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Article

Efficacy of Air-Polishing with Sodium Bicarbonate vs. Erythritol in the Decrease of the Bacterial Concentration on the Surface of Dental Implants: In Vitro Study

by
Ashley Yaressi Gómez-Rueda
,
Myriam Angélica De La Garza-Ramos
*,
Norma Idalia Rodríguez-Franco
,
Jesús Israel Rodríguez-Pulido
,
Claudia Lucía Elizalde-Molina
and
Omar Elizondo-Cantú
*
Universidad Autónoma de Nuevo León, Facultad de Odontología, Calle Dr. E. Aguirre Pequeño y Silao, Col. Mitras Centro, Monterrey 64460, Nuevo León, Mexico
*
Authors to whom correspondence should be addressed.
Coatings 2025, 15(3), 327; https://doi.org/10.3390/coatings15030327
Submission received: 21 January 2025 / Revised: 8 March 2025 / Accepted: 11 March 2025 / Published: 12 March 2025
(This article belongs to the Special Issue Surface Treatment and Mechanical Properties of Metallic Materials)
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Abstract

:
Dental implants are recognized as one of the most effective long-term solutions for the replacement of one or multiple missing teeth, addressing both aesthetics and functionality. However, one of the leading causes of implant failure is peri-implant diseases. This study aims to evaluate the effectiveness of air polishing with sodium bicarbonate compared to erythritol in reducing the bacterial concentration on dental implant surfaces in vitro. A sample of twenty-four implants (12 JD Evolution and 12 Straumann) was utilized and divided as follows: 10 implants contaminated with biofilm treated with sodium bicarbonate air polishing (1 min); 10 implants contaminated with biofilm treated with erythritol aeropolishing (1 min); two implants contaminated with biofilm (negative control); and two sterile implants (positive control). The entire experiment was performed in triplicate. The bacterial culture included P. gingivalis, S. gordonii, and F. nucleatum. Optical density (OD) at 600 nm was measured before and after the decontamination protocol to analyze the results. The JD Evolution implant demonstrated a slightly greater reduction in bacterial concentration, but the difference was not statistically significant (p > 0.05). Similarly, no differences were observed between erythritol and sodium bicarbonate in the Straumann implants. An increase in surface roughness is observed in the JD Evolution implant treated with erythritol, whereas the one treated with bicarbonate exhibits a smoother surface compared to the untreated implant. The findings suggest that air polishing with erythritol is as effective as sodium bicarbonate in reducing the bacterial concentration on dental implants in vitro. This could suggest the use of erythritol during air polishing due to its antimicrobial capacity and its increase in surface roughness on implant surfaces compared to bicarbonate.

1. Introduction

According to many authors, the survival rate of dental implant restorations is generally considered very high, with studies reporting a 5-year survival rate of around 95% and a 10-year survival rate of around 90%, meaning that in most cases, dental implants will last for a decade or more with proper care. However, there are cases in which these restorations fail [1,2]. Failures or complications are not usually attributed to defects in the restoration itself or its surface, but are often caused by surface degradation and the repair of defects localized in the lesion’s niche [3]. Moreover, surface treatment can enhance chemical interactions through unconverted C=C bonds and deeper penetration of certain materials, improving adhesion in surface irregularities. This advantage can significantly enhance the success of restorations [4]. However, despite advances in surface treatment methods, no approach has been universally accepted as the gold standard.
Currently, mechanical surface treatments, such as diamond bur polishing or air abrasion, are widely adopted, as they create a microrough surface that facilitates the interlocking of restorative material. Among these, aluminum oxide (Al2O3) abrasion and silica coating are the most researched and recommended techniques [5,6]. On the other hand, dental implants become part of the intraoral microenvironment, where microbial communities rapidly adhere to their surface, forming biofilms that can lead to peri-implant diseases. Bacterial colonization on the implant surface begins within 30 min of surgical placement, with a mature subgingival microbiota developing within a week, as has been reported in several studies [7,8,9,10].
Clinical studies have shown that the addition of sodium bicarbonate to fluoridated toothpaste, used twice daily, can reduce gingival bleeding in adults with gingivitis compared to toothpaste without sodium bicarbonate. While the mechanism of action of NaHCO3 has not been fully established, it has been hypothesised to relate to (i) the physical displacement of plaque by NaHCO3 crystals; (ii) a NaHCO3-induced reduction in the viscosity of the polysaccharide matrix of plaque, making it easier to brush away; or (iii) a NaHCO3-induced reduction in the bond strength between plaque bacteria and the tooth surface [11,12,13]. This aligns with minimally invasive techniques aimed at addressing such surgical defects or complications [14,15]. Air polishing with sodium bicarbonate is widely employed as part of maintenance therapy to remove deposits from the tooth surface, although it can roughen the root surface, which may be beneficial for subsequent repair [16,17]. Traditional scaling and root planing (SRP) is effective for cleaning but is often insufficient in areas that are anatomically challenging to access [18].
Given these anatomical constraints and limitations, novel therapeutic techniques have been explored to complement and improve manual methods for bacterial eradication and cleaning. These include antibiotics, antiseptics, non-chemical interventions such as laser therapy and photodynamic therapy. Recently introduced air polishing devices for periodontal treatment focus on low-abrasion, absorbable powders and subgingival tools [19]. Research indicates that these devices reduce postoperative discomfort, improve patient acceptance and have minimal impact on surrounding tissues. Originally designed for biofilm and stain removal, these devices now use absorbable powders like glycine and erythritol to address the risks associated with abrasive powders on exposed surfaces [20,21,22].
Erythritol is a four-carbon carbohydrate that is found in algae, fungi and lichens. It is twice as sweet as sucrose and can be used as a coronary vasodilator. This monosaccharide has the appearance of white powder, a molar mass of 122.12 g/mol, a melting point of 121 °C and a water solubility of ≈600 g/L. Erythritol has shown promising results in periodontal treatment compared to traditional methods. Studies suggest that erythritol powder can have prolonged antimicrobial effects on subgingival biofilms, reducing pathogens such as Porphyromonas gingivalis [23]. Bacterial biofilms are clusters of bacteria that are attached to a surface and/or to each other and embedded in a self-produced matrix. The biofilm matrix consists of substances like proteins (e.g., fibrin), polysaccharide (e.g., alginate), as well as eDNA [24]. Furthermore, it has been demonstrated that erythritol alters the microstructure and metabolic profile of biofilms formed by Streptococcus gordonii and P. gingivalis under in vitro conditions [25]. P. gingivalis forms three-species communities with Fusobacterium nucleatum and S. gordonii with the ability to increase its resistance and permanence on dental surfaces and implants. These periodopathogenic bacteria have been widely used as microbiological models for periodontology studies [26].
Randomized controlled trials have confirmed that erythritol air polishing effectively removes dental plaque during repeated instrumentation of residual pockets in supportive periodontal therapy. Combining agents that disrupt biofilm integrity (e.g., erythritol) with those possessing antimicrobial properties (e.g., chlorhexidine) may represent a novel strategy for biofilm elimination [27].
The objective of this study was to evaluate the effectiveness of air polishing with sodium bicarbonate in comparison to erythritol in reducing the bacterial concentration on dental implant surfaces in vitro. The present study proposes the inclusion of highly reliable methods, such as scanning electron microscopy, for the comparative evaluation of powders on the implant surface, unlike other studies [28].
We hypothesized that air polishing with erythritol would lead to a significantly greater reduction in bacterial concentration on dental implant surfaces compared to sodium bicarbonate, due to its non-abrasive properties and ability to preserve the surface integrity of the implants.

2. Materials and Methods

2.1. Study Design and Population

This is an in vitro study in which the sample consisted of 24 dental implants: 10 JD Evolution implants (five treated with sodium bicarbonate and five treated with erythritol) and 10 Straumann implants (five treated with sodium bicarbonate and five treated with erythritol), for one min each. Two implants served as positive controls (sterile medium) comprising one JD Evolution and one Straumann implant, and two as negative controls (bacteria) consisting of one JD Evolution and one Straumann implant. The entire experiment was performed in triplicate. Therefore, the total number of implants used was 72.

2.2. Sterilization and Decontamination Protocol for Dental Implants

The implants were sterilized in an autoclave at 121 °C for 15 min under 15 pounds of pressure. Subsequently, they were placed inside a laminar flow hood (Purifier Logic Class II, Type B2 Total Exhaust Biological Safety Cabinet with an 8-inch sash opening, UV light and service fixture), which was previously cleaned with 70% ethanol and sealed hermetically using the protective glass shield. The hood was equipped with an ultraviolet (UV) light, which was activated for 15 min. After completing the cleaning process, the experiment proceeded with the implementation of air-polishing methods, using separate procedures for sodium bicarbonate and erythritol [25].

2.3. Preparation of Bacterial Culture

The microorganisms utilized included P. gingivalis (ATCC BAA-308/W83), S. gordonii (ATCC 10558) and F. nucleatum (ATCC 23726), which were purchased from the American Type Culture Collection (ATCC) and imported to Mexico. The culture medium comprised 30 g/L of trypticase soy broth (TSB), incubated at 37 °C for 24–72 h [18].

2.4. Inoculation of Bacterial Culture on Dental Implants

Colonies of each bacterial strain were inoculated into 15 mL TSB tubes at 37 °C under anaerobic conditions until each strain reached its exponential growth phase, with an optical density (OD) at 600 nm (OD600nm) of 0.125 (McFarland scale 0.5), equivalent to 1 × 106 CFU/mL. This process took approximately 4.5 h for S. gordonii, 8 h for F. nucleatum and 4 h for P. gingivalis. The dental implants were then immersed in the tubes and incubated for 24 h under anaerobic conditions [18].

2.5. Optical Density Evaluation for Bacterial Growth Assessment

Optical density (OD) at a wavelength of 600 nm (OD600nm) was evaluated using a standardized bacterial growth curve based on the Relative Rate to Detection (RRD) technique, as described by Biesta-Peters et al. [27]. This method involves calibrating the quartz cuvettes using the negative control, which sets the optical density measurement to zero. After calibration, samples from each experiment are measured, with the resulting values reflecting cellular growth in each respective experiment. These values are then compared to the negative control (bacteria) to assess the experimental results and determine the corresponding value ranges. The higher value of OD600nm means bacterial growth in culture media. This method has been demonstrated to be reliable compared to traditional cell count methodologies. It relies on biomass measurement through light absorption, which forms the foundation of OD600nm usage for estimating biomass concentration. The accuracy of this approach has been corroborated in prior studies, emphasizing its effectiveness in quantifying cell and chromophore concentrations [27,29].

2.6. Implant Surface Treatment

The implants were sterilized in an autoclave at 121 °C for 15 min under 15 pounds of pressure. Subsequently, they were placed inside a laminar flow hood (Purifier Logic Class II, Type B2 Total Exhaust Biological Safety Cabinet with an 8-inch sash opening, UV light and service fixture), which was previously cleaned with 70% ethanol and sealed hermetically using the protective glass shield. The hood was equipped with an ultraviolet (UV) light, which was activated for 15 min [20]. After completing the cleaning process, the experiment proceeded with the implementation of air-polishing methods, using separate procedures for sodium bicarbonate and erythritol.

2.7. Treatment Efficacy Evaluation

A Biorad SmartSpec™ Plu (Hercules, CA, USA) spectrophotometer was used, following the manufacturer’s recommendations, to measure OD600nm with quartz cuvettes containing bacterial residue, both before and after treatment with sodium bicarbonate and erythritol. Biofilm was removed through centrifugation at 10,000× g for 10 min before the final spectrophotometer reading. After centrifugation, the liquid fraction was collected.
The inoculation procedure involved the use of Straumann® and JD Evolution implants, which were incubated with a sterile medium before being contaminated with bacteria (negative control), as shown in Figure 1A–C.
Simultaneously, the Strauaman® and JD Evolution implants were placed, repeating the same procedure with the bacteria at an initial concentration adjusted to OD600nm = 0.1 according to the 0.5 standard on the McFarland scale (Figure 1D,E).
Both preparations were incubated at 37 °C for 72 h, after which time 50 µL were taken and placed in a cuvette for reading the OD600nm using the Biorad spectrophotometer (Figure 1G–J). To evaluate the cleaning effectiveness and the ability to eliminate bacteria from the implants, an AIRFLOW® EMS dental with PLUS was used. The powders were prepared as suggested by the manufacturer (Figure 2A–C) and operated on the medium setting for 1 min. Infected and non-infected implants (controls) were removed from the culture medium for air polishing with bicarbonate and erythritol powders (Figure 2D–F). The implants were washed in saline solutions to remove powder residues, then placed in a culture medium and incubated at 37 °C for 24 h (Figure 2G,H). Finally, the OD600nm of the culture medium was quantified to evaluate the effectiveness of air polishing with the different powders.

2.8. Implant Surface Characterization

The implant surfaces were studied under the scanning electron microscope (FEI, NOVA nanoSEM 200) with a voltage of 15 kV, and images were taken.

2.9. Statistical Analysis

Analysis of variance (ANOVA) was employed for the statistical analysis. This test involved calculating the means and variances of data from each group and comparing them to identify any statistically significant differences in the variances among the experimental study groups. The Kolmogorov–Smirnov and Shapiro–Wilk tests were also performed to ascertain the normal distribution of variables. Approval was granted by the Ethics Committee of the Faculty of Dentistry, Universidad Autónoma de Nuevo León, under approval number SPSI-010613, Folio 00254.

3. Results

3.1. Bacterial Growth on Implant Surface Treated with Sodium Bicarbonate and Erythritol on Implant Surfaces

The bacterial concentration on surface implants treated with erythritol was 1.71 × 108 (±9.9 × 107) for the JD Evolution and 2.14 × 108 (±7 × 107) for the Straumann implants, as shown in Figure 3a. In addition, the bacterial concentration on surface implants treated with sodium bicarbonate was 1.57 × 108 (±4.8 × 107) for the JD Evolution and 1.7 × 108 (±6.3 × 107) for the Straumann implants (Figure 3b). The results indicated no significant difference in bacterial concentration reduction between the two implant groups, both those treated with erythritol (p = 0.803) and those treated with sodium bicarbonate (p = 0.979). Moreover, the results indicated no significant difference in bacterial concentration reduction between the two treatment groups on both the JD Evolution (p = 0.161) and the Straumann (p = 0.728) implants.
Based on this model, it is evident that no statistically significant difference exists between the two implant brands treated with bicarbonate compared to the negative control (implants without bacteria and sterile culture medium). However, a significant difference was observed when compared to the positive control (implants inoculated with bacteria but untreated). This suggests that there was increased bacterial formation on the surface (biofilm) after treatment, likely due to the separation of biofilm proliferation (after sonication and spectral reading). Specifically, the OD600nm readings were higher, indicating that more biofilm was detached, as the air polishing effectively prevented surface colonization and the formation of biofilm. The microorganism levels quantified in the treated groups were very similar to those in the sterile negative control implants, which were not inoculated with bacteria and were only exposed to a sterile culture medium. A similar result was observed for implants treated with erythritol. However, in contrast to the bicarbonate treatments, a slight tendency toward greater biofilm reduction was noted for the Straumann implants treated with erythritol, when compared to the negative control group.

3.2. Comparative Analysis of Control Groups with Sodium Bicarbonate and Erythritol on Implant Surfaces

Bacterial proliferation was greater with erythritol, while sodium bicarbonate exhibited superior antimicrobial properties, which inhibit microorganism proliferation. The JD Evolution implant showed a lower bacterial concentration with both powders compared to the Straumann implant. However, no significant differences were found between treatments groups and the two different implants.
In Figure 4, the Fold Change (FC) was calculated by taking the logarithm base 2 (Log2) of the ratio of the control positive value of the treatment for comparison between erythritol and sodium bicarbonate powders on the JD Evolution and Straumann implant surfaces. The FC results were as follows: FC = 2.736 for sodium bicarbonate vs. FC = 2.859 for erythritol on the JD Evolution implants and FC = 2.851 for sodium bicarbonate vs. FC = 3.183 for erythritol on the Straumann implants.
Although the JD Evolution implant demonstrated a slightly greater reduction in bacterial concentration, the difference was not statistically significant (p > 0.05). Similarly, no differences were observed between erythritol and sodium bicarbonate in the Straumann implants. The analysis included comparisons of positive control groups (sterile medium) and negative control groups (bacteria) after disinfection with erythritol and sodium bicarbonate on both implant surfaces.

3.3. The Surface Morphology of Implants Treated with Powders by Air Polishing

Figure 5 shows SEM images of untreated and treated JD Evolution and Straumann sandblasted large-grit, acid-etched (SLA) implants. An increase in surface roughness is observed in the JD Evolution implant treated with erythritol, whereas the one treated with bicarbonate exhibits a smoother surface compared to the untreated implant. Additionally, the treated Straumann SLA implants show a topography similar to that of the untreated implant, characterized by the presence of pores and pits. However, the implant treated with erythritol appears to have a flatter surface than both the untreated implant and the one treated with bicarbonate.

4. Discussion

The objective of this study was to evaluate the efficacy of air polishing with sodium bicarbonate versus erythritol in reducing the bacterial concentration on dental implant surfaces in vitro. The main results indicate that sodium bicarbonate showed a greater tendency toward bacterial concentration on the JD Evolution implant compared to the Straumann implant, but without statistical difference. The results obtained in this study agree with those observed by Pujarern et al. [30], where both treatments with air-polishing, such as erythritol, and sodium bicarbonate showed adequate removal of bacteria when compared with the control group. However, when comparing between erythritol and sodium bicarbonate, the difference is very small, without being statistically significant.
This is consistent with a 2017 study that showed similar results to the research conducted here. In that study, they concluded that the air-polishing system has a greater potential to reduce bacterial concentration on dental implant surfaces and defects. In that research, the researchers intended to evaluate the cleaning potential of commonly used implant debridement methods, simulating non-surgical peri-implantitis therapy in vitro. The methods employed were a Gracey curette, ultrasonic scaler and an air powder device with glycine, resulting in the glycine device showing greater potential for cleaning all defect angles [31].
Also in 2017, research showed similar results declaring that the best method for decontaminating the implant surface was the use of an air-abrasive device combined with an ER laser [32,33,34]. This results of this study coincide with our in vitro research, confirming that air polishing has an advantage as an effective method for decontaminating implant surfaces. The investigation conducted by Hakki and collaborators had the objective of exploring the effect of different cleaning methods on the surface and temperature of failed titanium dental implants. Therefore, they performed an analysis designed to compare the efficacy of different methods to remove residues from failed implants and to detect thermal changes in implants treated with various instruments.
Sodium bicarbonate is considered safe on enamel, amalgam, gold, porcelain and orthodontic brackets and bands. However, it should not be used on composites, glass ionomer and luting cements [35]. Air polishing with bicarbonates has been found to be safe and effective in subgingival biofilm even around titanium surfaces. This could be a step forward in the prevention and management of peri-implantitis [36].
In 2021, Matsubara et al. [37] conducted a study centered on investigating the cleaning potential of various abrasive powders and their effect on titanium implant surfaces. Twenty implants coated with red dye were used in 3D-printed circumferential bone defect models and three types of air-abrasive powders were applied for 60 s: sodium bicarbonate, glycine and erythritol. The results showed that sodium bicarbonate achieved a cleaning capacity of 49.3% ± 3.6%, but it caused alterations to the implant surface. Erythritol had a cleaning capacity of 25.1% ± 0.7%; it did not cause any alteration to the implant but showed limited cleaning capacity. As demonstrated in this study, the results aligned with this research and showed that sodium bicarbonate achieved a higher cleaning capacity compared to erythritol. This agrees with the present study.
Similarly, a 2021 study by Fernández et al. [38] aimed to determine whether erythritol combined with chlorhexidine applied with an air polishing system inhibits biofilm on dental implants, and compared the decontamination capacity of this therapy with mechanical removal using saline solution and gauze. The biofilm was composed of various bacteria (P. gingivalis, A. actinomycetemcomitans, F. nucleatum, A. naeslundii, V. parvula and S. oralis) and was present on 52 dental implants in an artificial mouth for 14 days. The result showed that the use of erythritol and chlorhexidine significantly inhibited biofilm compared to mechanical treatment. Erythritol powder with air polishing is consistent with the results of this in vitro study, demonstrating its ability to inhibit and eliminate various bacteria on dental implant surfaces.
Other research focused on evaluating the efficacy of two protocols for the in vitro decontamination of dental implant surfaces using an air-abrasive powder system with sodium bicarbonate and antimicrobial photodynamic therapy (aPDT). The results showed that both systems were effective in decontaminating dental implant surfaces in vitro [25]. This research agrees with the result obtained using an air polishing system with sodium bicarbonate, demonstrating similar results in the decontamination of different dental implant surfaces.
In 2022, Luengo et al. [39] conducted a study that evaluated the cleaning capacity of four mechanical devices designed to decontaminate implant surfaces. Ninety-six implants were stained and inserted into 3D-printed resin blocks simulating three different intraosseous defect configurations. The four decontamination devices used were air polishing with glycine powder, rotating titanium brush, ultrasonic tip coated with polyether ether ketone (PEEK) and stainless-steel ultrasonic tip, applied to the exposed 5 mm implant surface. The results showed that cleaning effectiveness decreased in the apical third threads when using titanium brushes, and the air polishing devices were more effective in removing the artificial biofilm using this in vitro model. This in vitro study showed results consistent with the present in vitro research, demonstrating that air polishing is effective in removing biofilm from dental implant surfaces for proper disinfection.
However, in a 2022 in vitro study, Junior and collaborators [40] used high-pressure sodium bicarbonate to decontaminate implants and demonstrated that no visible damage occurred to the surface. This shows that this type of surface decontamination is effective and not harmful to the implant structure. Based on these findings, sodium bicarbonate is considered an excellent antimicrobial agent that does not cause damage to the implant surface. One of the concerns when using this mechanical method for implant surface decontamination has been the potential damage to the implant structure itself. The aforementioned is consistent with what is reported in the present study, as the advantages of the different powders are highlighted.
A study in 2024 compared the removal of biofilm using air polishing with glycine versus erythritol combined with chlorhexidine on titanium discs, which were covered with a biofilm of S. aureus, B. fragilis and Candida albicans. The analysis was conducted using a spectrophotometric assay and qualitative analysis with laser scanning confocal microscopy. The results showed that glycine had a bacteriostatic effect, reducing the biofilm in only 30% of cases. In contrast, erythritol with chlorhexidine, as a bacteriostatic and bactericidal agent, showed better biofilm reduction at 65% [41]. In the present in vitro study, similar results were observed, indicating that erythritol powder is effective in reducing biofilm on dental implants.
Sodium bicarbonate is generally considered more effective than erythritol for removing plaque and stains due to its larger particle size, which provides greater abrasive power for cleaning, although this can also lead to potential damage to tooth enamel if used excessively; while erythritol has a smaller particle size, making it gentler on tooth surfaces but potentially less effective at removing heavy deposits [30,42,43].
This in vitro study has demonstrated that air polishing prepares implant surfaces to become more compatible with surgical and non-surgical niches. However, no significant antimicrobial differences were observed compared to negative controls, suggesting that while air polishing improves tissue compatibility, it does not directly influence biofilm affinity. According to the authors, the high survival rates of dental restorations (88%–98%) may result from a combination of mechanical and chemical surface treatments. Failures are often attributed to surface deterioration and insufficient management of defects rather than material deficiencies [44]. Abrasion techniques with aluminum oxide or sodium bicarbonate improve adhesion by enhancing chemical interactions with unpolymerized bonds and creating microroughened surfaces for better mechanical retention [45,46,47]. Despite advancements, no gold standard for surface treatment exists. Minimally invasive methods, such as air polishing with sodium bicarbonate, not only remove deposits but also create favorable textures for restoration repair [48,49]. These findings underline the need for an integrated approach to restoration management, combining preventive treatments and repair strategies.
The limitations of the research include limited sample size and in vitro conditions, and future studies could test long-term effects in clinical settings with a larger sample.

5. Conclusions

The results of this study demonstrate that air polishing with sodium bicarbonate and erythritol exhibit similar efficacy in reducing the bacterial concentration on dental implant surfaces in vitro, where an increase in surface roughness is observed in the implants treated with erythritol, whereas the treatment with sodium bicarbonate exhibited a smoother surface. Therefore, this could suggest the use of erythritol during air polishing due to its antimicrobial capacity and increased surface roughness on implant surfaces compared to bicarbonate. Further research is warranted to explore the long-term effects of these air polishing techniques in clinical settings and their impact on the overall success of dental implant therapies.

Author Contributions

Conceptualization, A.Y.G.-R. and J.I.R.-P.; methodology, M.A.D.L.G.-R.; software, C.L.E.-M.; validation, A.Y.G.-R., J.I.R.-P. and N.I.R.-F.; formal analysis, O.E.-C.; investigation, A.Y.G.-R.; resources, N.I.R.-F.; data curation, M.A.D.L.G.-R.; writing—original draft preparation, O.E.-C.; writing—review and editing, J.I.R.-P.; visualization, C.L.E.-M.; supervision, N.I.R.-F.; project administration, A.Y.G.-R.; funding acquisition, J.I.R.-P. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Approval was obtained from the Ethics Committee of the Faculty of Dentistry, Universidad Autónoma de Nuevo León, with approval number SPSI-010613, Folio 00254.

Informed Consent Statement

Not applicable.

Data Availability Statement

All data derived from this research is included within the manuscrirpt.

Acknowledgments

Authors would like to thank Jefatura de Investigación Pregrado for supporting this research.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. Inoculation procedure. (A) Straumann® implant, (B) JD Evolution implant, (C) microorganism incubation, (D) contamination of the Straumann® implant with bacteria, (E) contamination of the JD Evolution implant with bacteria, (F) implant removal, (G) tubes for measurement, (H) sample placement in quartz cuvettes, (I) preparation for reading, (J) BioRad equipment used.
Figure 1. Inoculation procedure. (A) Straumann® implant, (B) JD Evolution implant, (C) microorganism incubation, (D) contamination of the Straumann® implant with bacteria, (E) contamination of the JD Evolution implant with bacteria, (F) implant removal, (G) tubes for measurement, (H) sample placement in quartz cuvettes, (I) preparation for reading, (J) BioRad equipment used.
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Figure 2. Inoculation procedure. (A) Air-polishing equipment, (B) Bicarbonate and erythritol powders, (C) Containers with the prepared solution according to manufacturer conditions, yellow container is bicarbonate (AIR-FLOW® CLASSIC) and purple container is erythritol (AIR-FLOW® PLUS), (D) Implant preparation, (E) Implant sample before air-polishing treatment, (F) Air-polishing process, (G) Placement of the implant after treatment, (H) Inoculation with culture medium for laboratory incubation.
Figure 2. Inoculation procedure. (A) Air-polishing equipment, (B) Bicarbonate and erythritol powders, (C) Containers with the prepared solution according to manufacturer conditions, yellow container is bicarbonate (AIR-FLOW® CLASSIC) and purple container is erythritol (AIR-FLOW® PLUS), (D) Implant preparation, (E) Implant sample before air-polishing treatment, (F) Air-polishing process, (G) Placement of the implant after treatment, (H) Inoculation with culture medium for laboratory incubation.
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Figure 3. (a) Bacterial concentration treated with erythritol on the surface of the JD Evolution and Straumann implants. (b) Bacterial concentration treated with sodium bicarbonate on the surface of the JD Evolution and Straumann implants.
Figure 3. (a) Bacterial concentration treated with erythritol on the surface of the JD Evolution and Straumann implants. (b) Bacterial concentration treated with sodium bicarbonate on the surface of the JD Evolution and Straumann implants.
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Figure 4. (a) Representation of the positive control group (sterile medium) with sodium bicarbonate treatment on both implant surfaces. (b) Representation of the positive control group (bacteria) with erythritol treatment on both dental implant surfaces.
Figure 4. (a) Representation of the positive control group (sterile medium) with sodium bicarbonate treatment on both implant surfaces. (b) Representation of the positive control group (bacteria) with erythritol treatment on both dental implant surfaces.
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Figure 5. SEM images of (a) untreated JD Evolution SLA implants, (b) JD Evolution SLA implants treated with bicarbonate, (c) JD Evolution SLA implants treated with erythritol, (d) untreated Straumann SLA implants, (e) Straumann SLA implants treated with bicarbonate, and (f) Straumann SLA implants treated with erythritol.
Figure 5. SEM images of (a) untreated JD Evolution SLA implants, (b) JD Evolution SLA implants treated with bicarbonate, (c) JD Evolution SLA implants treated with erythritol, (d) untreated Straumann SLA implants, (e) Straumann SLA implants treated with bicarbonate, and (f) Straumann SLA implants treated with erythritol.
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MDPI and ACS Style

Gómez-Rueda, A.Y.; Garza-Ramos, M.A.D.L.; Rodríguez-Franco, N.I.; Rodríguez-Pulido, J.I.; Elizalde-Molina, C.L.; Elizondo-Cantú, O. Efficacy of Air-Polishing with Sodium Bicarbonate vs. Erythritol in the Decrease of the Bacterial Concentration on the Surface of Dental Implants: In Vitro Study. Coatings 2025, 15, 327. https://doi.org/10.3390/coatings15030327

AMA Style

Gómez-Rueda AY, Garza-Ramos MADL, Rodríguez-Franco NI, Rodríguez-Pulido JI, Elizalde-Molina CL, Elizondo-Cantú O. Efficacy of Air-Polishing with Sodium Bicarbonate vs. Erythritol in the Decrease of the Bacterial Concentration on the Surface of Dental Implants: In Vitro Study. Coatings. 2025; 15(3):327. https://doi.org/10.3390/coatings15030327

Chicago/Turabian Style

Gómez-Rueda, Ashley Yaressi, Myriam Angélica De La Garza-Ramos, Norma Idalia Rodríguez-Franco, Jesús Israel Rodríguez-Pulido, Claudia Lucía Elizalde-Molina, and Omar Elizondo-Cantú. 2025. "Efficacy of Air-Polishing with Sodium Bicarbonate vs. Erythritol in the Decrease of the Bacterial Concentration on the Surface of Dental Implants: In Vitro Study" Coatings 15, no. 3: 327. https://doi.org/10.3390/coatings15030327

APA Style

Gómez-Rueda, A. Y., Garza-Ramos, M. A. D. L., Rodríguez-Franco, N. I., Rodríguez-Pulido, J. I., Elizalde-Molina, C. L., & Elizondo-Cantú, O. (2025). Efficacy of Air-Polishing with Sodium Bicarbonate vs. Erythritol in the Decrease of the Bacterial Concentration on the Surface of Dental Implants: In Vitro Study. Coatings, 15(3), 327. https://doi.org/10.3390/coatings15030327

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