SEM AND PROFILOMETRIC ANALYSES OF SMOOTH SURFACES OF TITANIUM IMPLANTS CLEANED WITH 3 INSTRUMENTATIONS

Dental implants require regular maintenance of smooth surfaces. It’s crucial that the instrument used for clinic maintenance be able to remove ecosystems without causing damage to the implant surface. Several instrumentation may be useful for this maintenance, but studies of their effect are actually inconclusive. This study compares the effect of cleaning treatment of titanium implants using low-vacuum scanning electron microscopy (LV-SEM) and white-light confocal (WLC) profilometry to analyze curved surfaces. One sector of each titanium implants screwed to their abutments was left unprocessed (Us) or cleaned for 60 seconds, to simulate a single cleaning session, or for 180 seconds to simulate a series of sessions. Three types of instrumentation were randomly used on 60 implants: (Sc) stainless-steel Gracey curette; (Tc) titanium Langer curette; and (Pu) an ultrasonic device with the probe covered with a plastic tip. The morphology of the implant surfaces was analyzed by LV-SEM, without metal sputtering. Quantitative evaluations of the roughness of surfaces were then performed using a WLC-profilometer. The Kruskal-Wallis followed by the Dunn multiple comparison test were used in statistical comparisons. The unprocessed surfaces showed the presence of thin transverse ridges and grooves, i.e. a polarized surface roughness, being substantially compromised after Sc instrumentation. Small surface alterations, increasing with time, were also recorded after Tc and Pu instrumentation, lthough to a lesser degree. The gap of the fixture-abutment connection appeared almost completely clean after Tc, clotted with titanium debris after Sc, and with plastic debris after Pu treatment. The mean roughness (Ra) was nchanged after Pu, increased after Sc and decreased after Tc treatment, when compared with Us, but without statistical significance. The Rz roughness parameter, calculated along the fixture X-axis, was significantly greater after Sc treatment when compared with Us, Tc and Pu, whereas the differences between Tc, Pu and Us were not significant. All Rz roughness parameters of Sc, Tc and Pu, calculated along the fixture Y-axis, resulted almost identical and significantly lower than that of Us. Within the limitations of this study, a careful use of a titanium curette could produce a slight smooth surface alteration, particularly over prolonged treatments and may be more beneficial than the other treatments examined for stable ecosystem removal.