Assessment of Implant Surface and Instrument Insert Changes Due to Instrumentation with Different Tips for Ultrasonic-driven Debridement

Background: To assess the changes of implant surfaces of different roughness after instrumentation with ultrasonic-driven scaler tips of different materials.

Methods: Experiments were performed on two moderately rough surfaces (I-Inicell® and II-SLA®), one surface without pre-treatment (III) and one smooth machined surface (IV). Scaler tips made of steel (A), PEEK (B), titanium (C), carbon (D) and resin (E) were used for instrumentation with a standardized pressure of 100 g for ten seconds and under continuous automatic motion. Each combination of scaler tip and implant surface was performed three times on 8 titanium discs. After instrumentation roughness was assessed by profilometry, morphological changes were assessed by scanning electron microscopy, and element distribution on the utmost surface by energy dispersive X-ray spectroscopy.

Results: The surface roughness of discs I and II were significantly reduced by instrumentation with all tips except E. For disc III and IV roughness was enhanced by tip A and C and, only for IV, by tip D. Instrumentation with tips B, D and E left extensive residuals on surface I, II and III. The element analysis of these deposits proved consistent with the elemental composition of the respective tip materials.

Conclusion: All ultrasonic instruments led to microscopic alterations of all types of implants surfaces assessed in the present study. The least change of implant surfaces might result from resin or carbon tips on machined surfaces.