The Effects of Neodymium: Yttrium-Aluminum-Garnet Laser (Nd:YAG) On TiUnite® Surface at Set Distance and Energy Level in Different Ambient Environments: An in vitro Scanning Electron Microscopic Evaluation.

Abstract

Background: Lasers are gradually being used more for the surface treatment of contaminated implants in cases of peri-implantitis. Surface effects were recently characterized to evaluate changes to implants in a dry environment, using a single pass of a Nd:YAG laser at a variety of energy densities. The clinical surface treatment of ailing implants is usually complicated by the presence of blood and saliva. The aim of this study was to evaluate via scanning electron microscopy (SEM) the effect of a single pass of a Nd:YAG laser on the TiUnite® implant at 10mm distance and at 3.0 W energy level in different environments (dry, saline, saliva, blood). Methods: A total of eight NobelReplace® TiUnite® Tapered implants were mounted on a jig and pulled at a constant speed across a Nd:YAG laser at an energy level of 3.0W and at a distance of 10mm. Each experimental group (dry, saline, saliva, blood) consisted of two implants. Each of these two implants per group was irradiated on three different surfaces, contributing six samples to each experimental group. Each irradiated surface contributed four threads to the analysis. ImageJ software was used to calculate the area of surface alteration for each thread. Results: It was found that all irradiated implants (wet or dry) had damage on the irradiated surfaces using Nd:YAG laser at the set distance and energy level. The surface alterations on the implants included charring, blackening, loss of surface roughness, flattening, cracking, and in severe cases melting and crater formation. After one-way ANOVA analysis of all experimental groups, there was a statistically significant difference in surface alterations amongst groups (dry or wet). Verified with Tukey HSD test, it was found that there was no statistical difference in surface alterations between the saline and saliva groups. Conclusions: The application of Nd:YAG laser on TiUnite® implants regardless of the ambient environments produced surface damage when observed under SEM with the least damage observed in saline and saliva. Based on this study, it is desirable to irrigate implant surfaces with saline while using Nd:YAG in order to minimize the surface alterations seen in a blood environment.