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The effects of mechanical instruments on contaminated titanium dental implant surfaces: a systematic review
Anna Louropoulou1, Dagmar E Slot, Fridus Van der Weijden
1Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.
Objective:
The objective of this systematic review was to evaluate the ability of mechanical instruments to clean contaminated implant titanium surfaces.
Materials And Methods:
MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to May 2013 to identify controlled studies on the cleaning efficacy of mechanical instruments on contaminated titanium surfaces.
Results:
A comprehensive search identified 1893 unique potential papers. Fourteen studies met the inclusion criteria and were selected for this systematic review. Most of the studies were in vitro studies. Different surfaces and different contamination methods were used. Most studies used titanium discs, strips and cylinders. The air abrasive was the treatment mostly evaluated. The available studies had a high heterogeneity that precluded any statistical analysis of the data. Therefore, the conclusions are not based on quantitative data. Non-metal curettes and rubber cups were found to be ineffective. Positive results were reported for (ultra)sonic scalers with a metal tip on polished surfaces, (ultra)sonic scalers with a non-metal tip on smooth and sand-blasted and acid-etched (SLA) surfaces, metal curettes and rotating titanium brushes on SLA surfaces. The air abrasive was found to be effective in cleaning machined, SLA and titanium plasma-sprayed (TPS) surfaces.
Conclusion:
The available data suggest that the air abrasive may remove plaque effectively from machined, SLA and TPS titanium surfaces. Positive results were also observed for rotating titanium brushes on SLA surfaces and ultrasonic scalers with non-metal tip on polished and SLA surfaces. However, the clinical impact of these findings requires further clarification.
Insights
Air abrasives effectively clean titanium implant surfaces, including machined, sand-blasted and acid-etched (SLA), and titanium plasma-sprayed (TPS) types. Ultrasonic scalers and rotating titanium brushes also show promise for implant surface decontamination.
Area of Science:
- Biomaterials science
- Dental implantology
- Surface decontamination
Background:
- Titanium surfaces are crucial for dental implant success.
- Contamination of implant surfaces can impede osseointegration.
- Effective cleaning methods are needed to manage contaminated implant surfaces.
Purpose of the Study:
- To systematically review the efficacy of mechanical instruments in cleaning contaminated titanium implant surfaces.
- To identify effective mechanical cleaning strategies for various titanium surface topographies.
Main Methods:
- Systematic review of controlled studies identified through MEDLINE, Cochrane-CENTRAL, and EMBASE databases (up to May 2013).
- Inclusion of studies evaluating mechanical instrument cleaning efficacy on contaminated titanium.
- Analysis of diverse titanium surface types (discs, strips, cylinders) and contamination methods.
Main Results:
- Fourteen studies met inclusion criteria, exhibiting high heterogeneity that precluded statistical analysis.
- Air abrasive treatment demonstrated effectiveness on machined, sand-blasted and acid-etched (SLA), and titanium plasma-sprayed (TPS) surfaces.
- Ultrasonic scalers (metal or non-metal tips) and rotating titanium brushes showed positive results on specific titanium surface modifications (e.g., SLA).
- Non-metal curettes and rubber cups were found to be ineffective.
Conclusions:
- Air abrasive technology appears effective for plaque removal from various titanium implant surfaces.
- Ultrasonic scalers and rotating titanium brushes show potential for cleaning specific implant surface types.
- Further research is necessary to clarify the clinical implications of these mechanical cleaning methods.
