Peri-Implant Disease, a Consensus for Treatment: A Case Study

Implant Surface Topography Following Different Laser Treatments: An In Vitro Study

Background Although dental implants have demonstrated very high success rates, they are susceptible to complications such as peri-implantitis that can lead to failure. Methods Twenty implants with surfaces grit-blasted using hydroxyapatite and acid-etched were randomly divided into four groups (five in each group). Three groups were assigned to laser treatments: Group I (erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser), Group II (650-nm diode laser), and Group III (808-nm diode), and one control group, Group IV. The surface roughness parameters (roughness average(Ra) and root mean square roughness(Rq)) were measured using a non-contact optical profilometer and scanning electron microscope to evaluate the surface topography after the laser treatments. Results Significant differences were observed between the laser groups regarding the surface roughness Ra (3.56±0.26, 3.45±0.19, 3.77±0.42, p_c=0.0004, p_e=0.0002, p_f=0.001) and Rq values (4.49±0.34, 4.35±0.26, 4.72±0.56, p_c=0.0007, p_e=0.0006, p_f=0.002) and the control group (2.81±0.10; 3.57±0.19). However, no significant difference was observed between the different laser treatment modalities. The scanning electron microscope images revealed some morphological changes on the implant surfaces following laser treatment, but no melted morphology was observed. Conclusions The application of Er,Cr:YSGG, 650-nm diode laser, and 808-nm diode did not show melting changes on implant topography. However, some increase in surface roughness was detected. Further studies are recommended to assess the effectiveness of these laser settings on bacterial reduction and osseointegration.

The Bacterial Anti-Adhesive Activity of Double-Etched Titanium (DAE) as a Dental Implant Surface

This work aimed to compare the capability of Streptococcus oralis to adhere to a novel surface, double-etched titanium (DAE), in respect to machined and single-etched titanium. The secondary outcome was to establish which topographical features could affect the interaction between the implant surface and bacteria. The samples’ superficial features were characterized using scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS), and the wetting properties were tested through sessile methods. The novel surface, the double-etched titanium (DAE), was also analyzed with atomic force microscopy (AFM). S. oralis was inoculated on discs previously incubated in saliva, and then the colony-forming units (CFUs), biomass, and cellular viability were measured at 24 and 48h. SEM observation showed that DAE was characterized by higher porosity and Oxygen (%) in the superficial layer and the measurement of the wetting properties showed higher hydrophilicity. AFM confirmed the presence of a higher superficial nano-roughness. Microbiological analysis showed that DAE discs, coated by pellicle’s proteins, were characterized by significantly lower CFUs at 24 and 48 h with respect to the other two groups. In particular, a significant inverse relationship was shown between the CFUs at 48 h and the values of the wetted area and a direct correlation with the water contact angle. The biomass at 24 h was slightly lower on DAE, but results were not significant concerning the other groups, both at 24 and 48 h. The DAE treatment not only modifies the superficial topography and increased hydrophilicity, but it also increases the Oxygen percentage in the superficial layer, which could contribute to the inhibition of S. oralis adhesion. DAE can be considered a promising treatment for titanium implants to counteract a colonization pioneer microorganism, such as S. oralis.