Evaluation of different methods to clean titanium abutments. A scanning electron microscopic study.

The cleaning effectiveness of different treatment methods for titanium abutments was evaluated using scanning electron microscopy (SEM). In the mandible of 4 beagle dogs, 25 titanium abutments were installed (modum Brånemark). After 16 weeks of plaque accumulation, mineralized deposits had formed on 23 abutments. Each of these abutments was subjected to one of the following treatment methods: scaling with (1) metal, (2) plastic, or (3) ultrasonic instruments; (4) air-polishing, (5) weekly rubber cup polishing or (6) daily brushing with a conventional toothbrush. Fourteen abutments were removed immediately after treatment. On 9 abutments, the scaling procedures and air-polishing were repeated after another 16 weeks of plaque accumulation. The abutments were prepared for SEM, and each of them was viewed and photographed at 3 different magnifications. The photomicrographs were evaluated by 3 examiners who, guided by reference pictures, gave each abutment a "cleanliness" score, ranking from 0 to 5. Regular rubber cup polishing and regular brushing resulted in the highest surface cleanliness, while the air-polishing procedure showed the lowest cleanliness score. None of the 3 scaling methods created a cleanliness score better than 3. The 3 scaling methods were considered equal in their cleaning effectiveness. No differences could be observed between surfaces treated 1 x or 2 x. Taken the present findings and those of other studies concerning the effects of scaling on the surface roughness and biocompatibility into consideration, it was concluded that plastic scalers may be the instruments of choice for debridement of titanium implant surfaces.