Stavropoulos Andreas, Al Said Ahmad, Mustafa Ola, Spineli Loukia M, Heimel Patrick, Bertl Kristina
Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.
Department of Periodontology, Blekinge Hospital, Karlskrona, Sweden.
Clin Oral Implants Res. 2025 Sep;36(9):1146-1158. doi: 10.1111/clr.14464. Epub 2025 Jun 22.
To evaluate, in a simulation of surgical peri-implantitis treatment, the impact of type of handpiece, device settings, and instrumentation time on the efficacy of airflowing in cleaning the implant surface, depending on the type of bone defect and implant surface.
Turned and modified surface implants (54 each) were coated with biofilm imitation and mounted on resin models replicating purely horizontal or circumferential intraosseous peri-implant defects (both 5 mm deep). Implants were instrumented with an airflowing device using a supra- or submucosal handpiece, with three settings: (a) power 5, 5 s (b) power 10, 5 s, and (c) power 5, 15 s per implant/defect sextant.
The amount of residual biofilm imitation was associated with defect configuration, type of handpiece, and device settings (p < 0.15); implant surface did not have an effect. In horizontal defects, with the supramucosal handpiece, only 3 of 54 implants showed > 5% residual biofilm imitation and 23 of 54 implants were completely clean; with the submucosal handpiece, 12 of 18 implants showed ≤ 5% residual biofilm imitation when used for 15 s/sextant, yet none were completely clean. In intraosseous defects, all implants presented ≤ 5% residual biofilm imitation and 10 of 18 implants were completely clean with the submucosal handpiece used for 15 s/sextant; the supramucosal handpiece was largely inefficacious.
Within the limitations of this laboratory study, peri-implant bone defect configuration should dictate the choice of airflowing handpiece (i.e., for horizontal defects, the supramucosal handpiece; for intraosseous defects, the submucosal handpiece) and intrasurgical airflowing requires a prolonged instrumentation time, but not increased power.
在模拟手术治疗种植体周围炎的过程中，根据骨缺损类型和种植体表面情况，评估机头类型、设备设置及操作时间对气流清洁种植体表面效果的影响。
将经过车削和改性表面处理的种植体（各54个）涂上生物膜模拟物，安装在复制单纯水平或环形骨内种植体周围缺损（均为5毫米深）的树脂模型上。使用气流设备，通过龈上或龈下手头对种植体进行操作，设置三种参数：(a)功率5，持续5秒；(b)功率10，持续5秒；(c)每个种植体/缺损象限功率5，持续15秒。
残余生物膜模拟物的量与缺损形态、机头类型和设备设置有关（p < 0.15）；种植体表面无影响。在水平缺损中，使用龈上头时，54个种植体中只有3个显示残余生物膜模拟物>5%，54个种植体中有23个完全清洁；使用龈下手时，18个种植体中有12个在每象限使用15秒时显示残余生物膜模拟物≤5%，但无一完全清洁。在骨内缺损中，所有种植体的残余生物膜模拟物均≤5%，18个种植体中有10个在每象限使用龈下手15秒时完全清洁；龈上头基本无效。
在本实验室研究的局限性内，种植体周围骨缺损形态应决定气流机头的选择（即水平缺损用龈上头，骨内缺损用龈下手），手术中气流清洁需要延长操作时间，但无需增加功率。
