Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Surgical Methods

Abstract

Purpose. Peri-implantitis is one of the major causes of implant failure. The detoxification of the implant surface is necessary to obtain reosseointegration. The aim of this review was to summarize in vitro and in vivo studies as well as clinical trials that have evaluated surgical approaches for detoxification of the implant body surfaces. Materials and Methods. A literature search was conducted using MEDLINE (PubMed) from 1966 to 2013. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters, radiographic bone fill, and histological reosseointegration. Results. From 574 articles found, 76 were analyzed. The findings, advantages, and disadvantages of using mechanical, chemical methods and lasers are discussed. Conclusions. Complete elimination of the biofilms is difficult to achieve. All therapies induce changes of the chemical and physical properties of the implant surface. Partial reosseointegration after detoxification has been reported in animals. Combination protocols for surgical treatment of peri-implantitis in humans have shown some positive clinical and radiographic results, but long-term evaluation to evaluate the validity and reliability of the techniques is needed.

Nanoadhesion ofStaphylococcus aureusonto Titanium Implant Surfaces

“…CHX is a widely used oral antiseptic with demonstrated effectiveness against gram-positive bacteria (Valderrama and Wilson 2013). This resulted in the inhibition of specific adhesive events between the bacterial probe and Ti surfaces (Fig.…”

Citric acid reduces oral biofilm and influences the electrochemical behavior of titanium: Anin situandin vitrostudy

“…Different antimicrobial agents have been used, but there is no consensus about which is the most suitable chemotherapeutic agent for implant disinfection . Citric acid has been used to decontaminate titanium surfaces covered by biofilm . According to a systematic review, citric acid seems to be the chemical agent with the highest potential for biofilm removal from titanium surfaces .…”

The Use of the Dental Endoscope and Videoscope for Diagnosis and Treatment of Peri‐Implant Diseases

“…The author's opinion is that most surgical interventions should involve reduction of one-and two-wall bony craters, removal of affected soft tissues, and judicious smoothing of any exposed roughened surface of the implant followed by apical positioning of the flaps [3]. By definition, these individuals have lost bone that is assumed to have been originally attached to the implant surface.…”

“…However, current information suggests that appropriate treatment of periimplant disease may slow down or in some cases halt further bone loss, although reintegration of the lost bone has not yet been demonstrated in humans [3]. It should also be stated that appropriate treatment for periodontal diseases may not be totally applicable to the inflammatory responses seen around dental implants.…”