Assessment of implant surface and instrument insert changes due to instrumentation with different tips for ultrasonic-driven debridement

Philipp Sahrmann,Thomas Attin,Andrea Gubler,Sophie Winkler

doi:10.1186/s12903-020-01384-0

Abstract

BackgroundTo assess the changes of implant surfaces of different roughness after instrumentation with ultrasonic-driven scaler tips of different materials.MethodsExperiments 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.ResultsThe 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.ConclusionAll 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.

Highlights

To assess the changes of implant surfaces of different roughness after instrumentation with ultrasonicdriven scaler tips of different materials
While ultrasonic instrumentation is an uncomplicated measure for periodontal defects, for the treatment of peri-implantitis, one major problem exists concerning these devices: Since titanium alloys are rather soft materials, mechanical debridement with tips of hard materials like steel or titanium have been reported to change the elaborate surface topography of the pristine implant [11, 12]
Softer materials have been proposed for ultrasonic-driven tips that are used for implant surface debridement with the aim to avoid injury of the original surface morphology

Summary

Introduction

To assess the changes of implant surfaces of different roughness after instrumentation with ultrasonicdriven scaler tips of different materials. While ultrasonic instrumentation is an uncomplicated measure for periodontal defects, for the treatment of peri-implantitis, one major problem exists concerning these devices: Since titanium alloys are rather soft materials, mechanical debridement with tips of hard materials like steel or titanium have been reported to change the elaborate surface topography of the pristine implant [11, 12] Such changes refer to surface characteristics like roughness and hydrophilic properties, which can negatively affect healing in terms of osseo-integration when a regenerative approach is considered [13, 14] and may abet bacterial recolonization of formerly smooth surfaces [15]. Comprehensive studies involving different types of implant surfaces and a selection of the most frequently used ultrasonic tips that would be evaluated under standardized settings regarding treatment time, controlled contact pressure and standardized movements, seem to be lacking

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