The Evaluation of the atomic composition and the surface roughness of Titanium Implants following Various Laser treatment with air-powder abrasive

레이저 처리후 임프란트 표면 변화에 관한 연구

  • Kim, Tae-Jung (Department of Periodontology, College of Dentistry, Dan-Kook University) ;
  • Lim, Sung-Bin (Department of Periodontology, College of Dentistry, Dan-Kook University) ;
  • Chung, Chin-Hyung (Department of Periodontology, College of Dentistry, Dan-Kook University)
  • 김태정 (단국대학교 치과대학 치주과학교실) ;
  • 임성빈 (단국대학교 치과대학 치주과학교실) ;
  • 정진형 (단국대학교 치과대학 치주과학교실)
  • Published : 2002.09.30

Abstract

Various long-term studies have shown that titanium implants as abutments for different types of prostheses have become a predictable adjunct in the treatment of partially or fully edentulous patients. The continuous exposure of dental implants to the oral cavity with all its possible contaminants creates a problem. A lack of attachment, together with or caused by bacterial insult, may lead to peri-implantitis and eventual implant failure. Removal of plaque and calculus deposits from dental titanium implants with procedures and instruments originally made for cleaning natural teeth or roots may cause major alterations of the delicate titanium oxide layer. Therefore, the ultimate goal of a cleaning procedure should be to remove the contaminants and restore the elemental composition of the surface oxide without changing the surface topography and harming the surrounding tissues. Among many chemical and mechanical procedure, air-powder abrasive have been known to be most effective for cleaning and detoxification of implant surface. Most of published studies show that the dental laser may be useful in the treatment of pen-implantitis. $CO_2$ laser and Soft Diode laser were reported to kill bacteria of implant surface. The purpose of this study was to obtain clinical guide by application these laser to implant surface by means of Non-contact Surface profilometer and X-ray photoelectron spectroscopy(XPS) with respect to surface roughness and atomic composition. Experimental rough pure titanium cylinder models were fabricated. All of them was air-powder abraded for 1 minute and they were named control group. And then, the $CO_2$ laser treatment under dry, hydrogen peroxide and wet condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of the control models. The results were as follows: 1. Mean Surface roughness(Ra) of all experimental group was decreased than that of control group. But it wasn't statistically significant. 2. XPS analysis showed that in the all experimental group, titanium level were decreased, when compared with control group. 3. XPS analysis showed that the level of oxygen in the experimental group 1, 3($CO_2$ laser treatment under dry and wet condition) and 4(Soft Diode laser was used under toluidine blue O solution) were decreased, when compared with control group. 4. XPS analysis showed that the atomic composition of experimental group 2($CO_2$ laser treatment under hydrogen peroxide) was to be closest to that of control group than the other experimental group. From the result of this study, this may be concluded. Following air-powder abrasive treatment, the $CO_2$ laser in safe d-pulse mode and the Soft Diode laser used with photosensitizer would not change rough titanium surface roughness. Especially, $CO_2$ laser treatment under hydrogen peroxide gave the best results from elemental points of view, and can be used safely to treat peri-implantitis.

References

  1. Adell R, Lekholm V, Rockler Band Branemark PI: A 15-year study of osseointegrated implants in the treatment of edentulous jaw. Int J Oral Surg, 1981; 10: 387-416 https://doi.org/10.1016/S0300-9785(81)80077-4
  2. Zarb GAand Schmitt A: The longitudinal clinical effectiveness of osseointegrated dental implants. The Toronto study: part I, surgical results. J Prosthet Dent, 1990; 63: 451-457 https://doi.org/10.1016/0022-3913(90)90237-7
  3. Eriksson I, Lekholm V, Branemark PI, Llndhe J, Glantz PO and Nyman S:A clinical evaluation of fixed bridge restorations supported by the combination of tooth and osseointegrated titanium implants. J Clin Periodontol, 1986; 13: 307-312 https://doi.org/10.1111/j.1600-051X.1986.tb02227.x
  4. Meffert RM, Langer B and Fritz ME: Dental implant: A review. J Periodontol, 1992; 63: 859-870 https://doi.org/10.1902/jop.1992.63.11.859
  5. Babbush CA: Surgical atlas of implant techniques. Philadelphia. WE Saunders Co., 1980
  6. d'Hoedt B and Schulte W: A comparative study of results with various endosseous implant system. Int J Oral Maxillofac Implants, 1989; 4: 95-105
  7. Lavelle CL: Mucosal seal around endosseous dental implants: J Oral Implantol: 1981; 9: 357-371
  8. Gould TRL. Clinical implications of the attachment of oral tissue to permucosal implants. Tissue integration in oral and maxillo-facial reconstruction. Proceedings of an International Congress. Brussels: Excerpta Medica; 1985; 253-270
  9. McKinney RV, Steflik DE, Koth DL: Evidence for a junctional epithelial attachment to ceramic dental implants: J Periodontol: 1985; 56: 579-597 https://doi.org/10.1902/jop.1985.56.10.579
  10. Lindhe J, Berglundh T, Ericsson I, Liljenberg B, Marinello c: Experimental breakdown of periimplant and periodontal tissues: Clin Oral Impl Res: 1992; 3: 9-16 https://doi.org/10.1034/j.1600-0501.1992.030102.x
  11. Lang NP, Bragger U, Walther D, Beamer B, Komman KS: Ligature-induced peri-implant infectionin cynomolgus monkey: Clin Oral Impl Res: 1993; 4: 2-11. https://doi.org/10.1034/j.1600-0501.1993.040101.x
  12. Shou S, Holmstrup P, Keiding NE: Microbiology of ligature-induced marginal inflammation around osseointegrated implants and ankylosed teeth in cynomolgus monkeys(Macaca fascicularis): Clin Oral Impl Res: 1996; 7: 190-200 https://doi.org/10.1034/j.1600-0501.1996.070301.x
  13. Marinello CP, Berglundh T, Ericsson I, Kinge B, Glantz PO, Lindhe J: Resolution of ligatureinduced peri-implantitis lesion in the dog: J Clin Periodontol: 1995; 22: 475-479 https://doi.org/10.1111/j.1600-051X.1995.tb00180.x
  14. Tillmans H, Hermann JS, Tiffee JC, Burgess AV, Meffert RM: Evaluation of three different implants in ligature-induced peri-implantitis in the beagle dog. Part II. Histology and microbiology: Int J Oral Maxillofac Implants: 1998; 13: 59-68
  15. Isidor E: Loss of osseointegration caused by occlusal load of oral implants: Clin Oral Implants Res: 1996; 7: 143-152 https://doi.org/10.1034/j.1600-0501.1996.070208.x
  16. Isidor E: Histological evaluation of peri-implant bone at implants subjected to occlusal overload or plaque accumulation: Clin Oral Implants Res: 1997; 8: 1-9 https://doi.org/10.1111/j.1600-0501.1997.tb00001.x
  17. Hiirzeler MB, Quinones CR, Morrison E, Caffesse RG: Treatment of peri-implantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle dogs. Part I: Clinical findings and histologic observation: Int J Oral Maxillofac Implants: 1995; 10: 474-484
  18. Hiirzeler MB, Quinones CR, Schupbach P, Morrison E, Caffesse RG: Treatment of periimplantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle dogs. Part II: Histologic findings: Int J Oral Maxillofac Implants: 1997; 12: 168-175
  19. Choi P, Oyen O, Bissada N: Guided tissue regeneration and bone formation around endosseous dental implants: J Dent Res: 1989; 68: abstr no. 264
  20. Zablotsky MH, Meffert RM, Caudill R, Evans G: Histological and clinical comparisons of guided tissue regeneration on dehisced hydroxyapatitecoated and titanium implant surfaces: A pilot study: Int J Oral Maxillofac Implants: 1991; 6: 294-303
  21. Becker W, Becker BE, Handelsman M, Celletti R, Ochsenbein C, Hardwick R, Langer B: Bone formation at dehisced dental implant sites treated with implant augmentation material: A pilot study in dogs: Int J Periodont Rest Dent: 1990;10: 93-101
  22. Dahlin C, Sennerby L, Lekholm U, Lindhe A, Nyman S: Generation of new bone around titanium implants using a membrane technique: An experimental study in rabbits: Int J Oral Maxillofac Implants: 1989; 4: 19-25
  23. Nyman S, Lang N, Buser D, Bragger U: Bone regeneration adjacent to titanium dental implants using guided tissue regeneration: A report of two cases: Int J Oral Maxillofac Implants: 1990; 5: 9-14
  24. Jovanovic SA, Kenney EB, Carranza FA, Donath K: The regenerative potential of plaque-induced peri-implant bone defects treated by a submerged membrane technique: A experimental study: Int J Oral Maxillofac Implants: 1993; 8: 13-18
  25. Dennison DK, Huerzeler MB, Quinones C, Caffesse RG: Contaminated implant surfaces: An in vitro comparison of implant surface coating and treatment madalities for decontamination: J Periodontol: 1994; 65: 942-948 https://doi.org/10.1902/jop.1994.65.10.942
  26. Parham PL, Cobb CM, French AA, Love JW, Drisko CL, Killoy WJ Effects of an air-powder abrasive system on plasma-sprayed titanium implant surfaces: An in vitro evaluation: J Oral Implantol: 1989; 15: 78-86
  27. Bames CM, Fleming LS, Muenninghoff LA: An SEM evaluation of the in-vivo effects of an airabrasive system on various implant surfaces: Int J Oral Maxillofac Implants: 1991; 6: 463-469
  28. Coffelt DW, Cobb CM, MacNeill S, Rapley JW, Killoy WJ Determination of energy density threshold for laser ablation of bacteria: J Clin Periodontol: 1997; 24: 1-7 https://doi.org/10.1111/j.1600-051X.1997.tb01177.x
  29. Pick R, Pecaro B: Use of ${CO}_2$ laser in soft tissue dental surgery: Lasers in Surgical Medicine: 1987; 7: 207-213 https://doi.org/10.1002/lsm.1900070213
  30. Pick RM, Colvard MD: Current status of lasers in soft tissue surgery: J Periodontol: 1993; 64: 589-602 https://doi.org/10.1902/jop.1993.64.7.589
  31. Nammour S, Majerus P: Sterilization potential of the ${CO}_2$ laser: Acta Stomatologica Belgica: 1991; 88: 183-186
  32. Oyster KO, Parker WB, Gher ME:${CO}_2$lasers and temperature changes of titanium implants: J Periodontol: 1995; 1017-1024
  33. Mouhyi J, Sennerby L,Nammour S, Guillaume P, Van Reck J Temperature increases during sur face decontamination of titanium implants using ${CO}_2$laser: Clin Oral Impl Res: 1999; 10: 54-61 https://doi.org/10.1034/j.1600-0501.1999.100107.x
  34. Henry CA, Judy M, Dyer B, Wagner M, Matthews JL: Sensitivity of Porphyromonas and Prevotella species in liquid media to argon laser: Photochemistry and Photobiology: 1995; 61: 410-413 https://doi.org/10.1111/j.1751-1097.1995.tb08631.x
  35. Wilson M, Burns T, Pratten J, Pearson GJ: Bacteria in supragingival plaque samples can be killed by low-power laser light in presence of a photosensitizer: Journal of Applied Bacteriology: 1995; 78: 569-574 https://doi.org/10.1111/j.1365-2672.1995.tb03101.x
  36. Dobson J, Wilson M: Sensitization of oral bacteria in biofilrns to killingby light from low-power laser: Archives of Oral Biology: 1992; 37: 883-887 https://doi.org/10.1016/0003-9969(92)90058-G
  37. Hass R, Dortbudak O, Mensdorff-Pouilly N, Mailath G: Elimination of bacteria on different implant surfaces through photosensitization and soft laser. An in vitro study: Clin Oral Impl Res: 1997; 8: 249-254 https://doi.org/10.1034/j.1600-0501.1997.080401.x
  38. Albrektsson T, Hansson HA, Lindstrom J: Osseointegrated titanium implants-Requirements for ensuring a long-lasting direct bone-toimplant anchorage in man: Acta Orthop scand 1981; 52: 155-170 https://doi.org/10.3109/17453678108991776
  39. Albrektsson T, Zarb G, Worthington P, Eriksson AR: The long-term efficacy of currently used dental implants. A review of proposed criteria of success: Int J Oral Maxillofac Implants: 1986; 1: 11-25
  40. Meffert RM: The soft tissue interface in dental implantology: Int J Oral Implatol: 1988; 5: 55-58
  41. Quirynen M, Bollen CML: The influence of surface roughness and surface-free energy on supra- and subgingival plaque formation in man: A review literaturei J Clin Periodontol: 1995; 22: 1-14
  42. Quirynen M, Van Der Mei C, Bollen CML, Schotte A, Marechal M, Doombrusch GI: An in vivo study of the influence of the surface roughness of implants on the microbiology of supraand subgingival plaque: J Dent Res: 1993; 72: 1304-1309 https://doi.org/10.1177/00220345930720090801
  43. Quirynen M, Van Der Mei C, Bollen CML, Van Den Bossche LH, Doornbrush GI, van Steenberghe D: The influence of surface-free energy on supragingival plaque microbiology: An in vivo study on implants: J Periodontol: 1994; 65: 162-167 https://doi.org/10.1902/jop.1994.65.2.162
  44. Ingemar Olefjord, Prof/Stig Hansson and Lie Eng: Surface Analysis of Four Dental Implant Systems. Int J Oral Maxillofac Implants, 1993, 8: 32-40
  45. Mouhyi J, Sennerby L, Pireaux JJ, Dourov N, Nammour S and Van Reck J: An XPS and SEM evaluation of six chemical and physical techniques for cleaning of contaminated titanium implants. Clin Oral Impl Res, 1998, 9: 185-194 https://doi.org/10.1034/j.1600-0501.1998.090306.x
  46. Keller JC, Stanford CM, Wightman JP, Droughn RA, Zaharias R. Charaterization of titanium implant surfaces. III. J Biomed Mater Res. 1994; 28: 939-946 https://doi.org/10.1002/jbm.820280813
  47. Dederich DN, Pickard MA, Vaughn AS, Tulip J, Zakariasen KL: Comparative bactericidal exposures for selected oral bacteria using carbon dioxide laser radiation: Lasers in Surgery and Medicine: 1990; 10: 591-594 https://doi.org/10.1002/lsm.1900100612
  48. Eriksson A, Alberktsson T: Temperature threshold levels for heat induced bone tissue injury: A vital microscopy study in the rabbit: J Prosthet Dent: 1983; 50: 101-107 https://doi.org/10.1016/0022-3913(83)90174-9
  49. Swift JQ, Jenny JE, Hargreaves KM: Heat generation in hydroxyapatite-coated implants as a result of ${CO}_2$ laser application: Oral Surg Oral Med Oral Pathol: 1995; 79: 410-415 https://doi.org/10.1016/S1079-2104(05)80119-2
  50. Ganz CH: Evaluation of the safety of the carbon dioxide laser used in conjunction with root form implants: A pilot study: J Prosthetic Dentistry: 1994; 71: 27-30 https://doi.org/10.1016/0022-3913(94)90251-8
  51. Mombelli A, van Oosten MAC, Schtirch E, Lang NP:The microbiota associated with successful or failing osseointegrated titanium implants: Oral Microbiology and Immunology: 1987; 2: 145-151 https://doi.org/10.1111/j.1399-302X.1987.tb00298.x
  52. Becker W, Becker BE, Newman MG, Nyman S: Clinical and microbiologic findings that may contribute to dental implant failure: Int J Oral Maxillofac Implants: 1990; 5: 31-38
  53. Sbordone L, Barone A, Ramaglia L, Ciaglia RN, Iacono VJ Antimicrobial susceptibility of periodontopathic bacteria associated with failing implants: J Periodontol: 1995; 66: 69-74 https://doi.org/10.1902/jop.1995.66.1.69
  54. Block CM, Mayo JA, Evans GH: Effects of the Nd:YAG dental laser on plasma-sprayed and hydroxyapatite-coated titanium dental implants: Surface alteration and attempted sterilization: Int J Oral Maxillofac Impl: 1992; 7: 441-449
  55. Walsh LJ: The use of lasers in implantology: An overview: J Oral Implantology: 1992; 18: 1-6
  56. Romanos GE, Everts H, Nentwig GH: Effects of Diode and Nd:YAG laser irradiation on titanium discs: A scanning electron microscope examination: J Periodontol: 2000; 71 : 810-815 https://doi.org/10.1902/jop.2000.71.5.810
  57. Hass R, Baron M, Dortbudak O, Watzek G: Lethal photosensitization, autogenous bone and e-PTFE membrane for the treatment of periimplantitis: Preliminary results: Int J Oral Maxillofac Impl: 2000; 15: 374-382
  58. Giler S, Kadish U, Urea I: Peroral staining method with toluidine blue as an aid in the diagnosis of malignant gastric lesions: Am J Gastroenterol: 1976; 65: 37-40
  59. Ingemar Olefjord, Prof/Stig Hansson and Lie Eng: Surface Analysis of Four Dental Implant Systems. Int J Oral Maxillofac Implants, 1993; 8: 32-40
  60. Hallie E. Placko, Sourabh Mishra, Jeffery J. Weimer and Linda C. Lucas: Surface Characterization of Titanium-based implant materials. Int J Oral Maxillofac Implants, 2000; 15: 355-363