The Effects of Different Hygiene Instrumentations on Titanium Implant Fixture Surfaces

Background and objective Applying different hygiene tools for implant maintenance alters surface configurations, impacting bacterial adhesion on titanium implant surfaces and potentially leading to peri-implant diseases. This study aimed to assess the alterations in surface topography of titanium implant fixtures after utilizing hygiene instruments such as airflow; erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er, Cr: YSGG) laser; and titanium brush, under scanning electron microscope (SEM) observation. Materials and methods We employed an experimental laboratory study design for this research, involving 20 MegaGen ST titanium implant fixtures (MegaGen Implant Co., Ltd., Seoul, Republic of Korea). These were classified into four groups: untreated/control fixtures (n=5); fixtures treated with airflow using sodium bicarbonate powder (n=5); fixtures treated with an Er, Cr: YSGG laser system at 1.5 W power and a laser pulse of 30 Hz (n=5); and fixtures treated with titanium brush operating between 300 to 1000 rpm (n=5). All fixtures were then rinsed with normal saline, fixed with 2.5% glutaraldehyde, and observed under SEM. Results In the SEM analysis, at 50x magnification, there were no differences between the fixtures. However, at 1000x, 2000x, and especially at 5000x magnification, the control group surfaces appeared to have no obvious change and were quite similar, with clearer surface details. The airflow group exhibited smoother surfaces with less complex and more organized structures. The laser group displayed a more irregular and haphazard structure, revealing a rougher topography. The titanium brush group showed the areas of the implant fixture surfaces appearing smoother and flatter. Conclusions In this SEM study, the titanium brush group yielded the smoothest surfaces and the most favorable overall outcomes, highlighting its efficacy.