Maintenance of implants: an in vitro study of titanium implant surface modifications subsequent to the application of different prophylaxis procedures

The aim of the present study was to evaluate surface alterations on titanium implant necks subsequent to different prophylaxis procedures. Fifty ITI implants were utilized. Forty implants were treated with 10 different prophylaxis procedures (ultrasonic scaler, plastic tip ultrasonic scaler, stainless steel curette, titanium curette, teflon curette, air powered system, abrasive rubber cups, polishing rubber cup and brush), and 10 implants were left as untreated controls. Surface alterations were studied on an area of 1 mm x 0.9 mm and quantified using optical microscopic, SEM and laser prophylometer analysis. The use of laser prophylometer provided an objective criterion for evaluation, expressing implant neck surface alterations in numeric values in terms of two roughness indexes, Ra and Rz. The results showed that, in comparison with the controls (Ra = 0.50; Rz = 3.98) the procedures investigated could be divided into 3 main groups: 1) Methods which altered the implant neck surface producing increased roughness (Ra = 0.68-2.08; Rz = 4.68-11.92); 2) Methods which left the implant neck surface unaltered (Ra = 0.44-0.57; Rz = 0.42-3.46); 3) Methods resulting in a smoothening of the implant neck surface (Ra = 0.36; Rz = 2.15). Group 1 included procedures that should be avoided. However, it appeared safe to apply the procedures of groups 2 and 3. To confirm these results, it will be necessary to evaluate the plaque- and calculus-removing efficacy from titanium neck implant surfaces in vivo.