Guidelines for the depth of surface decontamination during peri-implantitis treatment: a scanning electron microscopy analysis.

Abstract

Purpose: The primary objective in treating peri-implantitis is the elimination of biofilm from the implant surface. This study aimed to measure the width of the contaminant-free zone in implants removed from patients and to determine the extent of surface decontamination achieved during peri-implantitis treatment.

Methods: Patients presenting with the chief complaint of implant discomfort were recruited. The inclusion criterion was implant removal due to biological or mechanical complications, including marginal bone loss extending to the apical third of the implant fixture, fixture tearing, or fixture fractures. Removed implants were analyzed using scanning electron microscopy (SEM). The width of the contaminant-free zone was defined as the distance from the apical end of the biofilm to the apical and coronal first bone-to-implant contact, measured with a caliper in conjunction with SEM. The mean width of the contaminant-free zone was compared across implant characteristics using the independent t-test.

Results: A total of 49 implants were removed from 39 patients. The mean width of the contaminant-free zone was 0.66±0.67 mm (range, 0-3.0 mm). No significant differences in the width of the contaminant-free zone were observed according to sex, age, presence of diabetes, smoking habits, implant location, reason for removal, fixture type, fixture length, or prosthetic type (P>0.05). No variable significantly affected the width of the contaminant-free zone.

Conclusions: The width of the contaminant-free zone was found to be less than 1 mm. Therefore, precise and delicate debridement of all fixture surfaces above the remaining marginal bone is required during peri-implantitis treatment.