title: Cell Attachment Following Instrumentation with Titanium and Plastic Instruments, Diode Laser, and Titanium Brush on Titanium, Titanium-Zirconium, and Zirconia Surfaces.
abstract: OBJECTIVE
  The aim of this study was to evaluate the surface characteristics and gingival fibroblast adhesion of disks composed of implant and abutment materials following brief and repeated instrumentation with instruments commonly used in procedures for implant maintenance, stage-two implant surgery, and periimplantitis treatment.
  
  
  METHODS
  One hundred twenty disks (40 titanium, 40 titaniumzirconium, 40 zirconia) were grouped into treatment categories of instrumentation by plastic curette, titanium curette, diode microlaser, rotary titanium brush, and no treatment. Twenty strokes were applied to half of the disks in the plastic and titanium curette treatment categories, while half of the disks received 100 strokes each to simulate implant maintenance occurring on a repetitive basis. Following analysis of the disks by optical laser profilometry, disks were cultured with human gingival fibroblasts. Cell counts were conducted from scanning electron microscopy (SEM) images.
  
  
  RESULTS
  Differences in surface roughness across all instruments tested for zirconia disks were negligible, while both titanium disks and titaniumzirconium disks showed large differences in surface roughness across the spectrum of instruments tested. The rotary titanium brush and the titanium curette yielded the greatest overall mean surface roughness, while the plastic curette yielded the lowest mean surface roughness. The greatest mean cell counts for each disk type were as follows: titanium disks with plastic curettes, titanium-zirconium disks with titanium curettes, and zirconia disks with the diode microlaser.
  
  
  CONCLUSIONS
  Repeated instrumentation did not result in cumulative changes in surface roughness of implant materials made of titanium, titanium-zirconium, or zirconia. Instrumentation with plastic implant curettes on titanium and zirconia surfaces appeared to be more favorable than titanium implant curettes in terms of gingival fibroblast attachment on these surfaces.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Lang
authors.forename: D Roselyn
authors.initials: DR
authors.lastname: Cerutis
authors.forename: Takanari
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Martha E
authors.initials: ME
authors.lastname: Nunn
mesh_terms: D000704:Analysis of Variance; D002448:Cell Adhesion; D002452:Cell Count; D003475:Curettage / Q000295:instrumentation; D003722:Dental Alloys / Q000737:chemistry; D015921:Dental Implants / Q000009:adverse effects; D003777:Dental Prophylaxis / Q000295:instrumentation*; D012534:Dental Scaling / Q000295:instrumentation*; D005347:Fibroblasts / Q000166:cytology / Q000502:physiology; D005881:Gingiva / Q000166:cytology; D005882:Gingival Diseases / Q000517:prevention & control; D006801:Humans; D054023:Lasers, Semiconductor; D008855:Microscopy, Electron, Scanning; D010969:Plastics; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry*; D015040:Zirconium / Q000737:chemistry*
chemical_list: D003722:Dental Alloys; D015921:Dental Implants; D010969:Plastics; D015040:Zirconium; D014025:Titanium; C028541:zirconium oxide