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.