Cleaning Potential of Different Air Abrasive Powders and Their Impact on Implant Surface Roughness
Air abrasion for management of biofilm and implants dentistry are two of the hottest topics in dentistry. There seems to be an increase in the practice of both therapies, but are they compatible? Studies in the past have concluded roughened implant surfaces increase the risk of peri-implantitis. How does the powder used for air abrasion affect the integrity of the implant? A study published in November 2019 in Clinical Implant Dentistry and Related Research investigated the cleaning potential of several air abrasive powders and their effects on titanium implant surface .1
Some studies in the past have shown the rate of progression of peri-implantitis associated with biofilm is more pronounced than that of periodontally involved natural teeth. Therefore, biofilm management is an important part of preventing peri-implantitis and peri-Implant mucositis. Currently, there is little to no reliable evidence to support the most effective practices for long-term maintenance and treatment of peri-implant mucositis.
Many meta-analyses have not found a statistical difference in probing depths and clinical attachment of patients with peri-implantitis treated with mechanical debridement or laser therapy. This led to the gaining popularity of air abrasives for biofilm management in patients with peri-implantitis and peri-implant mucositis. In vitro studies show that air abrasive powders have superior or equal efficacy of decontamination when compared to other modalities.
This in vitro study evaluated air abrasive powders with both large and small particles to determine if there is any significant difference in debridement and roughness of the implant surface. Large particles effectively removed biofilm, however, it also caused significant changes to the implant surface. While small particles effectively removed biofilm and less morphological changes to the implant surface. The study does note that large particles were superior in the removal of biofilm.
Though the large particles removed biofilm better, small particles are more likely to reach areas the larger particles can not reach, they also have higher solubility reducing the number of undissolved particles. Additionally, adding antimicrobials to small particle powder, such as glycine and erythritol, has been shown to adequately remove biofilm and lessen the likelihood of biofilm-associated infections.
The authors conclude by saying “Future in vivo studies are needed to validate the clinical efficacy of these air abrasive powders in removing biofilm, preventing bacterial colonization, and interfering with bone regeneration.”
Do you currently use air abrasion for biofilm control? What is your method of choice to control biofilm around implants? If future studies indicate air abrasion as a superior method to control biofilm, would you be willing to change your protocol?
1. Matsubara VH, Leong BW, Leong MJL, Lawrence Z, Becker T, Quaranta A. Cleaning potential of different air abrasive powders and their impact on implant surface roughness. Clin Implant Dent Relat Res. 2020;22(1):96‐104. doi:10.1111/cid.12875