Air Abrasion of Titanium Dental Implants with Water-Soluble Powders: An In Vitro Study

Timur V. Melkumyan, Gerhard K. Seeberger, Zurab S. Khabadze, Nuriddin Kh. Kamilov, Maria K. Makeeva, Marina U. Dashtieva, Surayo Sh. Sheralieva, Angela D. Dadamova

International Journal of Biomedicine. 2022;12(3):428-432.
DOI: 10.21103/Article12(3)_OA15
Originally published September 5, 2022


The aim of this study was to determine the average amount of silicon ions on the surface of titanium implants after air abrasion with powders based on glycine and erythritol, and to measure the content of silicon ions in separated water-insoluble fractions of these powders.
Methods and Results: The study investigated 2 air-abrasive powders, one based on glycine (Air-Flow Perio, EMS, Switzerland) and another on erythritol (Air-FlowPlus, EMS, Switzerland). These abrasives were tested for solubility in water and the content of Si+ in insoluble fractions of these powders. Also, the weight percent (wt %) of Si+ was measured on the surface of failed titanium implants after air abrasion with Air-Flow Perio (Group 1) and Air-FlowPlus (Group 2). Scanning electron microscopy and determining the elemental composition of obtained samples were carried out on an SEM-EVO MA 10 (Carl Zeiss) and energy dispersive X-ray spectrometer with EDS Aztec Energy Advanced X-Act (Oxford Instruments). It was found that air-abrasive mixtures based on glycine and erythritol are not completely soluble in water due to the presumed presence of silica in them. It was also found that air-abrasive cleaning of contaminated dental implants with an erythritol-based mixture contributed to a significant increase (P=0.000) in the Si+ content on their surfaces in comparison to implants treated with glycine-based powder.

air abrasion • water soluble powder • titanium implant • surface chemistry • peri-implantitis
  1. Schwarz F, Sahm N, Bieling K, Becker J. Surgical regenerative treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane: a four-year clinical follow-up report. J Clin Periodontol. 2009 Sep;36(9):807-14. doi: 10.1111/j.1600-051X.2009.01443.x. 
  2. Claffey N, Clarke E, Polyzois I, Renvert S. Surgical treatment of peri-implantitis. J Clin Periodontol. 2008 Sep;35(8 Suppl):316-32. doi: 10.1111/j.1600-051X.2008.01277.x.
  3. Dahlin C, Sennerby L, Lekholm U, Linde A, Nyman S. Generation of new bone around titanium implants using a membrane technique: an experimental study in rabbits. Int J Oral Maxillofac Implants. 1989 Spring;4(1):19-25. PMID: 2599578.
  4. Khoury F, Keeve PL, Ramanauskaite A, Schwarz F, Koo KT, Sculean A, Romanos G. Surgical treatment of peri-implantitis - Consensus report of working group 4. Int Dent J. 2019 Sep;69 Suppl 2(Suppl 2):18-22. doi: 10.1111/idj.12505.
  5. Ramanauskaite A, Obreja K, Sader R, Khoury F, Romanos G, Koo KT, Keeve PL, Sculean A, Schwarz F. Surgical Treatment of Periimplantitis With Augmentative Techniques. Implant Dent. 2019 Apr;28(2):187-209. doi: 10.1097/ID.0000000000000839.
  6.  Sahrmann P, Attin T, Schmidlin PR. Regenerative treatment of peri-implantitis using bone substitutes and membrane: a systematic review. Clin Implant Dent Relat Res. 2011 Mar;13(1):46-57. doi: 10.1111/j.1708-8208.2009.00183.x.
  7. Stricker A, Bergfeldt T, Fretwurst T, Addison O, Schmelzeisen R, Rothweiler R, Nelson K, Gross C. Impurities in commercial titanium dental implants - A mass and optical emission spectrometry elemental analysis. Dent Mater. 2022 Aug;38(8):1395-1403. doi: 10.1016/
  8. Duddeck DU, Albrektsson T, Wennerberg A, Larsson C, Beuer F. On the Cleanliness of Different Oral Implant Systems: A Pilot Study. J Clin Med. 2019 Aug 22;8(9):1280. doi: 10.3390/jcm8091280. 
  9. Cassinelli C, Morra M, Bruzzone G, Carpi A, Di Santi G, Giardino R, Fini M. Surface chemistry effects of topographic modification of titanium dental implant surfaces: 2. In vitro experiments. Int J Oral Maxillofac Implants. 2003 Jan-Feb;18(1):46-52. 
  10. Louropoulou A, Slot DE, Van der Weijden FA. Titanium surface alterations following the use of different mechanical instruments: a systematic review. Clin Oral Implants Res. 2012 Jun;23(6):643-658. doi: 10.1111/j.1600-0501.2011.02208.x. 
  11. Mellado-Valero A, Buitrago-Vera P, Solá-Ruiz MF, Ferrer-García JC. Decontamination of dental implant surface in peri-implantitis treatment: a literature review. Med Oral Patol Oral Cir Bucal. 2013 Nov 1;18(6):e869-76. doi: 10.4317/medoral.19420.
  12. Subramani K, Wismeijer D. Decontamination of titanium implant surface and re-osseointegration to treat peri-implantitis: a literature review. Int J Oral Maxillofac Implants. 2012 Sep-Oct;27(5):1043-54. 
  13. Sahm N, Becker J, Santel T, Schwarz F. Non-surgical treatment of peri-implantitis using an air-abrasive device or mechanical debridement and local application of chlorhexidine: a prospective, randomized, controlled clinical study. J Clin Periodontol. 2011 Sep;38(9):872-8. doi: 10.1111/j.1600-051X.2011.01762.x. 
  14. Quintero DG, Taylor RB, Miller MB, Merchant KR, Pasieta SA. Air-Abrasive Disinfection of Implant Surfaces in a Simulated Model of Periimplantitis. Implant Dent. 2017 Jun;26(3):423-428. doi: 10.1097/ID.0000000000000597. 
  15. Batalha VC, Bueno RA, Fronchetti Junior E, Mariano JR, Santin GC, Freitas KMS, Ortiz MAL, Salmeron S. Dental Implants Surface in vitro Decontamination Protocols. Eur J Dent. 2021 Jul;15(3):407-411. doi: 10.1055/s-0040-1721550.
  16. Petersilka GJ, Tunkel J, Barakos K, Heinecke A, Häberlein I, Flemmig TF. Subgingival plaque removal at interdental sites using a low-abrasive air polishing powder. J Periodontol. 2003 Mar;74(3):307-11. doi: 10.1902/jop.2003.74.3.307.
  17. Pranno N, Cristalli MP, Mengoni F, Sauzullo I, Annibali S, Polimeni A, La Monaca G. Comparison of the effects of air-powder abrasion, chemical decontamination, or their combination in open-flap surface decontamination of implants failed for peri-implantitis: an ex vivo study. Clin Oral Investig. 2021 May;25(5):2667-2676. doi: 10.1007/s00784-020-03578-w.
  18. Matsubara VH, Leong BW, Leong MJL, Lawrence Z, Becker T, Quaranta A. Cleaning potential of different air abrasive powders and their impact on implant surface roughness. Clin Implant Dent Relat Res. 2020 Feb;22(1):96-104. doi: 10.1111/cid.12875.
  19. Valderrama P, Wilson TG Jr. Detoxification of implant surfaces affected by peri-implant disease: an overview of surgical methods. Int J Dent. 2013;2013:740680. doi: 10.1155/2013/740680.
  20. Tastepe CS, van Waas R, Liu Y, Wismeijer D. Air powder abrasive treatment as an implant surface cleaning method: a literature review. Int J Oral Maxillofac Implants. 2012 Nov-Dec;27(6):1461-73.
  21. Seki K, Ikeda T, Kamimoto A, Hagiwara Y. Efficacy of glycine air-powder abrasion for treatment of peri-implantitis. J Dent Sci. 2022 Apr;17(2):1053-1055. doi: 10.1016/j.jds.2021.12.016.
  22. Toma S, Lasserre JF, Taïeb J, Brecx MC. Evaluation of an air-abrasive device with amino acid glycine-powder during surgical treatment of peri-implantitis. Quintessence Int. 2014 Mar;45(3):209-19. doi: 10.3290/j.qi.a31205.
  23. Lupi SM, Granati M, Butera A, Collesano V, Rodriguez Y Baena R. Air-abrasive debridement with glycine powder versus manual debridement and chlorhexidine administration for the maintenance of peri-implant health status: a six-month randomized clinical trial. Int J Dent Hyg. 2017 Nov;15(4):287-294. doi: 10.1111/idh.12206.
  24. Taschieri S, Weinstein R, Del Fabbro M, Corbella S. Erythritol-Enriched Air-Polishing Powder for the Surgical Treatment of Peri-Implantitis. ScientificWorldJournal. 2015;2015:802310. doi: 10.1155/2015/802310.
  25. Hentenaar DFM, De Waal YCM, Stewart RE, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol air polishing in the surgical treatment of peri-implantitis: A randomized controlled trial. Clin Oral Implants Res. 2022 Feb;33(2):184-196. doi: 10.1111/clr.13881.
  26. Flemmig TF, Hetzel M, Topoll H, Gerss J, Haeberlein I, Petersilka G. Subgingival debridement efficacy of glycine powder air polishing. J Periodontol. 2007 Jun;78(6):1002-10. doi: 10.1902/jop.2007.060420.
  27. Müller N, Moëne R, Cancela JA, Mombelli A. Subgingival air-polishing with erythritol during periodontal maintenance: randomized clinical trial of twelve months. J Clin Periodontol. 2014 Sep;41(9):883-9. doi: 10.1111/jcpe.12289. 
  28. Ulvik IM, Sæthre T, Bunæs DF, Lie SA, Enersen M, Leknes KN. A 12-month randomized controlled trial evaluating erythritol air-polishing versus curette/ultrasonic debridement of mandibular furcations in supportive periodontal therapy. BMC Oral Health. 2021 Jan 21;21(1):38. doi: 10.1186/s12903-021-01397-3. 
  29. Petersilka GJ, Bell M, Mehl A, Hickel R, Flemmig TF. Root defects following air polishing. J Clin Periodontol. 2003 Feb;30(2):165-70. doi: 10.1034/j.1600-051x.2003.300204.x. 
  30. Petersilka G, Faggion CM Jr, Stratmann U, Gerss J, Ehmke B, Haeberlein I, Flemmig TF. Effect of glycine powder air-polishing on the gingiva. J Clin Periodontol. 2008 Apr;35(4):324-32. doi: 10.1111/j.1600-051X.2007.01195.x.
  31. Bühler J, Amato M, Weiger R, Walter C. A systematic review on the effects of air polishing devices on oral tissues. Int J Dent Hyg. 2016 Feb;14(1):15-28. doi: 10.1111/idh.12120. 

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Received July 25, 2022.
Accepted August 25, 2022.
©2022 International Medical Research and Development Corporation.