Titanium implants affected by peri-implantitis lesions are often treated non-surgically with various instruments, which may produce titanium particles that can become lodged within the peri-implant mucosa. Thus, a foreign body reaction may ensue. The aim is to assess the embedment of titanium particles into soft tissues from titanium implants via a stainless-steel ultrasonic scaler (SSU) versus a titanium hand scaler (TH). Sand-blasted, large grit, acid-etched surface-treated titanium implants were implanted into pig legs after creating peri-implantitis defects. Each implant was subjected to only one instrument type. Sequential strokes were conducted followed by thorough irrigation with sterile water. Soft tissue curettage was not conducted. The surrounding soft tissue was then removed, prepared, and analyzed with a hemocytometer under a light microscope to ultimately determine the mean total number of metallic particles present in each group. Soft tissue samples were also analyzed with scanning electron microscopy (SEM) and elemental analysis (EDS). The mean titanium particle count based on the hemocytometer squares as well as the mean total number of titanium particles based on the samples in each group were significantly higher when scaled with the SSU as compared with the TH. SEM and EDS subsequently confirmed the presence of titanium within the soft tissue. Photomicrographs of the scaled implant surfaces depicted altered surface topography. Within the limitations of this study, the SSU and TH were both able to produce and embed titanium particles within the adjacent peri-implant mucosa. However, the SSU produced significantly more embedded titanium particles than the TH.

LLU Discipline





School of Dentistry

First Advisor

Yoon Jeong Kim

Second Advisor

Mario Flores

Third Advisor

Gina D. Roque-Torres

Fourth Advisor

Zhe Zhong

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Titanium; Peri-implantitis; Debridement -- instrumentation

Subject - Local

dental implants; titanium particles; non-surgical implant debridement; stainless-steel ultrasonic scaler; titanium hand scaler



Page Count

vi, 32 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives