Optimization of thermal protocols during diode irradiation of dental implants

Abstract

Introduction/Objectives Significant bacterial contamination of dental implant surfaces is associated with supporting bone degeneration, and traditional mechanical debridement treatments are often met with low rates of regenerative success. It has been demonstrated in previous studies that diode laser irradiation is capable of decontaminating titanium alloys that commonly comprise dental implants. Although diode laser irradiation can efficiently rid these surfaces of bacteria, prolonged use of laser systems on dental implants has the potential for dangerous thermal stresses on metallic surfaces and surrounding osseous tissues. The aim of this study was to assess implant surface thermometry after diode laser irradiation, and to develop optimal thermal safety recommendations for dental clinicians. Methods An in-vitro model comparative to a clinical presentation of peri-implantitis was created via placement of a 3.5x11mm titanium alloy dental implant into artificial Type-II bovine bone, and an irregular 3x5mm osseous segment was removed to create an infrabony defect. Diode laser systems of varying wavelengths (810nm, 940nm, 975nm, and 980nm) were subjected to different initiator pigments (uninitiated, blue, and cork) and beam types (continuous wave or pulsed mode) prior to surface irradiation. Axial implant surfaces were debrided at 2W mean power for 15 trials/group that were 30-seconds in duration. Implant surface temperature was monitored via apical and coronal thermocouple devices over these irradiation periods. Results The critical biologic thermal safety threshold for osseous necrosis (Δ+10°C) was commonly surpassed in continuous wave trials regardless of initiator or power condition. Initiated fibers achieved significantly faster changes in temperature than non-initiated fibers. Coronal implant surfaces demonstrated significantly greater temperature increases than that of apical portions, with no apical readings surpassing the critical biologic thermal safety threshold. Different initiating pigments were preferred to best control thermal climb for different wavelength diode systems. Conclusion Within study limitations, mean power settings for implant surface debridement should be less than manufacture recommendations to minimize risks of overheating and consequential implant failure. Utilization of pulsed modes and wavelength-specific initiators are necessary for thermal protection of implant titanium alloy surfaces and supporting bony structures during clinical decontamination. Introduction/Objectives Significant bacterial contamination of dental implant surfaces is associated with supporting bone degeneration, and traditional mechanical debridement treatments are often met with low rates of regenerative success. It has been demonstrated in previous studies that diode laser irradiation is capable of decontaminating titanium alloys that commonly comprise dental implants. Although diode laser irradiation can efficiently rid these surfaces of bacteria, prolonged use of laser systems on dental implants has the potential for dangerous thermal stresses on metallic surfaces and surrounding osseous tissues. The aim of this study was to assess implant surface thermometry after diode laser irradiation, and to develop optimal thermal safety recommendations for dental clinicians. Methods An in-vitro model comparative to a clinical presentation of peri-implantitis was created via placement of a 3.5x11mm titanium alloy dental implant into artificial Type-II bovine bone, and an irregular 3...