Tan Nathan Chiang Ping, Khan Ahsen, Antunes Elsa, Miller Catherine M, Sharma Dileep
College of Medicine and Dentistry, James Cook University, Smithfield, Australia.
College of Science and Engineering, James Cook University, Smithfield, Australia.
J Periodontal Implant Sci. 2021 Oct;51(5):298-315. doi: 10.5051/jpis.2005080254.
Peri-implantitis therapy and implant maintenance are fundamental practices to enhance the longevity of zirconia implants. However, the use of physical decontamination methods, including hand instruments, polishing devices, ultrasonic scalers, and laser systems, might damage the implant surfaces. The aim of this systematic review was to evaluate the effects of physical decontamination methods on zirconia implant surfaces.
A systematic search was conducted using 5 electronic databases: Ovid MEDLINE, PubMed, Scopus, Web of Science, and Cochrane. Hand searching of the OpenGrey database, reference lists, and 6 selected dental journals was also performed to identify relevant studies satisfying the eligibility criteria.
Overall, 1049 unique studies were identified, of which 11 studies were deemed suitable for final review. Air-abrasive devices with glycine powder, prophylaxis cups, and ultrasonic scalers with non-metal tips were found to cause minimal to no damage to implant-grade zirconia surfaces. However, hand instruments and ultrasonic scalers with metal tips have the potential to cause major damage to zirconia surfaces. In terms of laser systems, diode lasers appear to be the most promising, as no surface alterations were reported following their use.
Air-abrasive devices and prophylaxis cups are safe for zirconia implant decontamination due to preservation of the implant surface integrity. In contrast, hand instruments and ultrasonic scalers with metal tips should be used with caution. Recommendations for the use of laser systems could not be fully established due to significant heterogeneity among included studies, but diode lasers may be the best-suited system. Further research-specifically, randomised controlled trials-would further confirm the effects of physical decontamination methods in a clinical setting.
种植体周围炎治疗和种植体维护是提高氧化锆种植体使用寿命的基本措施。然而，使用包括手动器械、抛光设备、超声洁牙器和激光系统在内的物理去污方法可能会损坏种植体表面。本系统评价的目的是评估物理去污方法对氧化锆种植体表面的影响。
使用5个电子数据库进行系统检索：Ovid MEDLINE、PubMed、Scopus、科学网和Cochrane。还对手工检索OpenGrey数据库、参考文献列表以及6种选定的牙科期刊，以识别符合纳入标准的相关研究。
总体而言，共识别出1049项独特研究，其中11项研究被认为适合最终评价。发现使用含甘氨酸粉末的空气喷砂设备、预防性杯以及带有非金属尖端的超声洁牙器对种植体级氧化锆表面造成的损害极小或没有损害。然而，手动器械和带有金属尖端的超声洁牙器有可能对氧化锆表面造成重大损害。就激光系统而言，二极管激光似乎最有前景，因为使用后未报告有表面改变。
空气喷砂设备和预防性杯对氧化锆种植体去污是安全的，因为它们能保持种植体表面完整性。相比之下，应谨慎使用手动器械和带有金属尖端的超声洁牙器。由于纳入研究之间存在显著异质性，无法完全确定激光系统的使用建议，但二极管激光可能是最适合的系统。进一步的研究——特别是随机对照试验——将进一步证实物理去污方法在临床环境中的效果。
