Do Oral Hygiene Methods Alter Titanium Implant Surfaces? An In Vitro Surface Roughness Analysis

ABSTRACT Objectives This study evaluated and compared the effects of three simulated daily oral hygiene regimens on the surface roughness ( R a ) of titanium alloy ( Ti6Al4V ) discs. Methods Twenty‐four Ti6Al4V discs were allocated to two groups based on baseline surface characteristics ( n = 12/group): Group 1 (Polished) and Group 2 (Sandblasted). Each was subdivided into three 30‐day regimens ( n = 4/regimen): Regimen A (Chemical only: 0.2% chlorhexidine digluconate (CHX) mouthrinse immersion), Regimen B (Combined electric toothbrushing [ETb] + fluoridated toothpaste [TP] + CHX after a 30‐min washout), and Regimen C (mechanical control: ETb + distilled water). Atomic force microscopy (AFM) quantified R a values at baseline and at 30 days. Data were evaluated using three‐way mixed ANOVA, one‐way ANOVA, and post hoc Bonferroni corrections ( p < 0.05). Results Three‐way mixed ANOVA revealed a significant interaction among time, surface type, and regimen ( F (2, 18) = 30.58, p < 0.001). Post hoc tests showed that Regimens A and B significantly increased R a values in Group 1 (A: p = 0.0001; B: p = 0.001) and in Group 2 (A: p = 0.005; B: p = 0.0008). Conversely, Regimen C produced no significant alterations ( p > 0.05). Baseline one‐way ANOVA confirmed that Group 2 possessed significantly higher R a values than Group 1 ( p < 0.001). Conclusion Exposure to therapeutic oral hygiene protocols (Regimens A and B) significantly elevated Ti6Al4V roughness, while isolated bristle friction (Regimen C) had a negligible impact. Pre‐textured sandblasted surfaces exhibited greater vulnerability to structural wear than polished surfaces, highlighting the need for surface‐specific, individualized implant hygiene protocols.