Some Information about Dental Implant Surface

Dental root form implants are manufactured from a highgrade titanium alloy, the surface of which consists of a micro layer of titanium oxide. The implant surface can also be treated by plasma spraying, acid etching, sandblasting or coated with HA. The removal of plaque and calculus deposits from these implant surfaces with Dental Instruments designed originally for cleaning natural tooth surfaces can result in major alterations to the delicate titanium oxide layer. Altering the surface topography by roughening the surface may enhance calculus and bacterial plaque accumulation.

Resulting scratches, cuts or gouges may also reduce the corrosion resistancy of titanium, and corrosion and mechanical debris can accumulate in the surrounding tissue. The aim of procedures for debriding dental implants should be to remove microbial and other soft deposits, without altering the implant surface, and thereby adversely affect biocompatibility. Increased surface roughness can lead to an increase in bacterial accumulation and resultant soft tissue inflammation. Because of the critical nature of the implant/soft tissue relationship, metal ultrasonic scaler tips, hand scalers or curettes should not be used as they have been shown to significantly alter the titanium surface.

Current methods for professional cleaning of implant or titanium transmucosal elements include the set of plastic ultrasonic tips( ultrasonic scaler ) or hand instruments followed by the prophy cup polishing method or various types of floss and buffing strips. The design of the permanently cemented super structure often does not allow adequate access for the prophy cup, especially in interproximal areas, and plastic instruments are not very efficient for the removal of plaque or mineralized deposits. In addition, the prophy cup and paste method may leave residual paste at the implant/soft tissue interface area.

Airpolishing consists of directing, water, air and sodium bicarbonate towards the tooth or implant surface, resulting in efficient removal of bacterial plaque and soft mineralized deposits. The residual powder is biocompatible and being soluble is not retained at the implant/soft tissue interface( dental implant machine ).

Two airpolishing systems are currently available. One system, typically available on the Dentsply Prophyjet? and Cavijet,? the EMS Airflow, and the Satelec units, delivers the air and powder, typically at 60-80 psi pressure through one nozzel and the water through a separate concentric nozzel. Some mixing of the streams takes place at the interface of the streams, but the centre of the stream consists essentially of dry powder. This “Biphasic” stream is directed at the tooth or implant surface. Several studies have investigated this system, and its effects on implant surfaces, and conclude that this system can result in significant changes to the implant surface.