Effects of an Erbium-Yttrium-Aluminum-Garnet (Er-YAG) Laser and an Ultrasonic Scaler on TiO2-Coated Titanium Surfaces Contaminated with Subgingival Plaque: an in Vitro Study to Assess Post-Treatment Biocompatibility to Osteogenic Cells.

Author(s) Giannelli, M.; Bani, D.; Tani, A.; Materassi, F.; Chellini, F.; Sassoli, C.
Journal J Periodontol
Date Published 2017 Jul 10

BACKGROUND: We evaluated the effects of conventional ultrasonic scaler vs. Er-YAG laser on titanium surfaces contaminated with subgingival plaque from peri-implantitis patients in terms of: plaque and bio-corroded titanium oxide coating removal; surface change induction; residual biocompatibility towards osteoblasts.

METHODS: Subgingival plaque-coated titanium discs with moderately rough surface were fixed with ethanol and treated with ultrasonic scaler (metal tip) or Er-YAG laser (20.3 J/cm(2) or 38.2 J/cm(2)) in non-contact mode. Fluorescent detection of residual plaque was performed. Disc surface morphology was evaluated by scanning electron microscopy. Saos-2 osteoblasts viability, attachment, proliferation and differentiation on new and treated discs were assayed by propidium iodide/syto assay and confocal microscopic analysis of cytoskeleton, Ki67, expression of osteopontin and alkaline phosphatase and formation of mineralized nodules.

RESULTS: Both methods resulted in effective debridement of the treated surfaces, the plaque area being reduced to 11.7% with ultrasonic scaler and up to 0.03% with Er-YAG laser (38.2 J/cm(2)). The ultrasound-treated discs showed marked surface changes, incomplete removal of the TiO2 layer and scanty plaque aggregates, while Er-YAG laser (38.2 J/cm(2)) completely stripped away the plaque and TiO2 layer leaving a micro-pitted surface. Both treatments maintained a good bio-compatibility of the surfaces to Saos-2 osteoblasts. Air-water cooling kept the disc temperature below the critical threshold of 47°C.

CONCLUSIONS: This study shows that ultrasonic scaler with metal tip is less efficient than high-energy Er-YAG irradiation to remove plaque and TiO2 layer on anodized discs, although both procedures appear capable of restoring an adequate osseo-conductivity of the treated surfaces.

DOI 10.1902/jop.2017.170195
ISSN 1943-3670
Citation J Periodontol. 2017:115.

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