| Sumario: | Purpose: To evaluate the presence of titanium (Ti) ions and particles after instrumentation of implant surfaces using different debridement methods in vitro. Materials and Methods: Six debridement methods--including a stainless steel (SS) curette, Ti-curette, ultrasonic tip (CV), ultrasonic tip with plastic sleeve (CS), CO2-laser, and Er,Cr:YSGG (ECY) laser (WaterLase MD plus, Biolase)--were evaluated in this study. A simulated defect was created around an implant in a type 2 bone block, and irrigation was performed with water. For the laser groups, a CO2 laser (no contact, defocused beam, continuous wave, 2-W power) and an ECY laser tip were used (in contact with the implant; power of 2 W; 75 Hz; 40% water: 2% air). A total of 20 samples per method (120 samples total) were collected using paper points after 30 seconds of instrumentation. Chemical composition analysis of the bone block, water irrigation, and instruments (before the study [baseline]) were evaluated for the presence of Ti ions and particles via liquid samples after instrumentation with an X-ray fluorescence spectrometer. Statistical analysis using sample t test was performed for each debridement method. Results: Baseline measurements showed no Ti ions or particles. However, Ti ions and particles were found in the groups using SS curettes, CV ultrasonic inserts, and Ti curettes, with values of 0.0232 ± 0.0181 ppm, 0.0047 ± 0.0042 ppm, and 0.0072 ± 0.0037 ppm, respectively. Ti ions and particles were not observed in the CS ultrasonic insert group or either laser group. The semiquantitative data showed a higher presence of Ti ions and particles in the groups that used SS curettes, Ti curettes, and CV ultrasonic inserts in comparison to baseline (P < .0001). Conclusions: Ti ions and particles were found after instrumentation using SS curettes, Ti curettes, and CV ultrasonic inserts, which may affect the disease etiology and outcomes of peri-implantitis therapy more prominently compared to irradiation methods such as CS ultrasonic inserts, CO2 lasers, or ECY lasers.
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