Treatment of Peri-Implantitis—Electrolytic Cleaning Versus Mechanical and Electrolytic Cleaning—A Randomized Controlled Clinical Trial—Six-Month Results

Abstract

Objectives: The present randomized clinical trial assesses the six-month outcomes following surgical regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: 24 patients with 24 implants suffering from peri-implantitis with any type of bone defect were randomly treated by EC or PEC. Bone defects were augmented with a mixture of natural bone mineral and autogenous bone and left for submerged healing. The distance from implant shoulder to bone was assessed at six defined points at baseline (T0) and after six months at uncovering surgery (T1) by periodontal probe and standardized x-rays. Results: One implant had to be removed at T1 because of reinfection and other obstacles. None of the other implants showed signs of inflammation. Bone gain was 2.71 ± 1.70 mm for EC and 2.81 ± 2.15 mm for PEC. No statistically significant difference between EC and PEC was detected. Significant clinical bone fill was observed for all 24 implants. Complete regeneration of bone was achieved in 12 implants. Defect morphology impacted the amount of regeneration. Conclusion: EC needs no further mechanical cleaning by powder spray. Complete re-osseointegration in peri-implantitis cases is possible.

Is Complete Re-Osseointegration of an Infected Dental Implant Possible? Histologic Results of a Dog Study: A Short Communication

“…The regenerative potential of horizontal bone defects with no walls is worse than for contained, multi-walled defects [4,7]. In this animal study we observed massive horizontal bone loss and merging defects resulting in a severely resorbed ridge (Figure 3).…”

“…This paper does not investigate the reasons for this observation. In the context of previous literature, it may be assumed that EC in contrast to CC removes the bacterial biofilm and other remnants to an extent that makes complete re-osseointegration possible [6,7]. The latter was proven through histology ( Figures 5-8).…”

“…A hygiene program was set up, and the implants were treated at T4 (8 months) by either CC or EC in a randomized manner with the use of sealed envelopes. The mode of action of EC has been described before [6,7]. In summary, the implants were negatively loaded with a current of around 5 V, and rinsed with an electrolyte which passed an anode inside a spray-head ( Figure 4c).…”

Investigation of different electrochemical cleaning methods on contaminated healing abutments in vitro: an approach for metal surface decontamination

“…Therefore, complete decontamination around infected implant surfaces requires the clinical attention to achieve implant success. Electrolytic cleaning needs mechanical cleaning for complete removal of organic contaminants to achieve re-osseointegration in infected implants [ 28 ]. Without any mechanical cleaning, the optimized electrochemical treatment was able to achieve complete decontamination on the contaminated metal surface in the present study.…”

Regenerative Surgical Therapy of Peri-implantitis: An Umbrella Review of Answered/Unanswered Questions and Future Perspectives

“…Most importantly, the cleaning of the implant remains a critical pillar of any successful treatment, and promising developments in this field may also lead to optimized processes. One example, for instance, is the use of electrolytic systems to clean the implant surface (49). However, to date, no evidencebased justification of such treatment is available.…”