Laboratory Investigation of the Effect of Three Decontamination Methods on Surface Alterations of Dental Implants

Cell Attachment Following Instrumentation with Titanium and Plastic Instruments, Diode Laser, and Titanium Brush on Titanium, Titanium-Zirconium, and Zirconia Surfaces.

An essential component of peri-implantitis treatment is the effective decontamination of implant surfaces. The ideal decontamination technique should safely and efficiently remove biofilm without damaging the implant surface. This pilot study aimed to evaluate the cleaning efficacy and surface alterations associated with three mechanical decontamination protocols. Here, 12 implants were stained with indelible red ink and mounted into acrylic blocks to simulate horizontal peri-implant defects. Surface decontamination was performed for 2 min by the same examiner using one of the following devices: titanium brush (TiB), chitosan brush (ChB), or titanium curette (TiC). No chemical decontamination agents were used in combination with the mechanical tools. Standardized photographs were taken before and after the decontamination from buccal and oral frontal views, as well as at 30° and 60° angulations. The uncleaned implant surface area was calculated digitally. Scanning electron microscopy (SEM) was used to assess surface morphology. None of the tested methods achieved complete removal of the ink stain. Although 75.98% ± 2.42% of the stain remained, TiB showed the highest cleaning efficacy at buccal and oral frontal views (p = 0.027), followed by TiC (80.3% ± 0.86% stain remaining) and ChB (90.34% ± 6.07% stain remaining). Significant differences were observed between the ChB and TiB groups (p = 0.022). SEM analysis revealed that the TiC caused the greatest surface damage, whereas the TiB produced minimal alterations. Within the limitations of this pilot study, TiB demonstrated effective cleaning while preserving implant surface morphology. These findings suggest that titanium brushes may represent a safer and more efficient mechanical decontamination option during peri-implantitis treatment. However, further studies are warranted to evaluate combinations of mechanical and chemical techniques to enhance cleaning efficacy.

The objective of this study is to evaluate titanium decontamination after different protocols while assessing changes in surface roughness, chemical composition, and wettability. Ninety-six smooth (S) and 96 minimally rough (R) titanium microimplants were used. Pristine microimplants were reserved for negative control (S-nC/R-nC, n=9), while the remaining microimplants were incubated in Escherichia coli culture. Non-decontaminated microimplants were used as positive control (S-pC/R-pC, n=3). The other microimplants were divided into seven different decontamination protocols (12 S/R per group): 24% EDTA, 2% chlorhexidine (CHL), gauze soaked in 2% chlorhexidine (GCHL), gauze soaked in ultrapure water (GMQ), scaling (SC), titanium brush (TiB), and implantoplasty (IP). Contaminated areas were assessed by scanning electron microscope images, chemical composition by energy dispersive X-ray spectroscopy, wettability by meniscus technique, and roughness by an optical profiler. Higher residual bacteria were observed in R-pC compared with S-pC (P<0.0001). When comparing S and R with their respective pC groups, the best results were obtained with GCHL, SC, TiB, and IP, with no difference between these protocols (P>0.05). Changes in surface roughness were observed after all treatments, with S/R-IP presenting the smoother and a less hydrophilic surface (P<0.05). Apart from IP protocol, all the other groups presented a more hydrophilic surface in R than in S microimplants (P<0.003). All decontamination protocols resulted in a lower percentage of superficial Ti when compared with S/R-nC (P<0.002). All decontamination protocols resulted in changes in roughness, wettability, and chemical composition, but GCHL, SC, TiB, an IP presented the best decontamination outcomes.

Background: In peri-implant mucositis and peri-implantitis, inflammation extends to peri-implant tissue, which is associated with bone loss and can cause implant failure. To regain peri-implant tissue health, debridement and cleaning of implant surface without damaging it must be performed prior to any other treatment. Thus, this study aimed to assess the effect of titanium curette, air polishing and titanium brush on implant surface roughness. Methods: In this in vitro, experimental study, 2 SNUC titanium implants with 6 mm diameter and 10 mm length were sectioned into 10 pieces. Implant pieces were randomly divided into 4 groups (n=5) for polishing with titanium curette, air polishing, titanium brush and no intervention (control group). Surface roughness was determined under a scanning probe microscope (SPM) by measuring Ra and Rz parameters. Data was analyzed using Kruskal-Wallis and Mann-Whitney tests at significance level (α) of 0.05. Results: Ra and Rz values of the four groups were not significantly different (P=0.002). Air polishing group showed the lowest surface roughness and titanium curette group showed the highest surface roughness followed by titanium brush group, compared to control group. Conclusions: Air polishing group showed the lowest surface roughness compared to control group but an appropriate debridement technique should be chosen based on the treatment chosen for periimplantitis.

The aim of this invitro study was to evaluate the efficacy of different methods used for the decontamination of titanium surfaces previously infected with a Staphylococcus aureus biofilm. S. aureus biofilms were grown on three different titanium surfaces (n=114); polished, sandblasted large-grit acid-etched (SLA) and SLActive. The experimental groups were divided into six different disinfection modalities as follows: (i) rinsing with phosphate-buffered saline, (ii) rinsing with chlorhexidine digluconate 0.2% (CHX), (iii) application of photodynamic therapy (PDT), (iv) use of cotton pellet, (v) use of titanium brush (TiB) and (vi) the use of TiB and PDT. The decontamination effect of each modality was evaluated by microbial culture analysis and by scanning electron microscopy imaging. Two-way analysis of variance (ANOVA) and Bonferroni's post hoc comparisons were used to compare mean differences between colony-forming units per millilitre (CFU/ml) values, surfaces and treatments (P<0.025). This study demonstrated that the combination protocol (TiB and PDT) was the most effective in reducing S.aureus (P<0.025) on polished (2.0×103 CFU/Disc) and SLA surface (6.9×103 CFU/Disc). On the SLActive surface, the combination treatment was not significantly different to the TiB group (1.0×105 CFU/Disc) or the PDT group (2.0×105 CFU/Disc). The combined technique of TiB and PDT was shown to be an efficient method in reducing the number of S.aureus in both polished and rough titanium surfaces. These findings prompt further investigations in titanium decontamination techniques with a combination of TiB and PDT within a natural microcosm bacterial environment.

The clinical condition involving dental implants, characterized by soft tissue inflammation, bleeding, suppuration and rapid bone loss is widely known as peri implantitis. The main objective in the treatment of peri-implantis is to arrest the progression of the disease and at the same time to keep the dental implant in the mouth solving the inflammations signs of bleeding and pain. The aim of this paper is to highlight the effectiveness of the use of titanium brush and antimicrobial photodynamic therapy (aPDT) to decontaminate the implant surface, in association with regenerative procedures by means of autologous bone and demineralized bovine bone mineral (DBBM) in the treatment of peri-implantitis defects.

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.

Effect of Effervescent Denture Cleansers on 3D Surface Roughness of Conventional Heat Polymerized, Subtractively, and Additively Manufactured Denture Base Resins: An In Vitro Study.

Laser treatment has become a popular method for resolving peri-implantitis, but the full range of its effects on implant surfaces is unknown. The purpose of the present investigation was to analyze the influence of different clinically applicable erbium:yttrium-aluminum-garnet (Er:YAG), carbon dioxide (CO2), and diode laser parameters on titanium surfaces that were either polished or sandblasted, large-grit, acid-etched (SLA). Six polished and six SLA titanium disks were irradiated at nine different power settings (n = 54 polished, 54 SLA) with Er:YAG, CO2, or diode lasers. The CO2 and diode lasers were used in continuous wave mode, and the Er:YAG laser was used in a pulsed manner. The surface of each disk was analyzed by scanning electron microscopy and confocal white light microscopy. Each disk was irradiated on six circular areas of 5 mm in diameter with the same specific laser setting for 10 seconds. Within the chosen parameters, the CO2 and diode laser did not cause any visible surface alterations on either the polished or SLA disks. In contrast, both polished and SLA disks showed surface alterations when irradiated with the pulsed Er:YAG laser. The SLA surfaces showed alteration after 10 seconds of irradiation with Er:YAG laser at 300 mJ/10 Hz. The surfaces of the polished disks did not show alteration with the Er:YAG laser until they were irradiated at the higher energy of 500 mJ/10 Hz for 10 seconds. The results of confocal white light microscopy were in agreement with scanning electron micrographs. In contrast to continuous-wave diode and CO2 laser irradiation, pulsed Er:YAG laser irradiation caused distinct alterations with power settings beyond 300 mJ/10 Hz on the SLA surface and 500 mJ/10 Hz on the polished surface. Thus, it is only safe to use the Er:YAG laser for implant surface irradiation with settings no higher than 300 or 500 mJ/10 Hz.

Longevity of extrinsic stains on monolithic zirconia restorations: An in vitro study

Background: Peri-implantitis is the leading cause of implant failure, with a reported prevalence of 22–45%. Effective removal of bacterial biofilm from the implant surface is critical to non-surgical therapy. This study aimed to assess the efficacy of different implant surface cleaning methods across various bone defect configurations, considering operator experience. Methods: Thirty-six dental implants were coated to simulate biofilm, mounted in resin blocks with bone defects of varying geometries, and covered with silicone to simulate soft tissue. Three operators with differing levels of experience treated the implant surfaces using four instruments: a titanium curette (TiCu), ultrasonic scaler (US), titanium brush (TiBr), and air abrasion with erythritol (AirPo). Each combination was tested in triplicate. Implants were photographed and analyzed with dedicated software to quantify cleaning efficacy. Results: The expert dentist achieved the highest average cleaning efficacy (36.6%). The most effective tools were the titanium brush (37.2%) and ultrasonic scaler (35.0%), followed by the titanium curette (28.1%) and air-abrasion (22.9%). The first two instruments were the least operator-dependent. Among the defect types, the 60° defect was the easiest to clean. Complete implant surface decontamination was not achieved in any scenario. Conclusions: Ultrasonic scalers and titanium brushes demonstrated the highest and most consistent cleaning efficacy, independent of operator skill level. Sixty-degree defects were the most amenable to cleaning. These findings underscore the need to tailor decontamination approaches based on defect geometry and to consider combining non-surgical methods with adjunctive or surgical interventions, which may ultimately enhance clinical decision-making and improve treatment outcomes.

The response of turbulent boundary layers to sudden changes in surface roughness under adverse-pressure-gradient conditions has been studied experimentally. The roughness used was in the ‘d’ type array of Perry, Schofield &amp; Joubert (1969). Two cases of a rough-to-smooth change in surface roughness were considered in the same arbitrary adverse pressure gradient. The two cases differed in the distance of the surface discontinuity from the leading edge and gave two sets of flow conditions for the establishment and growth of the internal layer which develops downstream from a change in surface roughness. These conditions were in turn different from those in the zero-pressure-gradient experiments of Antonia &amp; Luxton. The results suggest that the growth of the new internal layer depends solely on the new conditions at the wall and scales with the local roughness length of that wall. Mean velocity profiles in the region after the step change in roughness were accurately described by Coles’ law of the wall-law of the wake combination, which contrasts with the zero-pressure-gradient results of Antonia &amp; Luxton. The skin-friction coefficient after the step change in roughness did not overshoot the equilibrium distribution but made a slow adjustment downstream of the step. Comparisons of mean profiles indicate that similar defect profile shapes are produced in layers with arbitrary adverse pressure gradients at positions where the values of Clauser's equilibrium parameter β (= δ*τ−10dp/dx) are similar, provided that the pressure-gradient history and local values of the pressure gradient are also similar.

To evaluate in vitrothe changes in implant surface topographyand roughness of commercial implants after instrumentation with five decontamination protocols. Seventy-two titanium implants with a sandblasted and acid-etched (SLA) surface were placed 5mm supra-crestally. Five groups of twelve implants were instrumented with the following protocols: a metal scaler tip (SCAL), a thermoplastic scaler tip (PEEK), a round titanium brush (RBRU), a tufted brush with titanium bristles (TNBRU), and a glycine-based air-powder abrasive (GLYC). A sixth group with untreated implants was used as control. Scanning electron microscope and confocal laser scanning microscope were utilized to evaluate the changes in the implant surfaces. The SCAL caused pronounced macroscopic alterations and damage of the implant surface, the PEEK left remnants of the plastic tip in the implant surface, and both titanium brush groups flattened the thread profile, while minimal alterations were observed in the GLYC. When compared to the control group, the roughness parameters (Sa) in the buccal aspect increased in the thread area of SCAL, and a minor reduction was observed in the PEEK while in the other groups, these values remained unchanged. In the valley areas, however the RBRU, TNBRU, and GLYC experienced a significant reduction (smoothening) indicating different accessibility of the decontamination protocols to the thread and valley. Similarly, the buccal aspects had more pronounced changes than those in the palatal aspect. Within the limitations of this in vitro investigation, the tested protocols induced different macroscopic alterations and surface roughness changes that varied in the thread and valley area.

The aims of this in vitro study are to compare the efficacy of different cleaning methods in removing debris of failed implants and to detect thermal changes of the implants treated by various scaling instruments. Twenty-seven failed implants and two unused implants as control were included to this study-group 1: plastic curette (P), group 2: titanium curette (T), group 3: carbon curette (C), group 4: titanium brush (TB), group 5: Er:YAG laser (laser 1 (L1) 100mJ/pulse at 10Hz), group 6: Er:YAG laser (laser 2 (L2) 150mJ/pulse at 10Hz), group 7: Er:YAG laser (laser 3 (L3) 200mJ/pulse at 10Hz), group 8: ultrasonic scaler appropriate for titanium (US), group 9: air abrasive method (AA) + citric acid, and group 10: implantoplasty (I). The changes on the treated/untreated titanium surfaces and remnant debris were observed by scanning electron microscopy (SEM). Temperature of the implants before and after treatment was detected using a thermocouple. The use of air abrasive and citric acid combination and Er:YAG laser groups was found as the best methods for the decontamination of titanium surfaces of failed implant. When the hand instruments were compared, titanium curette was found better than both the plastic and the carbon curettes which leave plastics and carbon remnants on the titanium surface. The temperature was higher after hand instrumentation when compared to other experimental groups (p < 0.05). Within the limitations of the present in vitro model, it can be concluded that the best method for decontamination of the implant surface is the use of air abrasives and Er:YAG laser.

Nanofilled composite resin is one of restorative materials with some weaknesses, such as changes of colour and surface roughness. These weaknesses are attributed to some factors, including frequent consumption some beverages, including yoghurt drinks. This study aims to determine the effect of long immersion of nanofilled composite resin in guava yogurt drink on discoloration and changes in surface roughness. Subjects of the study were nanofilled composite resin materials (3M Filtek Z350XT shade A3) in cylindrical shape with a diameter of 10 mm and 2 mm thickness. Study was conducted by immersing nanofilled resin composites in 10 mL of guava yogurt drink at 37 °C. Twelve specimens were divided into 3 groups with immersion duration of 12 hours, 24 hours, and 36 hours. Surface roughness measurements were carried out using a profilometer Starrett SR300 surface roughness tester, while the colour measurement parameters according to the system L * a * b * was measured using chromameter Konica Minolta CR-400 before and after treatment. Data of changes in surface roughness and colour changes data (ΔE) were calculated and analysed using one-way ANOVA. The results showed insignificant surface roughness changes but significant colour changes in nanofilled composite resin in the groups of 12 hours, 24 hours, and 36 hours. It is concluded that immersion duration in guava yoghurt drink significantly affects the colour of nanofilled composite resin.