Comparison of decontamination efficacy of two electrolyte cleaning methods to diode laser, plasma, and air-abrasive devices

Abstract

Objective: To compare the in vitro decontamination efficacy of two electrolytic cleaning methods to diode laser, plasma, and air-abrasive devices.

Material and methods: Sixty sandblasted large-grit acid-etched (SLA) implants were incubated with 2 ml of human saliva and Tryptic Soy Broth solution under continuous shaking for 14 days. Implants were then randomly assigned to one untreated control group (n = 10) and 5 different decontamination modalities: air-abrasive powder (n = 10), diode laser (n = 10), plasma cleaning (n = 10), and two electrolytic test protocols using either potassium iodide (KI) (n = 10) or sodium formate (CHNaO₂) (n = 10) solution. Implants were stained for dead and alive bacteria in two standardized measurement areas, observed at fluorescent microscope, and analyzed for color intensity.

Results: All disinfecting treatment modalities significantly reduced the stained area compared to the untreated control group for both measurement areas (p < 0.001). Among test interventions, electrolytic KI and CHNaO₂ treatments were equally effective, and each one significantly reduced the stained area compared to any other treatment modality (p < 0.001). Efficacy of electrolytic protocols was not affected by the angulation of examined surfaces [surface angulation 0° vs. 60° (staining %): electrolytic cleaning-KI 0.03 ± 0.04 vs. 0.09 ± 0.10; electrolytic cleaning-CHNaO2 0.01 ± 0.01 vs. 0.06 ± 0.08; (p > 0.05)], while air abrasion [surface angulation 0° vs. 60° (staining %): 2.66 ± 0.83 vs. 42.12 ± 3.46 (p < 0.001)] and plasma cleaning [surface angulation 0° vs. 60° (staining %): 33.25 ± 3.01 vs. 39.16 ± 3.15 (p < 0.001)] were.

Conclusions: Within the limitations of the present in vitro study, electrolytic decontamination with KI and CHNaO₂ was significantly more effective in reducing bacterial stained surface of rough titanium implants than air-abrasive powder, diode laser, and plasma cleaning, regardless of the accessibility of the contaminated implant location.

Clinical relevance: Complete bacterial elimination (residual bacteria < 1%) was achieved only for the electrolytic cleaning approaches, irrespectively of the favorable or unfavorable access to implant surface.

Keywords: Air abrasion; Debridement; Dental implants; Electrolytes; Fluorescence microscopy; Laser therapy; Peri-implantitis; Photodynamic therapy; Plasma ablation.