Implant Surface Disinfection: Treatment Modalities and Effectiveness

The rationale for implant surface decontamination includes elimination of calculus, biofilm, and hard deposits such residual cement, to better prepare the implant surface for re-osseointegration prior to or during reconstructive therapy, and/or to establish an implant surface with decreased biofilm adhesion in advance of resective procedures.¹⁰³ Commonly used methods for implant surface detoxification include mechanical methods, chemical methods, and laser therapy.¹⁰⁴ It should be noted that many implant surface decontamination methods induce changes in implant surface chemical and physical properties, which may impact long-term clinical outcomes of surgical and nonsurgical therapies.^103,105 It is also notable that little evidence exists on the impact of implant surface geography and baseline surface characteristics on outcomes of decontamination procedures.¹⁰³ It is clinically evident that endosseous dental implants with undercuts and screw-form threads present real-life difficulties for thorough debridement of the implant surface while reducing deleterious alterations to implant surface characteristics.¹⁰³ Further, there has been emerging evidence that some implant surface decontamination strategies targeting biofilm may lead to titanium particle dissolution.^103,105 Such titanium particles have also demonstrated cytotoxic effects on fibroblasts and osteoblasts and association with increased biofilm pathogenicity, which may lead to failed treatments.^103,105