Which instruments are safe for cleaning dental implant surfaces?

Based on the indexed literature, several instrument categories have been evaluated for implant surface safety.

For titanium implants, air-powder abrasive (APA) devices using erythritol or glycine powder caused no significant damage to implant surfaces and showed strong biofilm removal efficacy ^[1][2]. PEEK-tipped ultrasonic scalers are also considered safe for titanium surfaces ^[1][2]. Er:YAG and Er,Cr:YSGG lasers at specific settings produced minimal surface alterations ^[2]. Electrolytic cleaning likewise showed minimal surface changes ^[2]. In contrast, titanium or stainless steel curettes, metal-tipped ultrasonic scalers, titanium brushes, and implantoplasty induced significant surface alterations and thread peak flattening and should be avoided ^[2].

For zirconia implants, air-abrasive devices with glycine powder, prophylaxis cups, and ultrasonic scalers with non-metal tips caused minimal to no surface damage ^[3]. Hand instruments and metal-tipped ultrasonic scalers carry a risk of major damage to zirconia surfaces and should be used with caution ^[3]. Diode lasers appeared promising for zirconia with no reported surface alterations, though evidence remains heterogeneous ^[3].

One important caveat: plastic and carbon curettes, PEEK ultrasonic tips, and APA devices have been noted to leave material remnants on implant surfaces, which is worth considering when selecting an instrument ^[2]. Overall, mechanical decontamination generally yielded more favourable results than chemical or laser methods alone, and combination approaches may offer the best clinical outcomes ^[4].