Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d...
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, di...
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 1. Hard resin splint model carrying 6 implants
Fig. 1. Hard resin splint model carrying 6 implants
Rough surfaceContGUSAirRotLasMedian137.53.446.513.04.816.3Min73.00.36.80.50.63.0Max785.027.0240.035.537.034.0Machine surfaceContGUSAirRotLasMedian84.50.98.53.23.325.3Min43.00.20.92.01.60.4Max295.04.236.014.05.661.5Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Machined surface (microthread)No effectFairGoodExcellentG   +US  + Air  + Rot   +Las +  Machined surface (macrothread)No effectFairGoodExcellentG   +US  + Air  + Rot   +Las  + Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Rough surface (microthread)No effectFairGoodExcellentG  + US +  Air +  Rot  + Las+   Rough surface (macrothread)No effectFairGoodExcellentG  + US  + Air  + Rot  + Las+   Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d...
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, di...
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 1. Hard resin splint model carrying 6 implants
Fig. 1. Hard resin splint model carrying 6 implants
Rough surfaceContGUSAirRotLasMedian137.53.446.513.04.816.3Min73.00.36.80.50.63.0Max785.027.0240.035.537.034.0Machine surfaceContGUSAirRotLasMedian84.50.98.53.23.325.3Min43.00.20.92.01.60.4Max295.04.236.014.05.661.5Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Machined surface (microthread)No effectFairGoodExcellentG   +US  + Air  + Rot   +Las +  Machined surface (macrothread)No effectFairGoodExcellentG   +US  + Air  + Rot   +Las  + Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Rough surface (microthread)No effectFairGoodExcellentG  + US +  Air +  Rot  + Las+   Rough surface (macrothread)No effectFairGoodExcellentG  + US  + Air  + Rot  + Las+   Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Otsuki, M., Wada, M., Yamaguchi, M. et al. Evaluation of decontamination methods of oral biofilms formed on screw-shaped, rough and machined surface implants: an ex vivo study.
Int J Implant Dent 6, 18 (2020). https://doi.org/10.1186/s40729-020-00212-y
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Received: 06 February 2020
Accepted: 17 March 2020
Published: 22 April 2020
DOI: https://doi.org/10.118...
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All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. This study protocol was approved by the ethical committee of Osaka University (H26.E-36).
All participants consented to the publication of their data through a written consent form obtained from the ethical committee of Osaka University.
Motohiro Otsuki, Masa...
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Motohiro Otsuki, Masahiro Wada, Yoshinobu Maeda & Kazunori Ikebe
Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Osaka, Japan
Masaya Yamaguchi & Shigetada Kawabata
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GC Corporation provided the implants to this research.
The authors thank Tomoaki Mameno for his work on data analysis.
Romeo E, Ghisolfi M, Murgolo N, Chiapasco M, Lops D, Vogel G. Therapy of peri-implantitis with resective surgery. A 3-year clinical trial on rough screw-shaped oral implants. Part I: clinical outcome. Clin Oral Implants Res. 2007;16(1):9–18.
Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, et al. Periodontal and peri-implant wound healing following laser therapy. Periodontol 200...
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89(Suppl 1):S313–8.
Sousa V, Mardas N, Spratt D, Boniface D, Dard M, Donos N. Experimental models for contamination of ti...
Schwarz F, Ferrari D, Popovski K, Hartig B, Becker J. Influence of different air-abrasive powders on cell viability at biologically contaminated titanium dental implants surfaces. J Biomed Mater Res B Appl Biomater. 2009;88(1):83–91.
Widodo A, Spratt D, Sousa V, Petrie A, Donos N. An in vitro study on disinfection of titanium surfaces. Clin Oral Implants Res. 2016;27(10):1227–32.
Sahrmann P,...
Derks J, Schaller D, Hakansson J, Wennstrom JL, Tomasi C, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: prevalence of peri-implantitis. J Dent Res. 2016;95(1):43–9.
Fransson C, Lekholm U, Jemt T, Berglundh T. Prevalence of subjects with progressive bone loss at implants. Clin Oral Implants Res. 2005;16(4):440–6.
Wada M, Mameno T, Onodera Y, Matsuda H, Daimon...
Control (no decontamination)
Gauze soaked in saline
Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon Group, Bordeaux, France; power setting: P5, tip: Implant Protect IP3L/R)
Air abrasive (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland; power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, distance from the nozzle to the implant 2 ...
The datasets used during the current study are available from the corresponding author on reasonable request.
In the present ex vivo experimental study, none of the tested decontamination methods thoroughly eliminated biofilms formed on rough/machined surface implants intraorally. Gauze soaked in saline and the rotary stainless steel instrument showed better cleansability than the ultrasonic scaler in qualitative and quantitative analyses and may be advantageous for cleansing contaminated implant surfaces...
Through SEM analysis and CFU counts, it was demonstrated that, except for the Er:YAG laser, decontamination of the machined surface implant was easier than that of the rough surface implant regardless of decontamination method. Gauze soaked in saline and the ultrasonic scaler demonstrated a statistically significant difference in CFU counts between the two surfaces. In this context, a machined sur...
Sahrmann et al. [15] tested three instruments (ultrasonic scaler, Gracey curette, and air abrasive device with glycine powder) on rough surface implants stained with indelible ink used as artificial plaque. There was a statistically significant difference in terms of stain removal rate. The air abrasive device showed the best result among the tested instruments. The result of this study is in line...
It has been previously stated that the alteration of the implant surface during cleansing may attenuate biocompatibility [29]. However, several clinical studies revealed the considerable treatment effect even though there was certain expected damage on the implant surface [7, 34]. Therefore, it is assumed that the most important consideration for treating peri-implantitis in the clinical setting s...
Regarding the air abrasives, the cleansing effect in the SEM analysis was also as considerable as that achieved by the ultrasonic scaler in the present study, in contrast to the results of the aforementioned study. Louropoulou et al. [29] also stated in their systematic review that an air-powder abrasive system with sodium bicarbonate powder could cleanse contaminated rough/smooth implant surfaces...
Based on the results of the SEM qualitative analysis, gauze soaked in saline and the rotary stainless steel instrument consistently showed good cleansability on rough and machined surface implants compared with the other methods. Conversely, the Er:YAG laser showed inferior cleansability to all other methods especially on rough surface implants. The ultrasonic scaler and air abrasive exhibited fai...
This study was performed following an ex vivo design to overcome the drawbacks of previous studies. One particular difference in this study was the use of a commercially available screw-shaped implant. As the implant shape and design have rather complicated macro- and microstructures compared with titanium disks or different forms of titanium commonly used in experimental studies, previous results...
During the experiment, three participants experienced small ulcers caused by the implants carried on the splints; however, it did not affect their daily life. Additionally, there were no signs of gingival inflammation in any participant.
G and Rot achieved relatively clean implant surfaces compared with Las in micro- and macrothread areas. US and Air demonstrated fair cleansability in microthread...
The SEM analysis was performed as previously described [16,17,18]. The decontaminated implant samples were fixed with 2% glutaraldehyde-RPMI 1640 immediately for 1 h at room temperature and washed with distilled water. Then, the samples were dehydrated with 100% t-butyl alcohol and freeze-dried. Finally, the samples were coated with platinum and examined using an emission-scanning electron micro...
Eleven participants, nine men and two women between 28 and 42 years of age (mean age 31.3 ± 4.6), were recruited as the study subjects. All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. The inclusion criteria were as follows:
Generally healthy subjects
Dentate subjects without ill-fitting restorations (...
Dental implants are now used broadly for recovering loss of masticatory function and esthetics. Although it has been revealed that dental implants can often survive long term, biological and mechanical complications may arise. Recent cross-sectional and retrospective studies noted a higher prevalence of peri-implantitis at the implant and subject level than previously considered [1,2,3,4]. Additio...
To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces.
Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the titanium surfaces of the implants. Apart from sur...
Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Â
Rough surface
Cont
G
US
Air
Rot
Las
Median
137.5
3.4
46.5
13.0
4.8
16.3
Min
73.0
0.3
6.8
0.5
0.6
3.0
Max
785.0
27.0
240.0
35.5
37.0
34.0
Machine surface
Cont
G
US
Air
Rot
Las
Median
84.5
0.9
8.5
3.2
3.3
...
Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Â
Machined surface (microthread)
No effect
Fair
Good
Excellent
G
Â
Â
Â
+
US
Â
Â
+
Â
Air
Â
Â
+
Â
Rot
Â
Â
Â
+
Las
Â
+
Â
Â
Machined surface (macrothread)
No effect
Fair
Good
Excellent
G
Â
Â
Â
+
US...
Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Â
Rough surface (microthread)
No effect
Fair
Good
Excellent
G
Â
Â
+
Â
US
Â
+
Â
Â
Air
Â
+
Â
Â
Rot
Â
Â
+
Â
Las
+
Â
Â
Â
Rough surface (macrothread)
No effect
Fair
Good
Excellent
G
Â
Â
+
Â
US
Â
Â
...
Â
Figure 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Â
Figure 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Figure 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Â
Figure 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW®...
Figure 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Surface characteristics
Through SEM analysis and CFU counts, it was demonstrated that, except for the Er:YAG laser, decontamination of the machined surface implant was easier than that of the rough surface implant regardless of decontamination method. Gauze soaked in saline and the ultrasonic scaler demonstrated a statistically significant difference in CFU counts between the two surfaces. ...
Our results are also in accordance with their results in terms of the high cleansability of the rotary metal instrument. In addition, the cotton pellet showed moderate cleansability among the tested methods, but the cleansing time for the cotton pellet (60 s) was shorter than that of the titanium brush with (120 s + 60 s)/without (120 s) photodynamic therapy. If adjusting the d...
Charalampakis et al. examined the effectiveness of mechanical and chemical decontamination methods using titanium disks contaminated intraorally. They employed four decontamination methods: gauze in saline, chlorhexidine, delmopinol, and an essential oil mixture. The authors discovered there was no significant difference in CFU counts among the four methods. In the present study, our findin...
However, the rotary stainless steel instrument created numerous shallow scratches, especially on machined surface implants. John et al. compared the supragingival plaque cleansability of a rotary titanium instrument to that of a stainless metal curette on contaminated titanium disks. The residual biofilm area left on implant treated with the rotary titanium instrument was significantl...
However, the rotary stainless steel instrument created numerous shallow scratches, especially on machined surface implants. John et al. compared the supragingival plaque cleansability of a rotary titanium instrument to that of a stainless metal curette on contaminated titanium disks. The residual biofilm area left on implant treated with the rotary titanium instrument was significantl...
Regarding the air abrasives, the cleansing effect in the SEM analysis was also as considerable as that achieved by the ultrasonic scaler in the present study, in contrast to the results of the aforementioned study. Louropoulou et al. also stated in their systematic review that an air-powder abrasive system with sodium bicarbonate powder could cleanse contaminated rough/smooth implant surface...
The SEM analysis demonstrated that three different rough surface disks harbored complex and firmly attached biofilms after gauze scrubbing irrespective of which antiseptic or saline was used.
However, the disks with a turned surface hosted fewer biofilm clusters after scrubbing. This finding is in line with our result showing the better cleansability of gauze soaked in saline on the m...
Augthun et al. examined the cultivability of mouse fibroblasts after cleansing machined or plasma-splayed surface implants carried on acrylic plates that had been contaminated with supragingival plaque from individuals. A plastic hand scaler and an air-abrasive system with sodium bicarbonate powder were employed in their study. A similar number of viable fibroblasts were observed after clean...
Discussion
Study design
This study was performed following an ex vivo design to overcome the drawbacks of previous studies. One particular difference in this study was the use of a commercially available screw-shaped implant. As the implant shape and design have rather complicated macro- and microstructures compared with titanium disks or different forms of titanium commonly used in experi...
Results
Complications
During the experiment, three participants experienced small ulcers caused by the implants carried on the splints; however, it did not affect their daily life. Additionally, there were no signs of gingival inflammation in any participant.
SEM analysis (Fig 4, Tables 1 and 2)
Rough surface implants
G and Rot achieved relatively clean implant surfaces compared with Las in...
This study protocol was approved by the ethical committee of Osaka University (H26.E-36).
SEM analysis
The SEM analysis was performed as previously described. The decontaminated implant samples were fixed with 2% glutaraldehyde-RPMI 1640 immediately for 1 h at room temperature and washed with distilled water. Then, the samples were dehydrated with 100% t-butyl alcohol and freeze-dried. Finall...
At the end of the 4-day experimental period, the implants were carefully removed from the splints by breaking the resin caps that held them in place. Each implant was randomly assigned to a treatment method (Cont, control (no decontamination); G, gauze soaked in saline; US, ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon Group, Bordeaux, France; power setting: P5, tip: Implant Protect IP3L/R); ...
Materials and methods
Study subjects
Eleven participants, nine men and two women between 28 and 42 years of age (mean age 31.3 ± 4.6), were recruited as the study subjects. All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. The inclusion criteria were as follows:
Generally healthy subjects
Dent...
Background
Dental implants are now used broadly for recovering loss of masticatory function and esthetics. Although it has been revealed that dental implants can often survive long term, biological and mechanical complications may arise. Recent cross-sectional and retrospective studies noted a higher prevalence of peri-implantitis at the implant and subject level than previously considered. Add...
Abstract
Background
To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces.
Material and methods
Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the ti...