Surface alterations following instrumentation with a nylon or metal brush evaluated with confocal microscopy

Purpose: Surface alterations of titanium discs following instrumentation with either a nylon brush or a metal brush were evaluated. Methods: A total of 27 titanium discs with 3 surface types (9 discs for each type), including machined (M) surfaces, sandblasted and acid-etched (SA) surfaces, and surfaces treated by resorbable blast media (RBM), were used. Three discs were instrumented with a nylon brush, another 3 discs were instrumented with a metal brush, and the remaining 3 discs were used as controls for each surface type. Surface properties including the arithmetic mean value of a linear profile (Ra), maximum height of a linear profile (Rz), skewness of the assessed linear profile (Rsk), arithmetic mean height of a surface (Sa), maximum height of a surface (Sz), developed interfacial area ratio (Sdr), skewness of a surface profile (Ssk), and kurtosis of a surface profile (Sku) were measured using confocal microscopy. Results: Instrumentation with the nylon brush increased the Ra, Sa, and Sdr of the M surfaces. On the SA surfaces, Ra, Sa and Sdr decreased after nylon brush use. Meanwhile, the roughness of the RBM surface was not affected by the nylon brush. The use of the metal brush also increased the Ra, Sa, and Sdr of the M surface; however, the increase in Sdr was not statistically significant (P=0.119). The decreases in the Rz, Sz, Ra, Sa, and Sdr of the SA surfaces were remarkable. On the RBM surfaces, the use of the metal brush did not cause changes in Ra and Sa, whereas Rz, Sz, and Sdr were reduced. Conclusions: Titanium surfaces were altered when instrumented either with a nylon brush or a metal brush. Hence, it is recommended that nylon or metal brushes be used with caution in order to avoid damaging the implant fixture/abutment surface.