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Carbon compounds accumulate over time on titanium surfaces. This is reported to reduce osseointegration of titanium implants in bone. Ozonated water was found to remove carbon compounds and to have a sufficient cleaning effect. The effects of the ozonated water on the titanium surface were evaluated by cell culture and mechanical tests. In vitro study, titanium disks (diameter 20 mm, thickness 1 mm, Grade 2) were treated with sulfuric acid. Disks in the control group were surface cleaned with distilled water, and disks in the O3 group were surface cleaned for 10 min with ozonated water. The experimental animals were male Sprague-Dawley (SD) rats. We tested for cell proliferation activity, alkaline phosphatase (ALP) activity, calcification and measured calcium concentrations. In vivo study, titanium implants (diameter 1 mm, length 2 mm, Grade 2) were treated with sulfuric acid. Control group samples were washed for 10 min with distilled water immediately before implantation. O3 group samples were washed for 10 min with ozonated water. We performed push-in testing using a mechanical testing machine. The femurs were removed at 2 and 4 weeks after implantation. Cell proliferation activity was higher in the O3 group than in the control group at 24 h after cell seeding. Similarly, ALP activity was higher in the O3 group than in the control group, indicating higher cell differentiation potential. Cell calcification was higher in the O3 group than in the control group at all measurement times. Maximum compressive stress was significantly higher in the O3 group compared with the control group at 2 weeks after implantation (p < 0.05). At 4 weeks after implantation, no difference was found between the groups. Osseointegration time was decreased by cleaning titanium implants with ozonated water.

Effect on Osteogenesis of Cleaning Titanium Implants with Ozonated Water