Document Type : Original Article


1 Assistant Professor, Department of Periodontology, School of Dentistry, Gaziantep University, Gaziantep, Turkey

2 Ministry of Health Hospital, Gaziantep, Turkey



BACKGROUND AND AIM: Osteointegration is the connection between alveolar bone and implant surface. After peri-implant diseases, the surface structure is changed, but the surface properties of the dental implant are crucial in re-osseointegration. This study aimed to examine the surface element levels of explanted implants due to peri-implantitis by scanning electron microscopy/energy-dispersive x-ray spectroscopy analysis (SEM-EDX).
METHODS: Ten explanted sandblasted, large grit, acid-etched (SLA) surface dental implants (Straumann Roxolid, Straumann GmbH, Freiburg, Germany) were used for the study. Explanted implants were washed with distilled water/air spray to purify blood and debris, dried with air spray, and waited for test time at room temperature. Explanted implants were examined using a SEM. The samples were not coated with gold, and images were taken at 115x and 8000x. SEM-EDX was performed at three-point for each sample to analyze relative concentration or weight percent (wt%) of carbon (C), oxygen (O), sodium (Na), aluminum (Al), titanium (Ti), and zirconium (Zr) with same SEM.
RESULTS: In the explanted implants, osseointegrated bone (0.1-0.5 mm wide) residues were observed in places, especially in the apical region. Regarding metal-to-metal labeling on the surfaces of dismantled implants, no findings such as surface scratches, fractures, and cracks were found. In explanted implants, the amount of C was relatively higher, while the amount of Ti was relatively lower.
CONCLUSION: Within the limitation of this study, it can be said that the C amount is high, and the amount of Ti is low in explanted implants relatively. Further research is needed to understand the effect of surface elements on re-osseointegration, where the number of samples is high.


Main Subjects

  1. Block MS. Dental implants: The last 100 years. J Oral Maxillofac Surg 2018; 76(1): 11-26.
  2. Misch CE. Contemporary implant dentistry. Philadelphia, PA: Mosby; 1999.
  3. Williams DF. The biological applications of titanium and titanium alloys. In: Kossowsky R, Kossovsky N, editors. Materials sciences and implant orthopedic surgery. Dordrecht, Netherlands: Springer Netherlands; 1986. p. 107-16.
  4. Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969; 3(2): 81-100.
  5. Davies JE. Understanding peri-implant endosseous healing. J Dent Educ 2003; 67(8): 932-49.
  6. Albrektsson TO, Johansson CB, Sennerby L. Biological aspects of implant dentistry: Osseointegration. Periodontol 2000 1994; 4: 58-73.
  7. Uzun G, Keyf F. Surface characteristics of the implant systems. The Journal of Faculty of Dentistry of Ataturk University 2007; 2: 43-50. [In Turkish].
  8. Koka S, Razzoog ME, Bloem TJ, Syed S. Microbial colonization of dental implants in partially edentulous subjects. J Prosthet Dent 1993; 70(2): 141-4.
  9. Albrektsson T, Isidor, F. Consensus report of session IV. Proceedings of the 1st European Workshop on Periodontology; 1993 Feb 1-4; London: Quintessence: 1994. p. 365-9.

10. Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2018; 89(Suppl 1): S267-S290.

11. Saulacic N, Schaller B. Prevalence of peri-implantitis in implants with turned and rough surfaces: A systematic review. J Oral Maxillofac Res 2019; 10(1): e1.

12. Madi M, Htet M, Zakaria O, Alagl A, Kasugai S. Re-osseointegration of dental implants after periimplantitis treatments: A systematic review. Implant Dent 2018; 27(1): 101-10.

13. Larsen OI, Enersen M, Kristoffersen AK, Wennerberg A, Bunaes DF, Lie SA, et al. Antimicrobial effects of three different treatment modalities on dental implant surfaces. J Oral Implantol 2017; 43(6): 429-36.

14. Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018; 89(Suppl 1): S313-S318.

15. Quintero DG, Taylor RB, Miller MB, Merchant KR, Pasieta SA. Air-abrasive disinfection of implant surfaces in a simulated model of periimplantitis. Implant Dent 2017; 26(3): 423-8.

16. Jepsen S, Berglundh T, Genco R, Aass AM, Demirel K, Derks J, et al. Primary prevention of peri-implantitis: Managing peri-implant mucositis. J Clin Periodontol 2015; 42(Suppl 16): S152-S157.

17. Tastepe CS, Lin X, Werner A, Donnet M, Wismeijer D, Liu Y. Cleaning effect of osteoconductive powder abrasive treatment on explanted human implants and biofilm-coated titanium discs. Clin Exp Dent Res 2018; 4(1): 25-34.

18. Lindhe J, Meyle J. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008; 35(8 Suppl): 282-5.

19. Souza FA, Furtado TSM, Dayube URC, Melo WM, Nishioka RS, Poli PP, et al. Comparative in vivo study of alloy titanium implants with two different surfaces: Biomechanical and SEM analysis. Clin Oral Investig 2019; 23(12): 4383-97.