title: Instrumentation With Ultrasonic Scalers Facilitates Cleaning of the Sandblasted and Acid-Etched Titanium Implants.
abstract: Mechanical instrumentation is widely used to debride dental implants, but this may alter the surface properties of titanium, which in turn may influence bacterial adhesion and make it more difficult to remove the biofilm. This in vitro study was performed (1) to assess the amount of biofilm formation on a sand-blasted and acid-etched titanium fixture treated with ultrasonic scalers with metal, plastic, and carbon tips and (2) to evaluate how this treatment of titanium surfaces affects implant cleaning by brushing with dentifrice. The titanium fixtures were treated with various ultrasonic scaler tips, and surface roughness parameters were measured by confocal microscopy. Biofilm was formed on the treated fixtures by using pooled saliva from 10 subjects, and the quantity of the adherent bacteria was compared with crystal violet assay. The fixture surfaces with biofilm were brushed for total of 30 seconds with a toothbrush with dentifrice. The bacteria remaining on the brushed fixture surfaces were quantified by scanning electron microscopy. Surface changes were evident, and the changes of the surfaces were more discernible when metal tips were used. A statistically significant decrease in roughness value (arithmetic mean height of the surface) was seen in the 2 metal-tip groups and the single plastic-tip group. After brushing with dentifrice, the treated surfaces in all the treatment groups showed significantly fewer bacteria compared with the untreated surfaces in the control group, and the parts of the surfaces left untreated in the test groups. Within the limits of this study, treatment of titanium fixture surfaces with ultrasonic metal, plastic, or carbon tips significantly enhanced the bacterial removal efficacy of brushing. Thorough instrumentation that smooths the whole exposed surface may facilitate maintenance of the implants.
authors.affiliation: 1  Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Jun-Beom
authors.initials: JB
authors.lastname: Park
authors.affiliation: 2  Department of Oral Microbiology and Immunology, College of Dentistry, Dankook University, Cheonan-si, Chungnam, Republic of Korea.
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: 1  Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: NamRyang
authors.initials: N
authors.lastname: Kim
authors.affiliation: 1  Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seojin
authors.initials: S
authors.lastname: Park
authors.affiliation: 1  Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Jin
authors.affiliation: 3  Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
authors.forename: Bong-Kyu
authors.initials: BK
authors.lastname: Choi
authors.affiliation: 3  Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
authors.forename: Kack-Kyun
authors.initials: KK
authors.lastname: Kim
authors.affiliation: 1  Department of Periodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Youngkyung
authors.initials: Y
authors.lastname: Ko
mesh_terms: D015921:Dental Implants; D012534:Dental Scaling; D008855:Microscopy, Electron, Scanning; D013499:Surface Properties; D014025:Titanium; D014465:Ultrasonics
chemical_list: D015921:Dental Implants; D014025:Titanium
keywords: bacteria; dental implant; dental scaling; electron scanning; microscopy; surface properties; titanium; toothbrushing