Purpose: Peri-implantitis is a microbial infectious disease that is similar to periodontal disease. Although one of the most important procedures for managing peri-implantitis is to remove dental biofilm from titanium surfaces, this is less than adequate when the procedure is conducted using conventional dental devices. Ultrasound in the MHz range generates vibration in water, thereby accelerating water molecules through which debris on the surface of an object can be removed. The objective of this study was to investigate the effectiveness of ultrasonic water flow in removing plaque from titanium specimens.
Methods: Sound pressure was measured by the beam pattern distribution and a hydrophone. The optimum applied power and irradiation conditions were determined based on the relationship between artificial plaque removal effect and sound pressure. Plaque biofilms were formed over a period of 72 h on the surfaces of titanium specimens attached to custom-made stents fixed to the buccal surfaces of the molar and premolar teeth of volunteers. In this experiment, the titanium surfaces were exposed to an ultrasonic water flow of 400 kHz, with a sound pressure of 0.6 MPa, for 180 s. After cleaning by the ultrasonic water flow, the titanium surfaces were examined by a scanning electron microscope. For each specimen, the residual plaque biofilm areas were evaluated as percentages of the surface scanned.
Results: The sound pressure measurements were confirmed to be reasonably accurate based on the calculated results of the beam pattern distribution. The artificial plaque was removed in a sound pressure-dependent manner. The total proportions of residual plaque biofilm were 22.8% (median) and 7.05% (median) on mirror-finished and rough surfaces, respectively. The difference in residual plaque biofilm compared to the condition before treatment on both the mirror-finished and rough surfaces was judged to be significant at *p<0.05. Furthermore, the ultrasonic water flow completely destroyed the bacterial chains on the titanium specimens.
Conclusions: This study demonstrated that the 400 - kHz, 0.6 - MPa sound pressure ultrasonic water flow cleaning device can effectively remove plaque biofilm from titanium surfaces.
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