Review Finds Variability in Bacterial Colonisation on Dental Implants with Different Hygiene Instruments

Dental implants, a pinnacle of dental technology, offer a solution to tooth loss. However, they can also lead to peri-implant diseases, including peri-implantitis and peri-implant mucositis, which may ultimately result in implant failure. Despite patients maintaining oral hygiene, these diseases can persist, primarily due to hard-to-reach areas around the implants, such as the implant neck. 

Regular debridement by dental practitioners is essential to ensure implant longevity. The challenge lies in selecting hygiene instruments that efficiently remove plaque without damaging the implant surface, as some instruments can inadvertently increase bacterial colonisation and, consequently, the risk of peri-implant diseases.

Review Details

To address this challenge, a comprehensive review was conducted, evaluating bacterial colonization on dental implants following the use of different hygiene instruments. The review employed a literature search of articles published from 2012 to 2022, drawing from trusted sources like PubMed, ScienceDirect, and Scopus. 

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A total of 19 full-text papers were analyzed, comprising both in vitro and in vivo studies. Various assessment methods were used to evaluate bacterial colonization, including scanning electron microscopy, colony-forming unit counts, crystal violet assays, plaque index, probing depth, bleeding on probing, turbidity tests, and live-dead assays.

Findings & Instruments

The findings revealed intriguing variations in the effectiveness of different hygiene instruments. Notably, rubber cup polishing with an abrasive paste demonstrated a significant reduction in biofilm formation compared to air abrasion with glycine powder. Air abrasion, in turn, proved more efficient than piezoelectric, carbon, and stainless steel scalers. 

Surface treatment with Er, Cr: YSGG laser, and Er: YAG laser significantly outperformed titanium curettes and photodynamic therapy in dental biofilm removal. While air abrasion, plastic curettes, titanium curettes, and ultrasonic scalers showed no significant differences in bacterial colonisation, air abrasion and plastic curette were identified as safer options for zirconia implant decontamination. 

Furthermore, the titanium brush exhibited superior results in implant surface decontamination compared to the Er: YAG laser.

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Implications

The review highlights the complex landscape of hygiene instrument efficacy for dental implants. It underscores that no single instrument or method can be universally considered a gold standard for treating peri-implant diseases. 

Nevertheless, several instruments, including air abrasion with glycine powder, laser therapies, rubber cup polishing with an abrasive paste, and the titanium brush, were found to offer high levels of cleaning efficacy and were well-received by patients. These findings provide valuable guidance for dental practitioners seeking to minimise the prevalence of peri-implant diseases and implant failures, ultimately contributing to better patient outcomes.

In summary, this comprehensive review illuminates the multifaceted choices available to dental professionals for maintaining implant health, offering insights into which instruments are most effective in ensuring dental implant longevity and reducing the risk of peri-implant diseases.