Kristina Bertl^1,2,*; Alexandra Isik¹; Tai Truong¹; Patrick Heimel³; Andreas Stavropoulos^1,4

¹Department of Periodontology, University of Malmö, Malmö, Sweden; ²Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna; ³Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Medical University of Vienna; ⁴Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria

Background: Disinfection of the implant surface is essential for the management of peri-implantitis, but no method seems efficacious in achieving biofilm removal in a clinically relevant extent with a non-surgical approach. Air-polishing devices, however, which are easy to use and have gained popularity, have shown some advantages in laboratory studies.

Aim/Hypothesis: To evaluate the impact of different parameters (i.e., implant surface, treatment time, and manufacturer) on the efficacy of air-polishing devices in disinfecting the implant surface, in simulated non-surgical peri-implantitis treatment.

Material and Methods: Turned and moderately rough implants (28 each) were coated with a simulated biofilm. The implants were mounted in customized resin models simulating peri-implant intrabony defects 5 mm deep and with a 30° angle. Soft tissues were simulated with ballistic gelatin. Each implant was treated for 30 or 90 seconds in total (6 aspects per implant, 5 or 15 seconds per aspect) with one of two different air-polishing devices (W&H and EMS). Implants were photographed post-treatment in a standardized manner and the amount of residual biofilm on the implant surface was automatically assessed and expressed in percentage of the evaluated area (primary outcome parameter). Beta-regression models were used to assess the outcome on the entire implant surface treated (i.e., 0 to 5 mm from the bottom of the defect) as well as separately in the apical, central, and coronal aspect (i.e., 0 to 1.5 mm, 1.5 to 3 mm, and 3 to 5 mm, respectively, from the bottom of the defect).

Results: Overall, debridement of a turned implant surface, and a longer treatment time resulted in significantly less residual biofilm; this was independent of the implant surface aspect assessed. Independent of the manufacturer, most biofilm remained in the most apical aspect (i.e., 0 to 1.5 mm from the bottom of the defect), but EMS appeared to be more efficacious in more coronal aspects. Nineteen turned (W&H=11, EMS=8), but only 5 moderately rough (W&H=2, EMS=3) implants showed ≤ 10% residual biofilm after debridement.

Conclusion and Clinical implications: In a non-surgical peri-implantitis treatment simulation, complete biofilm removal, defined as ≤ 10% residual biofilm, was inconsistently achieved in 5 mm deep and 30° peri-implant bone defects, irrespective of implant surface, treatment time, and manufacturer. However, implants with turned surface are easier to clean, and longer treatment time results in less residual biofilm.

Disclosure of Interest: None Declared

Keywords: dental implants, implant surface, peri-implantitis

克里斯蒂娜·伯特^1,2,* ; 亚历山德拉·伊西克¹ ; 大长¹ ; 帕特里克·海默尔³ ; 安德烈亚斯·斯塔夫罗普洛斯^1,4

¹瑞典马尔默马尔默大学牙周病学系；²维也纳医科大学牙科大学诊所口腔外科部；³ Karl Donath 硬组织和生物材料研究实验室，维也纳医科大学；⁴维也纳医科大学牙科大学诊所保守牙科和牙周病学部，维也纳，奥地利

背景：种植体表面的消毒对于种植体周围炎的治疗至关重要，但似乎没有一种方法可以通过非手术方法在临床相关程度上有效去除生物膜。然而，空气抛光装置易于使用且已广受欢迎，在实验室研究中显示出一些优势。

目的/假设：在模拟非手术种植体周围炎治疗中，评估不同参数（即种植体表面、治疗时间和制造商）对空气抛光装置对种植体表面消毒效果的影响。

材料与方法：车削和中等粗糙的植入物（每个 28 个）涂有模拟生物膜。种植体安装在定制的树脂模型中，模拟种植体周围 5 毫米深和 30° 角的骨内缺损。软组织用弹道明胶模拟。使用两种不同的空气抛光设备（W&H 和 EMS）之一处理每个种植体总共 30 或 90 秒（每个种植体 6 个方面，每个方面 5 或 15 秒）。植入物在治疗后以标准化方式拍照，植入物表面残留生物膜的数量被自动评估并以评估面积的百分比表示（主要结果参数）。Beta 回归模型用于评估整个种植体表面处理的结果（即距离缺损底部 0 到 5 毫米）以及分别在根尖、中央、

结果：总体而言，翻转种植体表面的清创和较长的治疗时间导致残留生物膜显着减少；这与评估的种植体表面方面无关。独立于制造商，大多数生物膜保留在最顶端（即距缺损底部 0 至 1.5 毫米），但 EMS 在更多冠状面似乎更有效。19 个旋转（W&H=11，EMS=8），但只有 5 个中等粗糙（W&H=2，EMS=3）种植体在清创后显示 ≤ 10% 的残留生物膜。

结论和临床意义：在非手术种植体周围炎治疗模拟中，完全去除生物膜（定义为 ≤ 10% 残留生物膜）在 5 mm 深和 30° 种植体周围骨缺损中不一致地实现，无论种植体表面、治疗如何时间, 和制造商. 然而，具有翻转表面的植入物更容易清洁，更长的处理时间会导致更少的残留生物膜。

利益披露：无申报

关键词: 牙种植体，种植体表面，种植体周围炎