How do you scale yours?

22 December 2014
Volume 30 · Issue 5

Scott Julian reviews the treatment of dental implants.

Can I use a metal instrument to scale a dental implant? Many dental professionals would say it depends on the type of metal instrument used. If it is stainless steel then maybe not, as it’s quite easy to alter the implant surface; this, in turn, could attract more plaque to the area. Some hand instrument manufacturers would have us believe that some metal instruments are safe to use. Titanium or titanium-coated hand instruments were considered a safe option, but is this really the case?

 

In 2010, approximately 100,000 implants were placed in the UK. By the end of 2013, this figure was said to have doubled to 200,000. There are many implant manufacturers on the market. Each manufacturer has a distinct range of both implants and abutments. We know that most implants are made from titanium, but are you aware that there are five different grades of titanium?

 

Most abutments and implants are made from grades 4 and 5 titanium. Grades 1 to 4 are called CP titanium and are considered pure, and grade 5 is a titanium alloy (Ti-6Al-4V). The different grades of titanium have different properties; a major physical property is hardness. The grades get harder as they increase numerically. The majority of titanium scaling instruments are made from grade 5 titanium; therefore they are very hard.

 

If you use a titanium scaler (generally made from grade 5 titanium) to scale an implant that was not made from grade 5 titanium, but was composed of a softer grade (1-4), there is a very good chance that the harder blade of the scaler could alter the surface of the implant being scaled.

 

The grade of titanium used by the implant manufacturer often is available only from the manufacturer’s data sheet or implant passport. To my knowledge, it’s not something that is often recorded in the clinical notes.

 

Alternatives

Graphite instruments, like those available from Premier Dental Products Company, are an excellent alternative to titanium instruments - they are strong, sharp and, most importantly, will not scratch implants. Using a titanium tip to scale implants is excessive as it is not necessary to apply the same force used to scale natural dentition. Plaque and calcified deposits weakly adhere to the implant structure and only minimal force is required for removal. A light touch with graphite scalers is ideal for safe and effective scaling around implants.