• The Effects of Air Polishing Abrasives on the TiUnite® Implant Surface at Standardized Distance, Exposure Time, and Pressure Level: An in vitro Scanning Electron Microscopic Evaluation

      Metzger, Joshua Adam; Aichelmann-Reidy, Mary Beth (2014)
      Background: Air polishing abrasives are becoming increasingly popular as a part of the treatment for decontaminating implants with identified peri-implantitis. This study sought to evaluate via scanning electron microscopy (SEM) the effect of three commercially available air abrasive powders on the TiUnite® implant surface, at pre-determined standardized settings. Methods: 20 NobelReplace® Select implants were mounted on a custom jig which travelled uni-directionally at a constant speed. The implants passed across a fixed air polisher unit with the tip set 5mm from the implant surface. Each implant provided evaluation of one test abrasive (or control) which included three grooves of the TiUnite® surface, and was aligned with an orientation notch scored on the implant collar. The formulations of abrasives tested included sodium bicarbonate (EMS®, 60-70mm), glycine (EMS®, 60-70mm), and calcium carbonate (KaVo®, 65mm). For each test implant at 1000x magnification, an SEM image was captured at the center of each of the first three grooves of the TiUnite® surface for visual and statistical analyses. The characteristic micro-porosities of this particular roughened surface were identified and recorded within a standardized 100mm2 area, then subjected to statistical analysis (ANOVA) to determine significance between the abrasives on the surface. Results: It was found that both sodium bicarbonate (mean 145.1, SD 4.4) and calcium carbonate formulations (mean 20.0, SD 11.0) demonstrated significant reductions of identifiable micro-porosities and alteration of the anodized surface, when compared to the control group (mean 205.5, SD 2.2). The glycine abrasive powder, however, did not demonstrate a statistically significant difference (mean 199.3, SD 7.7) nor was there any notable alteration at magnifications up to 5000x. Conclusions: Sodium bicarbonate and calcium carbonate air abrasives formulations induce extensive irreversible surface effects when compared to glycine, which did not demonstrate a significant loss of the porous topography. Whether this alteration in surface topography is beneficial or facilitates equivalent biofilm removal that is compatible with re-osseointegration remains to be evaluated.