs (n = 13, 11.2%) (Goncalves et al, 2010;Mohn et al, 2011;Subramanian et al, 2012;Kaliaraj et al, 2014;Lewandowska et al, 2015;Narendrakumar et al, 2015;Park et al, 2015;John et al, 2016;Preissner et al, 2016;Cometa et al, 2017;Schmidt et al, 2017;Azizi et al, 2018;Schmidt et al, 2019). One study performed on discs and other form of titanium (n = 1, 0.9%) , four studies did not state whether they used discs (n = 4, 3.4%) (Cunha et al, 2016;Macpherson et al, 2017;Ramesh et al, 2017;Akhavan et al, 2018), while the others used discs (n = 98, 84.5%) (Schwarz et al, 2005;Duarte et al, 2009;Ewald and Ihde, 2009;Größner-Schreiber et al, 2009;Sennhenn-Kirchner et al, 2009;Tamai et al, 2009;Baffone et al, 2011;Ercan et al, 2011;Fröjd et al, 2011;Ntrouka et al, 2011;Bürgers et al, 2012;Cortizo et al, 2012;Lilja et al, 2012;Rehman et al, 2012;Trujillo The high voltage anodization treatments may contribute to preserving tissue integration and reduce bacteria colonization of titanium and titanium alloy for implant-based applications.…”