Characteristics of Local Delivery Agents for Treating Peri-Implantitis on Dental Implant Surfaces: A Preclinical Study
Local delivery agents (LDAs) are widely used in peri-implantitis treatments. The aim of this study was to identify LDAs remaining on the dental implant surfaces and to analyze the components of these residues after applying various cleaning methods. Implants were prepared with a sand-blasted, large-grit, acid-etched surface. Four kinds of LDAs were applied on the implant surfaces: chlorhexidine gel (group 2), tetracycline solution (group 3), and 2 kinds of minocycline hydrochloride agents (groups 4 and 5). Group 1 received normal saline as a control. Two cleaning methods were applied for different durations as follows: (1) running distilled water for 10 seconds (subgroup A), 5 minutes (subgroup B), and 15 minutes (subgroup C); and (2) water spray of a dental-unit chair for 10 seconds (subgroup D) and 5 minutes (subgroup E). Scanning electron microscopy and energy-dispersive x-ray spectroscopy were used to analyze the surface morphology and residue components for all implants. The amount of LDA removed from the implant surfaces in groups 1, 2, 3, and 5 increased with the cleaning duration and pressure. However, Minocline remained coated on the implant surfaces in group 4 under all cleaning conditions. Minocline could not be cleaned off well by water due to its hydrophobicity. Therefore, directly using this agent on implant surfaces with peri-implantitis should be carefully considered. The presence of LDA residues without drug efficacies on implant surfaces might interfere with reosseointegration and act as a reservoir of microorganisms.
Photographs of implants with a sand-blasted, large-grit, acid-etched surface that were treated with local delivery agents (LDAs): (a) group 1, normal saline (control group); (b) group 2, chlorhexidine gel; (c) group 3, tetracycline solution; (d) group 4, Minocline; and (e) group 5, Periocline. All of the LDAs were applied to the implant surfaces for 5 minutes to ensure complete coverage.
Two kinds of cleaning methods were applied to implant surfaces treated by local delivery agents: (a) rinsing with running distilled water and (b) washing with the water spray of a dental-unit chair. All of the implants were dried after the cleaning procedures at room temperature for 5 minutes.
Scanning electron microscopy images of the middle portion of implant surfaces rinsed with running distilled water (original magnification, ×50 [scale bar: 2 mm]). (a–e) Rinsing for 10 seconds (subgroup A) in groups 1–5, respectively. (f) through (j) Rinsing for 5 minutes (subgroup B) in groups 1–5, respectively. (k) through (o) Rinsing for 15 minutes (subgroup C) in groups 1–5, respectively.
Scanning electron microscopy images of the middle portion of implant surfaces washed with the water spray of a dental-unit chair (original magnification, ×50 [scale bar: 2 mm]). (a–e) Washing for 10 seconds (subgroup D) in groups 1–5, respectively. (f) through (j) Washing for 5 minutes (subgroup E) in groups 1–5, respectively.
Area ratios of local delivery agent remaining on implant surfaces in scanning electron microscopy images of implant surfaces rinsed with running distilled water. Area ratios (n [%]) are mean values.
Area ratios of local delivery agent remaining on implant surfaces in scanning electron microscopy images of implant surfaces washed with the water spray of a dental-unit chair. Area ratios (n [%]) are mean values.
Energy-dispersive X-ray spectroscopy analysis of local delivery agent remaining on implant surfaces in subgroup C.
Energy-dispersive X-ray spectroscopy analysis of local delivery agent remaining on implant surfaces in subgroup E.
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