Investigation of surface element properties in explanted implants due to peri-implantitis: An in vitro study

Osteointegration is the connection between alveolar bone and implant surface. After peri-implant diseases, the surface structure is changed, but the surface properties of the dental implant are crucial in re-osseointegration. This study aimed to examine the surface element levels of explanted implants due to peri-implantitis by scanning electron microscopy/energy-dispersive x-ray spectroscopy analysis (SEM-EDX).

Ten explanted sandblasted, large grit, acid-etched (SLA) surface dental implants (Straumann Roxolid, Straumann GmbH, Freiburg, Germany) were used for the study. Explanted implants were washed with distilled water/air spray to purify blood and debris, dried with air spray, and waited for test time at room temperature. Explanted implants were examined using a SEM. The samples were not coated with gold, and images were taken at 115x and 8000x. SEM-EDX was performed at three-point for each sample to analyze relative concentration or weight percent (wt%) of carbon (C), oxygen (O), sodium (Na), aluminum (Al), titanium (Ti), and zirconium (Zr) with same SEM.

In the explanted implants, osseointegrated bone (0.1-0.5 mm wide) residues were observed in places, especially in the apical region. Regarding metal-to-metal labeling on the surfaces of dismantled implants, no findings such as surface scratches, fractures, and cracks were found. In explanted implants, the amount of C was relatively higher, while the amount of Ti was relatively lower.

Within the limitation of this study, it can be said that the C amount is high, and the amount of Ti is low in explanted implants relatively. Further research is needed to understand the effect of surface elements on re-osseointegration, where the number of samples is high.