Mechanical and biological complications after implantoplasty – A systematic review

Abstract

Background : Implantoplasty, i.e., the mechanical modification of the implant, including thread removal and surface smoothening, has been proposed during surgical peri-implantitis treatment. Currently, there is no comprehensive appraisal of the literature regarding any potential mechanical and or biological complications after this approach.Aim/Hypothesis : The aim of the current review was to systematically assess the literature to answer the focused question ìAre there any mechanical and or biological complications due to implantoplasty?î Material and Methods : A systematic literature search was performed in 3 databases [Medline (PubMed), Scopus (Ovid), and CENTRAL (Ovid)] 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.Kappa scores regarding agreement on the articles to be included in the full-text analysis and those finally chosen were calculated.Results : Out of 386 titles, 26 publications were included in the present review (6 laboratory, 2 preclinical in vivo, and 18 clinical studies). Kappa scores regarding agreement on the articles to be included in the full-text analysis and those finally chosen were 0.91 and 0.95, respectively ( P < 0.001). Laboratory studies have shown that implantoplasty does not result in temperature increase, provided proper cooling is used, but leads in reduced implant strength in ìstandardî 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 in the studies identified in this review, no implant fracture was reported during a follow-up of 3 to 126 months, while only a single case of mucosal discoloration, likely due to titanium particle deposition, has been reported. Conclusion and Clinical Implications :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.

Titanium implant surface roughness after different implantoplasty protocols: A laboratory study

“…However, in a recent systematic review that summarized all laboratory, preclinical in vivo, and clinical research on IP (Stavropoulos et al, 2019), no remarkable mechanical or biological complications associated with IP, in the short-to medium-term, were identified. Only a single case of mucosal tattoo due to the titanium particle debris generated during IP was reported in one of the studies included in this review.…”

“…For example, a recent laboratory study demonstrated that IP significantly reduced the maximum implant failure strength, irrespective of implant type/design, diameter, or material, but in general, the maximum implant failure strength remained high (Bertl et al, 2021). However, in a recent systematic review that summarized all laboratory, preclinical in vivo, and clinical research on IP (Stavropoulos et al, 2019), no remarkable mechanical or biological complications associated with IP, in the short‐ to medium‐term, were identified. Only a single case of mucosal tattoo due to the titanium particle debris generated during IP was reported in one of the studies included in this review.…”

“…Treatment of peri‐implantitis remains a challenge and often includes surgery, ranging from open flap debridement to resective and reconstructive approaches (Figuero et al, 2014; Ramanauskaite et al, 2021; Renvert & Polyzois, 2015; Schwarz et al, 2022). In the case of implants with a modified (structured) implant surface, the surgical approach can be combined with implantoplasty (IP) (i.e., the mechanical modification of the implant surface, including the removal of the implant threads and smoothening of the implant surface, by means of rotating instruments), which—despite the favorable results presented in clinical studies (Bianchini et al, 2019; Englezos et al, 2018; Romeo et al, 2005, 2007)—remains a controversial procedure (Bertl & Stavropoulos, 2021; Stavropoulos et al, 2019).…”

Effect of crown to implant ratio and implantoplasty on the fracture resistance of narrow dental implants with marginal bone loss: an in vitro study

“…IP is a common procedure that consists of polishing rough implant surfaces outside the bony envelope, making them less prone to bacterial accumulation, as surface roughness may be risk factor for peri-implant disease. IP is effective in the long term for arresting bone loss caused by PI, both alone and in combination with surgical regenerative procedures and does not seem to be associated with any biological or mechanical complication of importance [9][10][11][12][13]. However, thermal increases during the procedure that could affect the bone, lower resistance to fractures due to reducing the thickness of the implant walls, and the local and systemic biological repercussions that the dispersion of titanium particles might have in the long term have been signaled as potential problems of IP performance [14][15][16][17][18][19].…”

Effect of Crown to Implant Ratio and Implantoplasty on The Fracture Resistance of Narrow Dental Implants with Marginal Bone Loss. An In Vitro Study.

“…IP is a common procedure that consists of polishing rough implant surfaces outside the bony envelope, making them less prone to bacterial accumulation as surface roughness may be risk factor perimplant disease. IP is effective in the long term to arrest bone loss caused by PI, both alone and in combination with surgical regenerative procedures [10][11][12][13] and does not seem to be associated with any biological or mechanical complication of importance [14].…”