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CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0044-1779424
Original Article

Efficacy of Biofilm Removal on the Dental Implant Surface by Sodium Bicarbonate and Erythritol Powder Airflow System

Patr Pujarern
1   Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
,
Arthit Klaophimai
2   Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
,
Parinya Amornsettachai
1   Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
,
Woraphong Panyayong
1   Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
,
Boontharika Chuenjitkuntaworn 
1   Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
,
Dinesh Rokaya 
3   Department of Prosthodontics, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
,
Suphachai Suphangul 
1   Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Abstract

Objective Peri-implantitis is a common complication in implant therapy and it is one of the main contributing factors to implant failure. This can be prevented by regular maintenance with mechanical debridement. One of the recent mechanical debridement methods is air abrasion therapy using different abrasive powders. This study aimed to evaluate the two common abrasive powders of different sizes (sodium bicarbonate and erythritol) for their biofilm cleaning efficacy on dental implant surfaces.

Materials and Methods In an in vitro setting, a total of 33 implants were divided into three groups: Group 1 (n =11) = no treatment; group 2 (n = 11) = air abrasion therapy treated group using a sodium bicarbonate powder (AIRFLOW Powder Classic Comfort, EMS Electro Medical Systems, Nyon, Switzerland); and group 3 (n = 11) = air abrasion therapy treated group using an erythritol powder (AIRFLOW Powder Plus, EMS Electro Medical Systems, Nyon, Switzerland). The implants in each group were subjected to biofilm formation, and group 2 and group 3 were treated with air abrasion therapy of two different powders having different sizes with the same settings. The particle sizes were sodium bicarbonate (40 µm) and erythritol (14µm). The surface characteristics of the dental implants in three groups were studied from a digital camera and under the scanning electron microscope at different magnifications. The comparison of biofilm-removal efficacy between the three groups was performed by using a one-way analysis of variance with post-hoc Dunnett's T3 test. A p-value less than 0.05 was chosen to indicate statistical significance.

Results There were no statistical differences (p > 0.05) between the two powder-treated groups for the biofilm cleaning efficacy. However, both groups showed significantly better biofilm-cleaning efficacy than the control group (p < 0.05).

Conclusion This suggests that both powders are effective in removing biofilm from the implant surface under ideal conditions. However, there was no clear distinction between the cleaning potential of the two powders, as both performed in a similar manner.

Keywords

dental implants - peri-implantitis - mechanical debridement - air abrasion therapy - erythritol - sodium bicarbonate - biofilm removal

Data Availability Statement

Supporting data are available on request.




Publication History

Article published online:
31 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Agliardi EL, Pozzi A, Romeo D, Del Fabbro M. Clinical outcomes of full-arch immediate fixed prostheses supported by two axial and two tilted implants: a retrospective cohort study with 12-15 years of follow-up. Clin Oral Implants Res 2023; 34 (04) 351-366
    CrossrefPubMedGoogle Scholar
  • 2 Shetty SR, Murray C, Kawas SA. et al. Acceptability of fully guided virtual implant planning software among dental undergraduate students. BMC Oral Health 2023; 23 (01) 336
    CrossrefPubMedGoogle Scholar
  • 3 Suphangul S, Rokaya D, Kanchanasobhana C, Rungsiyakull P, Chaijareenont P. PEEK biomaterial in long-term provisional implant restorations: a review. J Funct Biomater 2022; 13 (02) 33
    CrossrefPubMedGoogle Scholar
  • 4 Lertwongpaisan T, Amornsettachai P, Panyayong W, Suphangul S. Soft tissue dimensional change using customized titanium healing abutment in immediate implant placement in posterior teeth. BMC Oral Health 2023; 23 (01) 384
    CrossrefPubMedGoogle Scholar
  • 5 Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2018; 89 (Suppl. 01) S267-S290
    CrossrefPubMedGoogle Scholar
  • 6 Smeets R, Henningsen A, Jung O, Heiland M, Hammächer C, Stein JM. Definition, etiology, prevention and treatment of peri-implantitis–a review. Head Face Med 2014; 10: 34
    CrossrefPubMedGoogle Scholar
  • 7 Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis update: risk indicators, diagnosis, and treatment. Eur J Dent 2020; 14 (04) 672-682
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Fragkioudakis I, Tseleki G, Doufexi AE, Sakellari D. Current concepts on the pathogenesis of peri-implantitis: a narrative review. Eur J Dent 2021; 15 (02) 379-387
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Elemek E, Agrali OB, Kuru B, Kuru L. Peri-implantitis and severity level. Eur J Dent 2020; 14 (01) 24-30
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Algraffee H, Borumandi F, Cascarini L. Peri-implantitis. Br J Oral Maxillofac Surg 2012; 50 (08) 689-694
    CrossrefPubMedGoogle Scholar
  • 11 Robertson K, Shahbazian T, MacLeod S. Treatment of peri-implantitis and the failing implant. Dent Clin North Am 2015; 59 (02) 329-343
    CrossrefPubMedGoogle Scholar
  • 12 Cha JK, Paeng K, Jung UW, Choi SH, Sanz M, Sanz-Martín I. The effect of five mechanical instrumentation protocols on implant surface topography and roughness: a scanning electron microscope and confocal laser scanning microscope analysis. Clin Oral Implants Res 2019; 30 (06) 578-587
    CrossrefPubMedGoogle Scholar
  • 13 Ephros H, Kim S, DeFalco R. Peri-implantitis: evaluation and management. Dent Clin North Am 2020; 64 (02) 305-313
    CrossrefPubMedGoogle Scholar
  • 14 Ng E, Byun R, Spahr A, Divnic-Resnik T. The efficacy of air polishing devices in supportive periodontal therapy: A systematic review and meta-analysis. Quintessence Int 2018; 49 (06) 453-467 DOI: 10.3290/j.qi.a40341.
    CrossrefPubMedGoogle Scholar
  • 15 Martins O, Costa A, Silva D. The efficacy of air polishing devices in supportive periodontal therapy: Clinical, microbiological and patient-centred outcomes. A systematic review. Int J Dent Hyg 2023; 21 (01) 41-58
    CrossrefPubMedGoogle Scholar
  • 16 Hui WL, Ipe D, Perrotti V. et al. Novel technique using cold atmospheric plasma coupled with air-polishing for the treatment of titanium discs grown with biofilm: an in-vitro study. Dent Mater 2021; 37 (02) 359-369
    CrossrefPubMedGoogle Scholar
  • 17 Drago L, Bortolin M, Taschieri S. et al. Erythritol/chlorhexidine combination reduces microbial biofilm and prevents its formation on titanium surfaces in vitro. J Oral Pathol Med 2017; 46 (08) 625-631
    CrossrefPubMedGoogle Scholar
  • 18 Moharrami M, Perrotti V, Iaculli F, Love RM, Quaranta A. Effects of air abrasive decontamination on titanium surfaces: a systematic review of in vitro studies. Clin Implant Dent Relat Res 2019; 21 (02) 398-421
    CrossrefPubMedGoogle Scholar
  • 19 Matsubara VH, Leong BW, Leong MJL, Lawrence Z, Becker T, Quaranta A. Cleaning potential of different air abrasive powders and their impact on implant surface roughness. Clin Implant Dent Relat Res 2020; 22 (01) 96-104
    CrossrefPubMedGoogle Scholar
  • 20 Kim Y-K, Ahn K-J, Yun P-Y, Yi Y-J, Kim S-G. The clinical prognosis of implants that are placed against super-erupted opposing dentition. J Korean Assoc Oral Maxillofac Surg 2016; 42 (03) 139-143
    CrossrefPubMedGoogle Scholar
  • 21 May MC, Andrews PN, Daher S, Reebye UN. Prospective cohort study of dental implant success rate in patients with AIDS. Int J Implant Dent 2016; 2 (01) 20
    CrossrefPubMedGoogle Scholar
  • 22 Wu MJ, Wang XJ, Zou LD, Xu WH, Zhang XH. WU M-j. Evaluation of the therapeutic efficiency of mandibular anterior implant-supported fixed bridges with cantilevers. Chin Med J (Engl) 2013; 126 (24) 4665-4669
    CrossrefPubMedGoogle Scholar
  • 23 Dhir S. Biofilm and dental implant: the microbial link. J Indian Soc Periodontol 2013; 17 (01) 5-11
    CrossrefPubMedGoogle Scholar
  • 24 Lindhe J, Meyle J. Group D of European Workshop on Periodontology. Peri-implant diseases: consensus report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008; 35 (08) 282-285
    CrossrefPubMedGoogle Scholar
  • 25 Bermejo P, Sánchez MC, Llama-Palacios A, Figuero E, Herrera D, Sanz Alonso M. Biofilm formation on dental implants with different surface micro-topography: an in vitro study. Clin Oral Implants Res 2019; 30 (08) 725-734
    CrossrefPubMedGoogle Scholar
  • 26 Gianfreda F, Punzo A, Pistilli V. et al. Electrolytic cleaning and regenerative therapy of peri-implantitis in the esthetic area: a case report. Eur J Dent 2022; 16 (04) 950-956
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Prathapachandran J, Suresh N. Management of peri-implantitis. Dent Res J (Isfahan) 2012; 9 (05) 516-521
    CrossrefPubMedGoogle Scholar
  • 28 Mirchandani B, Skallevold HE, Heboyan A. et al. Natural Oral Care Therapy for Peri-Implant Diseases. Pharmacological Studies in Natural Oral Care.; 2023: 269-284
    Google Scholar
  • 29 Cochis A, Fini M, Carrassi A, Migliario M, Visai L, Rimondini L. Effect of air polishing with glycine powder on titanium abutment surfaces. Clin Oral Implants Res 2013; 24 (08) 904-909
    CrossrefPubMedGoogle Scholar
  • 30 Pratten J, Wiecek J, Mordan N. et al. Physical disruption of oral biofilms by sodium bicarbonate: an in vitro study. Int J Dent Hyg 2016; 14 (03) 209-214
    CrossrefPubMedGoogle Scholar
  • 31 Simon CJ, Munivenkatappa Lakshmaiah Venkatesh P, Chickanna R. Efficacy of glycine powder air polishing in comparison with sodium bicarbonate air polishing and ultrasonic scaling - a double-blind clinico-histopathologic study. Int J Dent Hyg 2015; 13 (03) 177-183
    CrossrefPubMedGoogle Scholar
  • 32 Lim JH, Song SH, Park HS, Lee JR, Lee SM. Spontaneous detachment of Streptococcus mutans biofilm by synergistic effect between zwitterion and sugar alcohol. Sci Rep 2017; 7 (01) 8107
    CrossrefPubMedGoogle Scholar
  • 33 Belibasakis GN, Manoil D. Microbial community-driven etiopathogenesis of peri-implantitis. J Dent Res 2021; 100 (01) 21-28
    CrossrefPubMedGoogle Scholar
  • 34 Louropoulou A, Slot DE, Van der Weijden F. The effects of mechanical instruments on contaminated titanium dental implant surfaces: a systematic review. Clin Oral Implants Res 2014; 25 (10) 1149-1160
    CrossrefPubMedGoogle Scholar
  • 35 Cafiero C, Aglietta M, Iorio-Siciliano V, Salvi GE, Blasi A, Matarasso S. Implant surface roughness alterations induced by different prophylactic procedures: an in vitro study. Clin Oral Implants Res 2017; 28 (07) e16-e20
    CrossrefPubMedGoogle Scholar
  • 36 Meschenmoser A, d'Hoedt B, Meyle J. et al. Effects of various hygiene procedures on the surface characteristics of titanium abutments. J Periodontol 1996; 67 (03) 229-235
    CrossrefPubMedGoogle Scholar
  • 37 Schmage P, Thielemann J, Nergiz I, Scorziello TM, Pfeiffer P. Effects of 10 cleaning instruments on four different implant surfaces. Int J Oral Maxillofac Implants 2012; 27 (02) 308-317
    Google Scholar
  • 38 Augthun M, Tinschert J, Huber A. In vitro studies on the effect of cleaning methods on different implant surfaces. J Periodontol 1998; 69 (08) 857-864
    CrossrefPubMedGoogle Scholar
  • 39 Biazussi BR, Perrotti V, D'Arcangelo C. et al. Evaluation of the effect of air polishing with different abrasive powders on the roughness of implant abutment surface: an in vitro study. J Oral Implantol 2019; 45 (03) 202-206
    CrossrefPubMedGoogle Scholar
  • 40 Batalha VC, Bueno RA, Fronchetti Junior E. et al. Dental implants surface in vitro decontamination protocols. Eur J Dent 2021; 15 (03) 407-411
    Article in Thieme ConnectPubMedGoogle Scholar