Cleaning effectiveness of implant prophylaxis instruments.

Area of Science:

• Dental Implantology
• Biomaterials Science
• Microbiology

Background:

• Dental implant surfaces undergo various treatments like polishing and acid-etching.
• Effective removal of bacterial biofilm (Streptococcus mutans) is crucial for implant maintenance.
• Different prophylaxis instruments are available, but their efficacy on diverse implant surfaces is not fully understood.

Purpose of the Study:

• To compare the cleaning effectiveness of seven different implant prophylaxis instruments.
• To evaluate instrument performance on both polished and acid-etched titanium implant surfaces.
• To identify instruments that achieve optimal biofilm removal.

Main Methods:

• Biofilm of Streptococcus mutans was cultured on 80 titanium disks (40 polished, 40 acid-etched).
• Seven instruments were tested: manual plastic curette, CFRP curette, sonic brush, rubber cup, sonic PEEK tip, ultrasonic PEEK tip, and air polishing (glycine).
• Remaining bacteria were quantified using light microscopy; statistical analysis employed ANOVA and Bonferroni-Dunn tests.

Main Results:

• Manual plastic and CFRP curettes showed significantly lower cleaning effectiveness on polished surfaces compared to machine-driven instruments.
• On acid-etched surfaces, the rubber cup was less effective than the ultrasonic PEEK tip and air polishing.
• Ultrasonic PEEK tips and air polishing achieved superior results, leaving less than 4% biofilm on both surfaces.

Conclusions:

• Not all tested implant prophylaxis instruments effectively remove biofilm to achieve <4% remaining.
• The efficacy of prophylaxis instruments is significantly influenced by the implant surface topography (polished vs. acid-etched).
• Ultrasonic PEEK tips and air polishing are recommended for effective biofilm removal on both implant surface types.