Evaluation of The Surface Roughness after Various Professional Cleaning Procedures on Implant Fixture Surfaces

Background: Peri-implantitis is a pathological condition which occurs as an inflammation involving the dental implant’s surrounding connective tissues and gradual loss of periimplant bony support. It has been found that bacteria and their endotoxins have a direct correlation with peri-implant diseases. Even though peri-implantitis and periodontitis have comparable microbiota, the former involves greater difficulty in its treatment because of the modified surfaces and structural configuration of the implants. Aim: this study was to investigate the cleaning method that is the least destructive to the implant surfaces as well as to determine the presence of bacterial adhesion after implant surface cleaning using light and scanning electron microscopes. Method: In the present study, 6 implants (Straumann SLA) were used. They were mounted in acrylic blocks with three threads exposed, which were then subjected to four different cleaning techniques, Gracey curettes, ultrasonic stainless steel tip, air polishing and diode laser. The instrumented surfaces were observed under field emission scanning electron microscopy(FESEM) for evaluation of surface topography. An untreated implant were used as control. Furthermore, the implants were incubated in Enterococcus faecalis broth culture for 24 hours before viewed under Field Emission Scanning Electron Microscope (FESEM) to determine the bacterial biofilm adhesion. Result; On implant surfaces treated with curette and ultrasonic tips, pitting and detachment of implant coating was observed under FESEM. However, implants treated with diode laser and air polishing showed minimal changes on the surface. The Savaluemeasured of the exposed threads of mounted implants were in the range of 2.3 to 2.8μm. The treatment with metal curette altered the surface significantly, while ultrasonic steel tip, and diode laser (both 810nm and 980nm wavelength) did not significantly alter the surface roughness in the implant threads. For mechanical cleaning using metal curette, the surface roughness was the highest compared to other cleaning methods. For bacterial biofilm adhesion, the surface treated by metal curette (mechanical cleaning) retained the highest amount of biofilm on its surface among all of the cleaning methods. Conclusion; mechanical cleaning with metal curette induced the greatest amount of visual alterations on the implant surface followed by increase in surface roughness, and maximum bacterial biofilm adhesion. This is sequentially followed by air polishing, ultrasonic stainless steel tip and diode laser, which had the least effect on the implant surface and bacterial adhesion.