Balderrama Ísis de Fátima, Stuani Vitor de Toledo, Cardoso Matheus Völz, Oliveira Rodrigo Cardoso, Lopes Marcelo Milanda Ribeiro, Greghi Sebastião Luiz Aguiar, Adriana Campos Passanezi Sant'Ana
Department of Diagnosis and Surgery, Araraquara School of Dentistry, Sao Paulo State University, Araraquara, SP, Brazil; Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
Photodiagnosis Photodyn Ther. 2021 Mar;33:102105. doi: 10.1016/j.pdpdt.2020.102105. Epub 2020 Nov 18.
The aim of this preliminary study was to analyze the effectiveness of three different protocols of decontamination on five commercial moderate rough implants.
The types of implants investigated were: Neoporos Drive CM (CM; Neodent®), Drive CM Acqua (ACQ; Neodent®), SLActive (SLA; Straumann®), Osseotite (OT; Biomet 3i®) and Nanotite (NT; Biomet 3i®). Implant surface properties (n = 2/type of implant; control groups) were analyzed by scanning electron microscopy (SEM) images to determine surface roughness parameters (SRP) and energy disperse X-ray spectrometry to determine the chemical composition. Implants were then inoculated with Aggregatibacter actinomycetencomitans in vitro (n = 6/type of implant;experimental groups) and the contaminated areas were determined in SEM images (500x magnifications). Decontamination of implants was performed in duplicate by three protocols: antimicrobial photodynamic therapy (aPDT), EDTA associated with citric acid (EDTA + CA) and 0.12 % chlorhexidine (CHX). The remaining contaminated area (rCtA) was determined in SEM images (500x magnifications). All quantitative analysis through SEM images were analyzed in ImageJ® software for two-dimensional parameters.
No significant differences were found in SRP among implants (control group), except for Rv (lowest valley) between SLA vs. OT (p=0.0031; Kruskal Wallis post hoc Dunn). NT implants showed highest contaminated area vs. ACQ implants (68.19 % ± 8.63 % and 57.32 % ± 5.38 %, respectively; p = 0.0016, Tukey's test). SRP after decontamination showed statistical difference for Ra (arithmetical mean deviation) for all decontamination groups when compared to control (p < 0.05; ANOVA with post-hoc Tukey's multiple comparisons test), only CM implants showed statistical difference when compared decontamination protocols to control with highest modification of SRP for EDTA + AC group. For decontamination analysis, for applicability of different protocols in the same type of implant, only SLA showed statistical significant difference for aPDT vs. EDTA + CA (p = 0.0114; ANOVA with post-hoc Tukey's multiple comparisons test) with lowest rCTA for aPDT, however for ACQ implants the aPDT showed lowest rCTA with no statistical difference (p > 0.05; ANOVA with post-hoc Tukey's multiple comparisons test). No statistical difference was observed between the decontamination protocols at other implant types.
It can be suggested that the chemical-physical characteristics of dental implants can be effected by the process of contamination and decontamination by aPDT and chemical agents.
本初步研究的目的是分析三种不同去污方案对五种商用中等粗糙度种植体的有效性。
所研究的种植体类型有:Neoporos Drive CM(CM;Neodent®)、Drive CM Acqua(ACQ;Neodent®)、SLActive(SLA;Straumann®)、Osseotite(OT;Biomet 3i®)和Nanotite(NT;Biomet 3i®)。通过扫描电子显微镜(SEM)图像分析种植体表面特性(每种种植体n = 2;对照组),以确定表面粗糙度参数(SRP),并通过能量色散X射线光谱法确定化学成分。然后在体外将伴放线聚集杆菌接种到种植体上(每种种植体n = 6;实验组),并在SEM图像(500倍放大)中确定污染区域。种植体的去污通过三种方案重复进行:抗菌光动力疗法(aPDT)、与柠檬酸联合使用的乙二胺四乙酸(EDTA + CA)和0.12%的洗必泰(CHX)。在SEM图像(500倍放大)中确定剩余污染区域(rCtA)。通过SEM图像进行的所有定量分析均在ImageJ®软件中分析二维参数。
除SLA与OT之间的Rv(最低谷)外,种植体(对照组)之间的SRP未发现显著差异(p = 0.0031;Kruskal Wallis事后邓恩检验)。与ACQ种植体相比,NT种植体显示出最高的污染区域(分别为68.19% ± 8.63%和57.32% ± 5.38%;p = 0.0016,Tukey检验)。去污后的SRP与对照组相比,所有去污组的Ra(算术平均偏差)均显示出统计学差异(p < 0.05;方差分析及事后Tukey多重比较检验),只有CM种植体在将去污方案与对照组比较时,EDTA + AC组的SRP变化最大,显示出统计学差异。对于去污分析,就不同方案在同一类型种植体中的适用性而言,只有SLA在aPDT与EDTA + CA之间显示出统计学显著差异(p = 0.0114;方差分析及事后Tukey多重比较检验),aPDT的rCTA最低,然而对于ACQ种植体,aPDT的rCTA最低,但无统计学差异(p > 0.05;方差分析及事后Tukey多重比较检验)。在其他种植体类型的去污方案之间未观察到统计学差异。
可以认为,牙科种植体的化学物理特性会受到aPDT和化学试剂的污染及去污过程的影响。