Journal of Prosthetic Dentistry
Research Article| Volume 78, ISSUE 3, P286-294, September 1997

The qualitative effects of various types of hygiene instrumentation on commercially pure titanium and titanium alloy implant abutments: an in vitro and scanning electron microscope study


      Statement of problem. Implant survival depends on proper and timely oral hygiene maintenance, and a wide variety of oral prophylaxis procedures have been recommended and used on implant abutments.
      Purpose. This in vitro study compared the surface quality of both commercially pure titanium and titanium-alloy implant abutments, subjected to various hygiene methods and instruments with a standardized, clinically applicable scaling force.
      Material and methods. Commercially pure titanium and titanium-alloy abutments were exposed to five oral hygiene methods; a gold-alloy–tipped scaler, a high-grade resin scaler, a graphite-reinforced scaler, an air-powder abrasive system, and a rubber cup with tin oxide slurry. A customized test device that simulated the scaling motion and allowed the application of a standard load at the tip of the scaler was used. Scanning electron photomicrographs (×200) of the pretreatment and treated surfaces were obtained and compared qualitatively.
      Results and Conclusions. No significant surface alteration was produced by the air abrasive system. All other hygiene methods either created significant surface alterations, left residual particles on the abutment surfaces, or both. (J Prosthet Dent 1997;78:286-94.)
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        • Brånemark PI
        • Zarb GA
        • Albrektsson T
        Tissue-integrated prostheses: osseointegration in clinical dentistry.
        : Quintessence Publishing Co, Chicago1985
        • Adell R
        • Lekholm U
        • Rockler B
        • Brånemark PI
        A 15-year study of osseointegrated implants in the treatment of the edentulous jaw.
        Int J Oral Surg. 1981; 10: 387-416
        • Hobo S
        • Ichida E
        • Garcia L.
        Osseointegration and occlusal rehabilitation.
        : Quintessence Publishing Co., Inc, Chicago1991
        • Niznick GA.
        The Core-Vent implant system.
        J Oral Implantol. 1982; 10: 379-418
        • Lekholm U
        • Ericsson I
        • Adell R
        • Slots J.
        The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges. A microbiological and histological study.
        J Clin Periodontol. 1986; 13: 558-562
        • Adell R
        • Lekholm U
        • Rockler B
        • Brånemark PI
        • Lindhe J
        • Eriksson B
        • et al.
        Marginal tissue reactions at osseointegrated titanium fixtures. (I) A 3-year longitudinal prospective study.
        Int J Oral Maxillofac Surg. 1986; 15: 39-52
        • Lekholm U
        • Adell R
        • Lindhe J
        • Brånemark PI
        • Eriksson B
        • Rockler B
        • et al.
        Marginal tissue reactions at osseointegrated titanium fixtures. (II) A cross-sectional retrospective study.
        Int J Oral Maxillofac Surg. 1986; 15: 53-61
        • Mombelli A
        • Van Oosten MA
        • Schurch Jr, E
        • Land NP.
        The microbiota associated with successful or failing osseointegrated titanium implants.
        Oral Microbiol Immunol. 1987; 2: 145-151
        • Rams TE
        • Roberts TW
        • Tatum Jr, H
        • Keyes PH.
        The subgingival microbial flora associated with human dental implants.
        J Prosthet Dent. 1984; 51: 529-534
        • Rams TE
        • Link Jr., CC
        Microbiology of failing dental implants in humans: electron microscopic observations.
        J Oral Implantol. 1983; 11: 93-100
        • 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
        • Apse P
        • Ellen RP
        • Overall CM
        • Zarb GA.
        Microbiota and crevicular fluid collagenase activity in the osseointegrated dental implant sulcus: a comparison of sites in edentulous and partially edentulous patients.
        J Periodont Res. 1989; 24: 96-105
        • Rosenberg ES
        • Torosian JP
        • Slots J.
        Microbial differences in 2 clinically distinct types of failures of osseointegrated implants.
        Clin Oral Impl Res. 1991; 2: 135-144
        • Nakazato G
        • Tsuchiya H
        • Sato M
        • Yamauchi M.
        In vivo plaque formation on implant materials.
        Int J Oral Maxillofac Implants. 1989; 4: 321-326
        • Orton GS
        • Steele DL
        • Wolinsky LE.
        Dental professional's role in monitoring and maintenance of tissue-integrated prostheses.
        Int J Oral Maxillofac Implants. 1989; 4: 305-310
        • Balshi T.
        Hygiene maintenance procedures for patients treated with the tissue integrated prosthesis (osseointegration).
        Quintessence Int. 1986; 17: 95-102
        • Barnes CM
        • Fleming LS
        • Mueninghoff LA.
        An SEM evaluation of the in-vitro effects of an air-abrasive on various implant surfaces.
        Int J Oral Maxillofac Implants. 1991; 6: 463-469
        • Thomson-Neal D
        • Evans GH
        • Meffert RM.
        Effects of various prophylactic treatments on titanium, sapphire, and hydroxyapatite-coated implants: An SEM study.
        Int J Perio Res Dent. 1989; 9: 300-311
        • Rapley JW
        • Swan RH
        • Hallmon WW
        • Mills MP.
        The surface characteristics produced by various oral hygiene instruments and materials on titanium implant abutments.
        Int J Oral Maxillofac Implants. 1990; 5: 47-52
        • Homiak AW
        • Cook PA
        • DeBoer J.
        Effect of hygiene instrumentation on titanium abutments: a scanning electron microscopy study.
        J Prosthet Dent. 1992; 67: 364-369
        • McCollum J
        • O'Neal RB
        • Brennan WA
        • Van Dyke TE
        • Horner JA.
        The effect of titanium implant abutment surface irregularities on plaque accumulation in vivo.
        J Periodontol. 1992; 63: 802-805
        • Parr G
        • Gardner K
        • Toth R.
        Titanium: the mystery metal of implant dentistry. dental materials aspects.
        J Prosthet Dent. 1985; 54: 410-414
        • Orton GS.
        Clinical use of an air-powder abrasive system.
        Dent Hyg. 1987; 61: 513-518
        • Galloway SE
        • Pashley DH.
        Rate of removal of root structure by the use of the Prophy-Jet device.
        J Periodontol. 1987; 58: 464-469
        • Goldstein JI
        • Newbury DE
        • Echlin P
        • Joy DC
        • Fiori C
        • Sifshin E.
        Scanning electron microscopy and x-ray microanalysis: a text for biologists, materials scientists, and geologists. Chaps. 9 and 10. : Plenum Press, New York1981: 447-459
        • Zappa U
        • Cadosch J
        • Simona C
        • Graf H
        • Case D.
        In vivo scaling and root planing forces.
        J Periodontol. 1991; 62: 335-340
        • Gantes BG
        • Nilveus R.
        The effects of different hygiene instruments on titanium surfaces: SEM observations.
        Int J Periodont Rest Dent. 1991; 11: 225-239
        • Kwan JY
        • Zablotsky MH
        • Meffert RM.
        Implant maintenance using a modified ultrasonic instrument.
        J Dent Hyg. 1990; 64 (430, 442): 424-425
        • Fox SC
        • Moriarty JD
        • Kusy RP.
        The effects of scaling a titanium implant surface with metal and plastic instruments: an in vitro study.
        J Periodontol. 1990; 61: 485-490
        • Zappa U
        • Rothlisberger JP
        • Somona C
        • Case D.
        In vivo scaling and root planing forces in molars.
        J Periodontol. 1993; 64: 349-354
        • Quirynen M
        • Bollen CM
        • Willems G
        • van Steenberghe D.
        Comparison of surface characteristics of six commercially pure titanium abutments.
        Int J Oral Maxillofac Implants. 1994; 9: 71-76
        • Quirynen M
        • Bollen CM
        • Papaioannou W
        • Van Eldere J
        • van Steenberghe D.
        The influence of titanium abutment surface roughness on plaque accumulation and gingivitis: short term observations.
        Int J Oral Maxillofac Implants. 1996; 11: 169-178
        • Cross-Poline G
        • Newman S
        • Stach D
        • Shaklee R.
        SEM study of titanium implant surfaces treated with implant curettes.
        J Dent Res. 1994; 73 (Abstract 1833): 331
        • Hallmon WW
        • Waldrop TC
        • Meffert RM
        • Wade BW.
        A comparative study of the effects of metallic, nonmetallic, and sonic instrumentation on titanium abutment surfaces.
        Int J Oral Maxillofac Implants. 1996; 11: 96-100
        • Phillips RW.
        Skinner's science of dental materials.
        in: 9th ed. : WB Saunders, Philadelphia1991: 559
        • Keenan MP
        • Shillingburg Jr, HT
        • Duncanson Jr, MG
        • Wade CK.
        Effects of cast gold surface finishing on plaque retention.
        J Prosthet Dent. 1980; 43: 168-173
        • Quirynen M
        • Maechal M
        • Buscher HJ
        • Weerkamp AH
        • Darius PL
        • van Steenberghe D.
        The influence of surface free energy and surface roughness on early plaque formation. An in vivo study in man.
        J Clin Periodontol. 1990; 17: 138-144
        • Carlsson J.
        Microbiology of plaque associated periodontal disease.
        in: 2nd ed. Textbook of clinical periodontology. : Musksgaard, Copenhagen1989: 129-149
        • Dmytryk JJ
        • Fox SC
        • Moriarty JD.
        The effects of scaling titanium implant surfaces with metal and plastic instruments on cell attachment.
        J Periodontol. 1990; 61: 491-496
        • Yerkes D.
        Webster's encyclopedic unabridged dictionary of the English language.
        in: : Portland House, New York1989: 580
        • Meffert RM.
        Chemotherapeutic mouthrinses as adjuncts in implant dentistry.
        Am J Dent. 1989; 2: 317-321
        • Kasemo B.
        Biocompatibility of titanium implants: surface science.
        J Prosthet Dent. 1983; 49: 832-837
        • Schutz RW
        • Thomas DE.
        Corrosion of titanium and titanium alloys.
        in: 9th ed. Metals handbook.Vol. 13. : ASM-International, Ohio1987: 669-698