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Purpose: To assess the effects of grade IV titanium ultrasonic tip instrumentation on different grade IV titanium implant surfaces and compare the decontamination of different implant surfaces using chlorhexidine, blue laser, or ozone. Materials and methods: Profilometry and energy-dispersive x-ray spectroscopy (EDS) analyses were performed on smooth, laser-micropatterned, and sandblasted grade IV titanium sample disks before (t0) and after (t1) ultrasonic instrumentation with an ultrasonic grade IV titanium tip. Samples were also incubated with a Streptococcus sanguinis culture. Each surface type was then treated with chlorhexidine, blue laser, or ozone (three test groups + control group). Scanning electron microscopy (SEM) images were taken after bacterial growth and after decontamination. Results: After ultrasonic instrumentation, surface roughness (Ra) decreased on sandblasted and micropatterned surfaces, whereas it remained substantially unvaried on the smooth surface. SEM images revealed that the laser-micropatterned structure remained substantially unvaried after instrumentation. EDS revealed a minimal quantity of carbon and iron, found in the laser-treated and sandblasted group at t0. A minimal quantity of aluminum and oxygen was found on the sandblasted surface at t0 and t1. Ozone therapy achieved the highest decontaminating effect, regardless of implant surface topography. Conclusion: Among the alternative therapies to ultrasonic instrumentation with titanium tips, ozone appears to be effective regardless of the type of implant surface; it can be used for the decontamination treatment of implants without altering the surface structure.

Background: The blood wettability of titanium implant surfaces favors primary osseointegration and tissue healing in peri-implantitis. The current study aims to evaluate this property on the main different kinds of surfaces, brand new and after treatments. Methods: grade IV titanium disks were used, five machined, five laser-treated, five sandblasted. The experiment was on four steps. Between each step, specimens were sterilized. At the end of each step, a 4 µL blood drop was put on the samples, and contact angles were calculated. The steps consisted of—1: no treatment, 2: surface instrumentation with an ultrasonic titanium tip, 3: platelet-rich fibrin (PRF) coating and drying with sterile gauze, 4: etching with phosphoric acid, rinse and saline solution and air-drying. At the end of each phase, a blood drop was placed on the surfaces. Blood for PRF preparation and for calculation of contact angles was collected from a single source. Results: average wettability decreased after instrumentation, and increased after the PRF application to a superior level both to the first and second steps. The highest wettability was obtained after etching. This trend is statistically significant for machined and sandblasted surfaces. Conclusions: In the clinical environment, PRF and phosphoric acid used for conditioning exposed implant surfaces can be used for the healing of peri-implant tissues.