Comparison between four different implant surface debridement methods: an in-vitro experimental study

Background: Peri-implantitis treatment is a very challenging topic to discuss. What is certain is that preventive/supportive therapy plays a key-role in peri-implant tissues' health maintenance and non-surgical implant surface mechanical debridement remains one of the solid pillars in the therapeutic pathway. The aim of this study was to compare four different commonly used non-surgical implant debridement methods in terms of cleaning potential in vitro, using a peri-implant pocket-simulating model. Methods: Sixty-four dental implants were ink-stained and placed into a simulated peri-implant pocket. Samples were then divided into four groups and treated with different debridement methods: stainless-steel ultrasonic tip (PS), peek-coated ultrasonic tip (PI), sub-gingival air-polishing with erythritol powder (EHX) and sub-gingival air-polishing with glycine powder (GLY). For each treatment group, half of the samples were treated for 5 seconds and the other half for 45 seconds. Results: A paired comparison between all treatments in terms of debridement potential (cleaned area percentage) was performed. Air-polishing methods (EHX and GLY) showed significantly higher ink removal compared to ultrasonic instrumentation (PS and PI) across all conditions. Maximum ink removal was 62.78% achieved by erythritol air-polishing at 45 seconds with 90° angulation. Conclusions: Among the four treatments considered, air-polishing therapy represents the best one in terms of ink removal from the implant surface. Furthermore, increasing the treatment time to 45 seconds, air-polishing resulted considerably more efficient.