(50) The Effect of Er:YAG Laser Treatment on Biofilm Formation on Titanium and Zirconia Disc Surfaces

Introduction: Peri-implantitis and peri-implant mucositis are considered biofilm-initiated infectious diseases. Despite the numerous surgical and non-surgical treatment approaches available for these diseases, evidence to support a specific implant decontamination protocol remains unclear. Thus, the present study assessed and compared surface alterations of titanium and zirconia discs secondary to Er:YAG treatment and subsequent biofilm formations on the Er:YAG treated titanium and zirconia surfaces in vivo.

Methods: A two-stage (in vitro and in vivo) experiment utilizing Er:YAG laser on titanium and zirconia discs was performed. At the 1st stage (in vitro), surface alterations, roughness, and elemental-material weight differences were assessed following laser treatment using scanning electron microscopy (SEM) and atomic force microscopy (AFM). At the 2nd stage (in vivo), four participants wore custom-made intra-oral stents, with the titanium and zirconia discs in place overnight. Biofilm-coated discs were stained using LIVE/DEAD nucleic acid fluorescence dye and visualized using multiphoton confocal laser scanning microscopy. Biofilm 3D structure, biomass, thickness, and LIVE/DEAD bacteria ratio were assessed.

Results: Both titanium (TiZir) and zirconia (YTZP) discs treated with Er:YAG laser resulted in visual surface alterations but showed no significant change in surface roughness (titanium P=0.53, zirconia P=0.34) or elemental-material-weight (TiZir, P=0.98), (YTZP, P=0.96). No differences were identified in the biofilm formation of laser-treated titanium and zirconia discs compared to the untreated groups (titanium P= 0.55, zirconia P= 0.30). Generally, zirconia discs presented with a lower LIVE/DEAD bacteria ratio when compared to titanium discs, regardless of laser treatment.

Conclusions: Er:YAG laser treatment of titanium and zirconia implant surfaces does not significantly affect surface roughness, elemental–material weight, and early biofilm formation in the oral cavity.

Lead Author's Contributions to the Research Project. : The lead author was responsible for the design of the study, conduction of the study protocols, imaging with different types of microscopes, and writing the abstract.