Presence of Titanium Particles After Cleaning of Implant Surfaces

Objectives: The purpose of this study was to evaluate the presence of titanium ions and particles (TiP) after instrumentation of implant surfaces using common dental debridement methods.
Methods: Three types of debridement instruments, stainless steel curette (SS), ultrasonic tip (CV), and ultrasonic tip with plastic sleeve (CS) were evaluated. A simulated peri-implantitis defect was created around a titanium dental implant in type II bone block and irrigation was performed with operatory unit water. Twenty samples (per debridement method) were collected using paper points after 30 seconds of instrumentation. Chemical composition analysis of the bone block, water irrigation and instruments (baseline) were evaluated for presence of TiP and liquid samples after instrumentation were examined with an x-ray fluorescent spectrometer. Statistical analysis using simple t-test was performed for each debridement method.
Results: Baseline measurements showed no presence of TiP. After instrumentation, TiP parts per million (ppm) were found in SS and CV groups with the values of 0.0234±0.0181 and 0.0047±0.0042, respectively. Titanium particles were not observed in CS group. The semiquantitative data showed a higher presence of TiP in the SS and CV groups in comparison to the baseline (p<0.0001).
Conclusions: Titanium ions and particles were found after instrumentation using stainless steel curettes and ultrasonic device without plastic sleeve which may affect the disease etiology and outcomes of peri-implantitis therapy.