ABSTRACT
Background:
Scaling and root planing (SRP) are non-surgical periodontal treatments used to remove plaque and calculus, essential for maintaining peri-implant health. However, the mechanical action of SRP may affect the surface characteristics of dental implant materials, potentially impacting implant osseointegration and longevity.
Materials and Methods:
A total of 60 dental implant specimens were categorized into three groups based on the material composition: Group A (Titanium), Group B (Zirconia), and Group C (Polyetheretherketone - PEEK). Each group consisted of 20 specimens. All specimens underwent SRP using a stainless steel curette and ultrasonic scaler. Surface roughness (Ra) was measured before and after treatment using a profilometer. Scanning electron microscopy (SEM) was used to evaluate the surface topography changes. Statistical analysis was performed using ANOVA and paired t-tests, with a significance level set at P < 0.05.
Results:
The surface roughness (Ra) of all implant materials increased following SRP. Group A (Titanium) showed an increase in roughness from 0.65 μm to 0.85 μm (P < 0.01), while Group B (Zirconia) exhibited an increase from 0.55 μm to 0.70 μm (P < 0.01). Group C (PEEK) demonstrated the most significant change, with roughness increasing from 0.30 μm to 0.60 μm (P < 0.001). SEM images revealed that Group A and B implants had minor surface scratches, while Group C showed deeper grooves post-SRP. The difference in surface alteration was statistically significant between the groups (P < 0.05).
Conclusion:
Scaling and root planing lead to increased surface roughness and topographical changes in dental implant materials, with PEEK implants being most affected. The findings suggest that while SRP is effective for peri-implant maintenance, care should be taken with material selection as surface alterations may influence implant success rates.
KEYWORDS: Dental implants, root planing, scaling
INTRODUCTION
Plaque and calculus buildup surrounding the implant surfaces might jeopardise the health of the peri-implant tissues, which are crucial to the long-term effectiveness of dental implants. One popular non-surgical periodontal therapy for peri-implant inflammation and tissue repair is scaling and root planing (SRP). However, as surface changes may affect osseointegration, plaque buildup, and overall implant durability, questions have been raised about how SRP affects the surface properties of various implant materials.[1]
The biological performance of dental implants is significantly influenced by surface characteristics including roughness and topography, which have an impact on cell adhesion, proliferation, and differentiation at the bone-implant interface.[2] Because of its superior strength, biocompatibility, and bone-integration capabilities, titanium is the most widely utilized material for dental implants.[3] Other materials with benefits like better aesthetics and less allergic reactions, such zirconia and polyetheretherketone (PEEK), are also being investigated as titanium substitutes.[4,5] But the mechanical action of SRP, particularly when done with stainless steel curettes or ultrasonic scalers, may harm these surfaces, changing their topography and surface roughness.[4]
Increased surface roughness has been shown in earlier research to promote bacterial adhesion and biofilm development, potentially having a negative impact on peri-implant health.[6] Smoother surfaces, on the other hand, could hinder osseointegration but also lessen plaque buildup.[7]
MATERIALS AND METHODS
Study design and sample preparation
This in vitro experimental study included 60 dental implant specimens divided into three groups based on their material composition: Group A (Titanium), Group B (Zirconia), and Group C (Polyetheretherketone - PEEK). Each group consisted of 20 standardized cylindrical specimens with dimensions of 4 mm in diameter and 10 mm in height. All implant specimens were provided by a single manufacturer to ensure consistency in material properties and surface treatment. Prior to the experiment, the specimens were cleaned and sterilized in an autoclave at 121°C for 15 minutes.
Scaling and root planing procedure
Each specimen underwent scaling and root planing (SRP) using two different methods. First, a manual stainless steel curette was used for mechanical debridement on one-half of the specimen’s surface. The other half of the surface was treated using an ultrasonic scaler (Cavitron®) with a metal tip, set at a medium power setting (30 kHz frequency).
Surface roughness measurement
Surface roughness (Ra) was measured before and after SRP using a contact profilometer (MitutoyoSurftest SJ-210, Japan) with a 2 μm diamond stylus. Each specimen was scanned along three randomly selected lines, and the average Ra value was recorded. The profilometer was calibrated before each set of measurements to ensure accuracy. The mean difference in surface roughness before and after SRP was calculated for each material group.
Statistical analysis
Data were analyzed using IBM SPSS Statistics version 25.0
RESULTS
Surface roughness
The surface roughness (Ra) values of the specimens before and after SRP are presented in Table 1. All implant materials exhibited a statistically significant increase in surface roughness after SRP (P < 0.05). Group C (PEEK) showed the highest increase in surface roughness, followed by Group A (Titanium) and Group B (Zirconia).
Table 1.
Surface Roughness (Ra) before and after SRP for different implant materials
| Material Group | Mean Ra Before SRP (µm) | Mean Ra After SRP (µm) | Change in Ra (µm) | P |
|---|---|---|---|---|
| Group A (Titanium) | 0.65±0.08 | 0.85±0.09 | 0.20±0.05 | 0.01 |
| Group B (Zirconia) | 0.55±0.06 | 0.70±0.07 | 0.15±0.04 | 0.02 |
| Group C (PEEK) | 0.30±0.05 | 0.60±0.08 | 0.30±0.06 | 0.001 |
The results indicated that PEEK implants exhibited the most substantial increase in roughness, with a mean change of 0.30 μm (P < 0.001). Titanium implants showed a moderate increase (0.20 μm, P < 0.01), while Zirconia implants demonstrated the least increase in roughness (0.15 μm, P < 0.02).
Surface topography
The SEM analysis revealed noticeable changes in surface topography after SRP. The images show that Group A (Titanium) implants displayed minor surface scratches and irregularities. Group B (Zirconia) implants had relatively shallow grooves and a smoother appearance compared to the other groups [Table 2]. In contrast, Group C (PEEK) exhibited deep scratches and significant surface alterations, consistent with the substantial increase in surface roughness observed in the profilometry analysis.
Table 2.
Statistical comparison of surface roughness changes between groups
| Comparison | Mean Difference (µm) | P |
|---|---|---|
| Group A vs Group B | 0.05 | 0.03 |
| Group A vs Group C | 0.10 | 0.001 |
| Group B vs Group C | 0.15 | 0.005 |
Statistical comparison between groups
One-way ANOVA indicated a statistically significant difference in the surface roughness changes among the three groups (P < 0.05). Tukey’s post-hoc test confirmed that the change in surface roughness for Group C (PEEK) was significantly higher compared to Group A (Titanium) and Group B (Zirconia) (P < 0.01). The differences between Groups A and B were also statistically significant (P < 0.05).
The statistical analysis revealed that Group C (PEEK) experienced the most pronounced surface changes, suggesting that this material is more susceptible to mechanical damage from SRP compared to Titanium and Zirconia.
DISCUSSION
One important component affecting how implants interact with the biological tissues around them is surface roughness. A higher surface roughness might encourage the production of biofilms and bacterial adherence, two important risk factors for implant failure and peri-implantitis.[1] All implant materials in this investigation showed an increase in surface roughness (Ra) during SRP, supporting earlier findings that mechanical debridement methods might harm implant surfaces.[2,3] Compared to titanium and zirconia, PEEK implants showed the most noticeable increase in surface roughness, indicating that this material is more prone to surface changes during SRP.
PEEK’s biocompatibility and advantageous mechanical qualities, such as its low weight and flexibility, make it a material that is becoming more and more popular in dental implantology.[4] Its vulnerability to surface damage, as shown in this research, raises questions over how long it will last under standard peri-implant maintenance practices. PEEK implants have a noticeable increase in roughness (0.30 μm), which might encourage bacterial colonization and eventually jeopardize the health of the peri-implant.[5] This is in line with research by Schwitalla and Müller,[4] who found that mechanical instrumentation may negatively impact PEEK’s surface integrity, increasing its roughness and the likelihood of bacterial biofilm development.
Because of its superior osseointegration and biocompatibility, titanium implants—which showed a slight increase in roughness of 0.20 μm—are the most often utilized in clinical practice.[6] Titanium implants only displayed modest surface scratches and localized damage, indicating that titanium is still comparatively robust to mechanical instrumentation, even with the observed increase in surface roughness. These results are consistent with earlier research that found titanium surface properties changed very little during SRP, particularly when non-metal-tipped ultrasonic scalers were used.[7,8,9]
CONCLUSION
The study’s findings demonstrate how scaling and root planing have varied impacts on the surface properties of dental implants made of titanium, zirconia, and PEEK. Titanium and zirconia implants exhibited superior resistance to mechanical instrumentation, while PEEK implants were most vulnerable to surface damage.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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