In vitro cleaning potential of three different implant debridement methods

ObjectivesTo assess the cleaning potential of three different instrumentation methods commonly used for implant surface decontamination in vitro, using a bone defect-simulating model. Materials and methodsDental implants were stained with indelible ink and mounted in resin models, which represented standardized peri-implantitis defects with different bone defect angulations (30, 60 and 90 degrees). Cleaning procedures were performed by either an experienced dental hygienist or a 2nd-year postgraduate student. The treatment was repeated 20 times for each instrumentation, that is, with a Gracey curette, an ultrasonic device and an air powder abrasive device (PAD) with glycine powder. After each run, implants were removed and images were taken to detect color remnants in order to measure planimetrically the cumulative uncleaned surface area. SEM images were taken to assess micromorphologic surface changes (magnification 10,000x). Results were tested for statistical differences using two-way ANOVA and Bonferroni correction. ResultsThe areas of uncleaned surfaces (%, meanstandard deviations) for curettes, ultrasonic tips, and airflow accounted for 24.1 +/- 4.8%, 18.5 +/- 3.8%, and 11.3 +/- 5.4%, respectively. These results were statistically significantly different (P<0.0001). The cleaning potential of the airflow device increased with wider defects. SEM evaluation displayed distinct surface alterations after instrumentation with steel tips, whereas glycine powder instrumentation had only a minute effect on the surface topography. ConclusionWithin the limitations of the present in vitro model, airflow devices using glycine powders seem to constitute an efficient therapeutic option for the debridement of implants in peri-implantitis defects. Still, some uncleaned areas remained. In wide defects, differences between instruments are more accentuated.