Decontamination of Titanium Implant Surface and Re-osseointegration to Treat Peri-Implantitis: A Literature Review

Purpose: To review the literature on decontamination of titanium implant surfaces following peri-implantitis and the effect of various cleaning methods on re-osseointegration. Materials and Methods: An electronic search of the literature at PubMed was conducted on the studies published between 1966 and October 2010. In vitro, animal, and clinical studies were included. Results: Of 597 studies retrieved, 74 manuscripts were selected for the review. Various implant surface decontamination methods using various chemical and mechanical agents have been suggested for treatment and re-osseointegration following periimplantitis. It has been shown that re-osseointegration of contaminated implant surfaces is possible; this largely depends upon the surface of the implant and the types of decontamination techniques and bone regenerative materials used. Complete re-osseointegration cannot be achieved by surface decontamination alone. Titanium implants with titanium plasma-sprayed or sandblasted and acid-etched surfaces may be effectively decontaminated by applying chlorhexidine and saline-soaked gauze or by repeated rinsing with these solutions. Conclusions: Both mechanical and chemical decontamination techniques should be applied alongside regenerative surgical procedures to obtain optimum re-osseointegration and successfully treat peri-implantitis. In recent years, lasers and photodynamic therapy have shown minor beneficial results, which need to be confirmed by long-term clinical studies with comparable groups. Keywords: biofilm removal, chemical and mechanical cleaning, laser, peri-implantitis, photodynamic therapy, re-osseointegration