Decontamination of multispecies oral biofilm from rough implant surface by airflow with glycine.

OBJECTIVES: Decontamination of biofilm-colonized rough implant surfaces remains challenging. We investigated the effect of airflow with glycine powder (AFG) on decontamination of mature oral multispecies biofilm from a sandblasted and acid etched (SLA) titanium surface. MATERIALS AND METHODS: Subgingival dental plaque was cultured on SLA disks anaerobically for 21 days. AFG with various settings and distances was applied directly on the disks with or without previous rinse of 0.9% NaCl. The specimens were then analyzed through scanning electron microscope and remaining bacteria on the implant surface were quantified and statistically compared. RESULTS: Mature oral biofilm with cocci and rods as major morphotypes, as well as spiral- and filamentous-shaped organisms, was formed on the untreated disks. Saline rinsing removed the thick biofilm layer but left numerous of coccoid bacteria in rough surface pits. AFG effectively removed most of the bacteria from the pits. Both 25% and 50% power settings were equally effective at 3-mm distance. With 50% power, AFG successfully removed bacteria at both 3- and 6-mm distance. When AFG was applied on native biofilm without prior rinsing with saline, it effectively removed the biofilm including bacteria in the pits. CONCLUSION: Application of AFG appears effective in removing bacteria from rough implant surfaces.

Optimization of cone beam computed tomography image quality in implant dentistry.

This study was conducted to optimize the cone beam computed tomography image quality in implant dentistry using both clinical and quantitative image quality evaluation with measurement of the radiation dose. A natural bone human skull phantom and an image quality phantom were used to evaluate the images produced after changing the exposure parameters (kVp and mA). A 10 × 5 cm2 field of view was selected for average adult. Five scans were taken with varying kVp (70-90 kVp) first at fixed 4 mA. After assessment of the scans and selecting the best kVp, nine scans were taken with 2-12 mA, and the kVp was fixed at the optimal value. A clinical assessment of the implant-related anatomical landmarks was done in random order by two blinded examiners. Quantitative image quality was assessed for noise/uniformity, artifact added value, contrast-to-noise ratio, spatial resolution, and geometrical distortion. A dosimetry index phantom and thimble ion chamber were used to measure the absorbed dose for each scan setting. The anatomical landmarks of the maxilla had good image quality at all kVp settings. To produce good quality images, the mandibular landmarks demanded higher exposure parameters than the maxillary landmarks. The quantitative image quality values were acceptable at all selected exposure settings. Changing the exposure parameters does not necessarily produce higher image quality outcomes but does affect the radiation dose to the patient. The image quality could be optimized for implant treatment planning at lower exposure settings and dose than the default settings.

Sterilization of Ceramic Sharpening Stones.

Traditionally, periodontal hand instruments are honed or sharpened during patient care as they dull easily during contact with enamel, calculus and cementum. This approach is taught in dental and hygiene schools around the world and remains the standard of care. Recently, some professional organizations have questioned whether this practice should be abandoned because of safety issues. Questions have been raised whether sharpening stones can be properly sterilized and whether the sharpening of contaminated instruments poses a health hazard for the provider. Using bacteria culture techniques and scanning electron microscopy, we tested whether contaminated ceramic sharpening stones can be sterilized. Our results demonstrate that the stones were sterile after being subjected to the manufacturer's sterilization protocol. In addition, over the last year, no incidents related to periodontal instrument sharpening have been reported among nearly 400 students at the faculty of dentistry, University of British Columbia, where chair-side sharpening is taught. Therefore, we conclude that ceramic sharpening stones can be sterilized using normal office protocols and that chair-side sharpening adds little risk beyond routine handling of operatory or periodontal instruments during patient care when proper protocols are followed.