Cihan UYSAL, Esra ERCAN, Levent KARA, Tuna ARIN

ER,CR:YSGG LASER AS A SURFACE DETOXIFICATION METHOD IN ENHANCEMENT OF OSSEOINTEGRATION

Amaç: Bu çalışmanın amacı; enfekte implant yüzeyini en uygun şekilde detoksifiye edecek ve aynı zamanda yüzey biyouyumluluğunu koruyarak, iyileşme sürecinde osteoblastların yeniden osseointegrasyonunu kolaylaştıracak Er,Cr:YSGG lazer uygulama protokollerini ortaya koymaktır. Bu amaçla lazer ile ilgili dört farklı değişken (güç-W, frekansHz, mesafe-mm ve süre-sn.) üç farklı düzeyde incelendi. Materyal ve Metot: S.aureus ile enfecte edilen Grade 5 titanium diskler Erbium Chromium-doped YttriumScandium-Gallium-Garnet (Er,Cr:YSGG) lazer ile farklı protokollerde detoksifiye edildi. Lazer uygulamasından sonra, titanyum disklerin yüzey morfolojileri, yüzey pürüzlülükleri, 24 saat ve 48 saat sonundaki osteoblast hücre proliferasyonları (SaOs-2 hücre kültürü) ve osteoblast hücre morfolojileri incelendi. Bulgular: Çalışma sonucunda; titanyum disk yüzeyinde en fazla morfolojik değişikliğe neden olan protokolün güç yoğunluğunun (W/cm2) en fazla olduğu test 8 grubu (3 W- 25 Hz-2 mm-45 sn) olduğu görüldü. Bu protokolde yüzeydeki ergime ve düzleşmenin en fazla, yüzey pürüzlülük değerinin (Ra) ise en düşük olduğu belirlendi. Hücresel proliferasyon değerleri incelendiğinde, 48 saat sonundaki proliferasyon değerlerine göre test 1 ve test 7 gruplarındaki proliferasyon değerlerinin kontrol grubuna göre istatistiksel olarak anlamlı derecede arttığı gösterildi. Ayrıca, bu iki test grubunun (test 1 ve test 7) Ra değerleri incelendiğinde, kontrol grubuna oldukça benzer Ra değerlerine sahip oldukları belirlendi. Sonuç: Sonuçta, yüzey morfolojisinin değişiminde en etkili parametrenin güç yoğunluğu olduğu bununda doğrudan uygulama mesafesi ile ilgili olduğu görüldü. Ayrıca yüzey pürüzlülüğünü neredeyse değiştirmeden, ilk haline yakın olacak şekilde koruyarak, yüzey biyouyumluluğunu arttıran uygulama koşullarının reosseointegrayon sürecinde hücresel proliferasyona olumlu katkı sağladığı görüldü

Anahtar Kelimeler:

Periimplantitis, Detoksification, Er, Cr:YSGG, Osteoblast, Osseointegrasyon, Titanium Disk

ER,CR:YSGG LASER AS A SURFACE DETOXIFICATION METHOD IN ENHANCEMENT OF OSSEOINTEGRATION

Purpose: The aim of the current study was to establish protocols for Erbium Chromium-doped Yttrium-ScandiumGallium-Garnet (Er,Cr:YSGG) laser application for detoxification of implant surface, preservation of surface biocompatibility and enhancement of osseointegration. In this purpose, four different variables including power (W), frequency (Hz), distance (mm) and duration (sn) were investigated at 3 different levels. Material and Methods: Grade 5 titanium discs infected by S.aureus were detoxified with Er, Cr: YSGG laser according to various protocols. After laser application, surface morphology and surface roughness of titanium discs as well as cellular morphology and proliferation of osteoblasts-like cells at the end of 24 and 48 hours (SaOs-2 cell culture) were examined. Results: The most remarkable changes on the surface of titanium discs were observed in group Test 8 (3 W-25 Hz-2 mm-45 sn) which was exposed to the highest power density (W/cm2).. In this protocol, melting and flattening on the surface was observed most prominently and surface roughness (Ra) was lowest. Proliferation indicators in groups Test 1 and Test 7 were found to be statistically significantly increased compared to the control group at the end of 48 hours. Furthermore, Ra values of these 2 groups (Test 1 and Test 7) were similar to that of control group. Discussion: To conclude, our results have shown that power intensity, which is linked with distance, was the leading parameter for alteration of surface morphology. We suggest that cellular proliferation during reosseointegration is facilitated by conditions that maintain surface roughness in its initial form and amplify surface biocompatibility.

Keywords:

Periimplantitis, Detoxification, Er, Cr:YSGG, Osteoblast, Osseointegration, Titanium Disc.,

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