Mechanical and biological complications after implantoplasty—A systematic review

Abstract

Objectives Implantoplasty, that is, the mechanical modification of the implant, including thread removal and surface smoothening, has been proposed during surgical peri‐implantitis treatment. Currently, there is no information about any potential mechanical and/or biological complications after this approach. The aim of the current review was to systematically assess the literature to answer the focused question “Are there any mechanical and/or biological complications due to implantoplasty?”. Materials and methods A systematic literature search was performed in three databases until 23/09/2018 to assess potential mechanical and/or biological complications after implantoplasty. All laboratory, preclinical in vivo, and clinical studies involving implantoplasty were included, and any complication potentially related to implantoplasty was recorded and summarized. Results Out of 386 titles, 26 publications were included in the present review (six laboratory, two preclinical in vivo, and 18 clinical studies). Laboratory studies have shown that implantoplasty does not result in temperature increase, provided proper cooling is used, but leads in reduced implant strength in “standard” dimension implants; further, preclinical studies have shown titanium particle deposition in the surrounding tissues. Nevertheless, no clinical study has reported any remarkable complication due to implantoplasty; among 217‐291 implants subjected to implantoplasty, no implant fracture was reported during a follow‐up of 3–126 months, while only a single case of mucosal discoloration, likely due to titanium particle deposition, has been reported. Conclusions Based on all currently available, yet limited, preclinical in vivo and clinical evidence, implantoplasty seems not associated with any remarkable mechanical or biological complications on the short‐ to medium‐term.

Experimental implantoplasty outcomes correlate with fibroblast growth in vitro

“…That fibroblasts respond differently according to substrate roughness is already known [17,18,27]. However, this has only been shown on surfaces prepared in laboratories with delicate equipment and procedures impossible to replicate intraorally in patients.…”

“…Implantoplasty is above all performed to counter microbial challenges, and its impact on preventing bacterial recolonization and facilitating removal of bacterial colonization is considered pivotal to healing and homeostasis of peri-implant health following implantoplasty treatment in response to peri-implantitis challenges. So far in vitro studies on implantoplasty have focused on surface roughness [8][9][10], heat generation [11][12][13], and fracture resistance [14,16,17]. This study provides some new insights on the soft tissue component following experimental implantoplasty.…”

“…More recent in vitro studies have focused on the optimum bur sequence [8][9][10][11], the heat generation following titanium polishing [11][12][13], and biocompatibility [14,15]. Fracture resistance has also been the focus of in vitro studies [16], but according to a recent systematic review no fractures following implantoplasty have been reported in the literature [17].…”

Experimental implantoplasty outcomes correlate with fibroblast growth in vitro

“…So far in vitro studies on implantoplasty have focused on surface roughness, 8,9,10 heat generation, 11,12,13 and fracture resistance. 14,16,17 This study Although efforts were made to collect the experimental implantoplasty debris, particles may have been lost as aerosols during drilling. The fibronectin imaging was not possible to perform with standardized laser strength in all cases, which may have influenced the subsequent arbitrary quantification.…”

“…14,15 Fracture resistance has also been the focus of in vitro studies 16 , but according to a recent systematic review no fractures following implantoplasty have been reported in the literature. 17 A possible advantage of implantoplasty in addition to facilitated oral hygiene is a potential improvement of the soft tissue adaptation to the dental implant. An ideal implant surface should impede bacteria and biofilm growth and adhesion while at the same time allow rapid connective tissue attachment.…”