Comparison of the Effect of Teflon vs Non-Teflon Hand Scalers in the Maintenance of Peri-Implant Tissue

Inflammation Clinical Trial

Official title:

Comparison of the Effect of Teflon vs Non-Teflon Hand Scalers in the Maintenance of Peri-Implant Tissue: A Randomized Clinical Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03316937
• Other study ID #: B2017:124
• Status: Completed
• Phase: N/A
• Start date: January 10, 2018
• Est. completion date: June 6, 2019

Study information

• Verified date: August 2019
• Source: University of Manitoba
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The buccal and lingual surface of the 23 participants' crowns will be randomly assigned to receive scaling and root planing with either Teflon scalers, or non-Teflon scalers after implant crown delivery. Each patient will act as their own control.

Patients will receive scaling and root planing at 3, 6, 9 and 12 months by a calibrated dental hygienist. All surfaces of the implant will be debrided for 1 minute using a transversal movement. Each patient will receive oral hygiene instructions by the hygienist at the end of each maintenance therapy appointment. The participants will be instructed to use a Modified Stillman brushing technique twice per day and cross shoe shine flossing motion once per day. Each patient will be provided with a three-month home care kit with dental aids. These aids will consist of toothpaste, a toothbrush and implant floss.

Measurements will be taken at 0, 3, 6, 9 and 12 months by a calibrated periodontal resident. The parameters assessed at the implant site and patient level will be modified plaque index (IPI) by Mombelli, modified gingival index (IBOP) by Mombelli, implant probing depths (PD) at six sites, presence of keratinized gingiva (KT), recession (REC), Full mouth plaque index (FPI) and Full mouth bleeding on probing (FBOP).

The Peri-implant Crevicular Fluid will be collected at 0, 3, and 12 months by isolating the implant site from saliva and introducing Periopaper strips into the buccal, mesial, distal and lingual sites of the implant sulcus for 30 seconds. The strips will be placed in a sealed Eppendorf tubes and transported by portable freezer to the laboratory where they will be stored at -86 degrees Celsius. The Periopaper samples will be treated for the detection and quantification of the following cytokines: Interleukin-2, Interleukin-4, Interleukin-6, Interleukin-8, Interleukin-10, Tumor Necrosis Factor alpha and Interferon gamma.

Periapicals will be taken at baseline and 12 months. All radiographs will be standardized.

After 12 months, the implant crown will be removed and the implant crown's surface alterations will be evaluated using atomic force microscopy (AFM) using the RA, or average roughness, and the RZ, or mean roughness depth, scores. The implant crown surface will then be repolished/reglazed and delivered back to the patient's mouth. Crowns will be evaluated before delivery to determine adequate level of smoothness.

Based on the presence of cytokines in the Peri-implant Crevicular Fluid, the degree of surface alterations, the modified plaque index, implant probing depths, full mouth plaque index, and full mouth bleeding on probing, we can determine if scratching affects the inflammation around the screw retained dental implant.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 13
• Est. completion date: June 6, 2019
• Est. primary completion date: June 6, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 20 Years and older

Eligibility

Inclusion criteria:

• patients who require a single unit implant crown

• patients requiring a single, screw retained, zirconia implant supported crown

• patient who are non-smokers

Exclusion Criteria:

• patients on corticosteroids

• patients who have used antibiotics within the preceding 3 months

• patients with uncontrolled diabetes mellitus

• patients on daily nonsteroidal anti-inflammatory drugs

• patients who are smokers.

Related Conditions & MeSH terms

• Inflammation
• Maintenance of Dental Implants
• Surface Roughness

Intervention

Procedure:
• Types of scalers
Scaling

Locations

Country	Name	City	State
Canada	University of Manitoba; College of Dentistry; Faculty of Periodontics	Winnipeg	Manitoba

Sponsors (1)

Lead Sponsor	Collaborator
University of Manitoba

Country where clinical trial is conducted

Canada, 

References & Publications (16)

Augthun M, Tinschert J, Huber A. In vitro studies on the effect of cleaning methods on different implant surfaces. J Periodontol. 1998 Aug;69(8):857-64. — View Citation

Baek SH, Shon WJ, Bae KS, Kum KY, Lee WC, Park YS. Evaluation of the safety and efficiency of novel metallic ultrasonic scaler tip on titanium surfaces. Clin Oral Implants Res. 2012 Nov;23(11):1269-74. doi: 10.1111/j.1600-0501.2011.02302.x. Epub 2011 Sep 30. — View Citation

Brookshire FV, Nagy WW, Dhuru VB, Ziebert GJ, Chada S. The qualitative effects of various types of hygiene instrumentation on commercially pure titanium and titanium alloy implant abutments: an in vitro and scanning electron microscope study. J Prosthet Dent. 1997 Sep;78(3):286-94. — View Citation

Fakhravar B, Khocht A, Jefferies SR, Suzuki JB. Probing and scaling instrumentation on implant abutment surfaces: an in vitro study. Implant Dent. 2012 Aug;21(4):311-6. doi: 10.1097/ID.0b013e3182588822. — View Citation

Fugazzotto PA, Gulbransen HJ, Wheeler SL, Lindsay JA. The use of IMZ osseointegrated implants in partially and completely edentulous patients: success and failure rates of 2,023 implant cylinders up to 60+ months in function. Int J Oral Maxillofac Implants. 1993;8(6):617-21. — View Citation

Hallmon WW, Waldrop TC, Meffert RM, Wade BW. A comparative study of the effects of metallic, nonmetallic, and sonic instrumentation on titanium abutment surfaces. Int J Oral Maxillofac Implants. 1996 Jan-Feb;11(1):96-100. — View Citation

Homiak AW, Cook PA, DeBoer J. Effect of hygiene instrumentation on titanium abutments: a scanning electron microscopy study. J Prosthet Dent. 1992 Mar;67(3):364-9. — View Citation

Kawashima H, Sato S, Kishida M, Yagi H, Matsumoto K, Ito K. Treatment of titanium dental implants with three piezoelectric ultrasonic scalers: an in vivo study. J Periodontol. 2007 Sep;78(9):1689-94. — View Citation

Lindh T, Gunne J, Tillberg A, Molin M. A meta-analysis of implants in partial edentulism. Clin Oral Implants Res. 1998 Apr;9(2):80-90. — View Citation

Lindquist LW, Carlsson GE, Jemt T. A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss. Clin Oral Implants Res. 1996 Dec;7(4):329-36. Erratum in: Clin Oral Implants Res 1997 Aug;8(4):342. — View Citation

Mann M, Parmar D, Walmsley AD, Lea SC. Effect of plastic-covered ultrasonic scalers on titanium implant surfaces. Clin Oral Implants Res. 2012 Jan;23(1):76-82. doi: 10.1111/j.1600-0501.2011.02186.x. Epub 2011 Apr 13. — View Citation

Park JB, Kim N, Ko Y. Effects of ultrasonic scaler tips and toothbrush on titanium disc surfaces evaluated with confocal microscopy. J Craniofac Surg. 2012 Sep;23(5):1552-8. doi: 10.1097/SCS.0b013e31825e3ba6. — View Citation

Pontoriero R, Tonelli MP, Carnevale G, Mombelli A, Nyman SR, Lang NP. Experimentally induced peri-implant mucositis. A clinical study in humans. Clin Oral Implants Res. 1994 Dec;5(4):254-9. — View Citation

Sato S, Kishida M, Ito K. The comparative effect of ultrasonic scalers on titanium surfaces: an in vitro study. J Periodontol. 2004 Sep;75(9):1269-73. — View Citation

Speelman JA, Collaert B, Klinge B. Evaluation of different methods to clean titanium abutments. A scanning electron microscopic study. Clin Oral Implants Res. 1992 Sep;3(3):120-7. — View Citation

Unursaikhan O, Lee JS, Cha JK, Park JC, Jung UW, Kim CS, Cho KS, Choi SH. Comparative evaluation of roughness of titanium surfaces treated by different hygiene instruments. J Periodontal Implant Sci. 2012 Jun;42(3):88-94. doi: 10.5051/jpis.2012.42.3.88. Epub 2012 Jun 30. — View Citation

* Note: There are 16 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Degree of surface roughness	The implant crown's surface alterations will be evaluated using atomic force microscopy (AFM) using the average roughness (Ra) and the mean roughness depth (Rz), scores. Crowns will be evaluated before delivery to determine adequate level of smoothness. For our study, Ra and Rz should range from 0.1µm to 0.5µm. Higher values represent more scratching.	12 months