Abstract
The aim of this study is to test the cleaning effect and surface modification of a new implant surface treatment on explanted dental implants and titanium discs. It is a modified air powder abrasive (APA) treatment applied using osteoconductive powders. Twenty‐eight in vitro Ca‐precipitated organic film‐coated titanium discs and 13 explanted dental implants were treated. In a 2‐step approach, 3 powders were used: hydroxylapatite (HA) and biomimetic calcium phosphate (BioCaP), which are osteoconductive, and erythritol, which is not. APA treatment was applied. (Air pressure: 2.4 bar; water flow for cleaning: 41.5 ml/min, for Coating 1: 2.1 ml/min, and for Coating 2: 15.2 ml/min.) The test groups were as follows: Group 1: HA cleaning + BioCaP Coating 1; Group 2: HA cleaning + BioCaP Coating 2; Group 3: erythritol cleaning + BioCaP Coating 1; Group 4: erythritol cleaning + BioCaP Coating 2; Group 5: HA cleaning; Group 6: erythritol cleaning; and control: no powder. Cleaned areas were calculated by point counting method. Surface changes and chemical content were evaluated using light microscopy, scanning electron microscopy, and energy‐dispersive X‐ray spectroscopy. Cleaning effect between groups was compared by a pairwise Student's t test. The significance level was fixed at p < .05. Cleaning effect on the discs was 100% in all test groups and 5% in the control. Powder particles in varying size and shape were embedded on the surface. All HA‐ or CaP‐treated surfaces showed Ca and P content but no surface damage. Calcified biofilm remnants were removed from the implant surface by the test groups, whereas in control groups, they remained. APA treatment with CaP and HA powders under clinically applicable pressure settings gives positive results in vitro; therefore, they could be promising when used in vivo.
Highlights
The treatment of peri‐implantitis is primarily focused on elimination of the infection and restoration of the original peri‐implant condition (Baron, Haas, Dortbudak, & Watzek, 2000)
According to the studies done by Persson, Araujo, Berglundh, Grondahl, and Lindhe (1999) and Wetzel, Vlassis, Caffesse, Hämmerle, and Lang (1999) even after biofilm removal, the true reosseointegration is very difficult to achieve on previously contaminated implant surfaces
We suggested to apply the air powder abrasive (APA) treatment with osteoconductive powders that would remove the biofilm and improve the surface properties in favor to reosseointegration (Tastepe, Liu, Visscher, & Wismeijer, 2013)
Summary
The treatment of peri‐implantitis is primarily focused on elimination of the infection and restoration of the original peri‐implant condition (Baron, Haas, Dortbudak, & Watzek, 2000). On the basis of the outcome of the studies, it was concluded that the problem inherent in the reosseointegration appears to be the implant surface rather than the host tissues at the site (Persson, Berglundh, Lindhe, & Sennerby, 2001) To overcome this problem, implant surface treatment methods should remove the biofilm and debris and restore the initial implant surface properties or even improve them. We suggested to apply the APA treatment with osteoconductive (hydroxylapatite [HA], calcium phosphate [CaP], and TiO2) powders that would remove the biofilm and improve the surface properties in favor to reosseointegration (Tastepe, Liu, Visscher, & Wismeijer, 2013). If the results of this in vitro study are positive, this treatment approach may be promising when used in vivo
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