Peri-implantitis may be aggravated by ultrasonic scaling of titanium implants

Wednesday, June 7, 2017

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A new study reports that the ultrasonic scaling of titanium implants may release particles which can lead to peri-implantitis. The study, from researchers at Tel Aviv University in Israel, may be the first of its kind in exploring the biological impact of scaling titanium implants.

Peri-implantitis is the main cause of long-term implant failure. It is triggered by bacteria and leads to inflammation and bone dissolution around implants. There is no set method of treating the disease, but often the first step is cleaning the afflicted implant mechanically using ultrasonic scaling.

Titanium particles are believed to cause aseptic inflammation and joint-loosening in orthopaedic joint replacements. This information inspired the researchers to investigate the effects of the scaling of titanium implants to see if a similar phenomenon affected them.

The in vivo study found that ultrasonic scaling led to the release of particles that ‘stimulated the secretion of pro-inflammatory cytokines’. Researchers also found that the roughness of the titanium played a significant role. Many implants undergo some form of surface roughening since roughened surfaces have been shown to be beneficial during the healing stages of implant integration. It was found that particles from sandblasted surfaces caused the most inflammation while machined surfaces caused the least.

This paper only looked at the short-term effects of exposure to titanium particles and the authors note that there is a need to look at the long-term effects of scaling on periodontal health. The study was published in Scientific Reports.