Effects of decontamination and implant surface characteristics on re-osseointegration following treatment of peri-implantitis

Background: Although considerable bone fill may occur following treatment of peri‐implantitis, re‐osseointegration appears to be limited and unpredictable. Objectives: To evaluate the effects of various decontamination techniques and implant surface configurations on re‐osseointegration of contaminated dental implants. Material and methods: Three months after tooth extraction, implants consisting of a basal part and an exchangeable intraosseous implant cylinder (EIIC) were placed in the mandibles of dogs. The EIIC was machined (M), sandblasted and acid‐etched (SLA), or titanium plasma sprayed (TPS). Ligature‐induced peri‐implantitis was initiated 8 weeks post‐implantation and lasted until bone loss reached the junction of the two implant parts. Three treatment modalities were applied: (T1) the EIIC was exchanged for a pristine EIIC; (T2) the EIIC was sprayed in situ with saline; and (T3) the EIIC was removed, cleansed outside the mouth by spraying with saline, steam‐sterilized, and remounted. A collagen barrier was placed over each fixture, and 3 months later, samples were processed for histology and histomorphometry. Results: T2 revealed the highest bone‐to‐implant contact (BIC) level (significantly better than T1 and T3). T2 also yielded the highest bone crest level (significantly better than T1), followed by T3 (significantly better than T1). SLA showed the highest BIC level (significantly better than M), followed by TPS. There were no statistically significant differences in bone crest height between implant types. Conclusions: Both SLA implants and in situ cleansing resulted in the best re‐osseointegration and bone fill of previously contaminated implants.