Human Implant Retrieval by Piezosurgery and Er:YAG Laser

Objective: this preliminary study aimed to evaluate the effect of piezosurgery and Er:YAG laser in focused beam mode in bone surrounding endosseous dental implants after retrieval

Methods: Screw root form implants (SRF) and blade form implants (BFI) were selected for retrieval for prosthetic reasons. The surgical procedures were carried out by one operator, and the retrievals were performed with either piezosurgery (Mectron, Genova, Italy) or Er:YAG laser in focused beam mode (Hoya, Tokyo, Japan). The surgical retrieval allowed at least 1.5 mm bone thickness between the instrument cutting region and implant surface. The retrieved specimens were kept in 10% buffered formaline for 14 days, dehydrated in a series of ethanol concentrations, and embedded in Technovit 9100 (Heraeus Kulzer, Hanau, Germany). The samples were sectioned with a diamond blade, grounded and polished to ~30 µm thickness, and evaluated under an optical microscope in both transmitted and polarized light mode.

Results: Histomorphologic analysis showed that despite the various prosthetic reasons which resulted in SRF implant retrieval was not detrimental to their osseointegration, where lamellar bone surrounded the perimeter of the SRF implant surfaces. Fibrous encapslulation along with bone intimate contact with the BFI was observed. General observation showed that regardless of retrieval method utilized, an affected necrotic bone region was observed where either piezosurgery and laser instrumentation cut bone. Preliminary histomorphometric analysis showed that similar quantities of bone were affected by both techniques.

Conclusion: Both piezosurgery and Er:YAG in focused beam mode were effectively utilized for implant retrieval. Comparable amount of necrotic bone resulted from both techniques.