Titanium Brushes Non-Inferior to Implantoplasty in surgical treatment of peri implantitis: Study

A new study published in the Journal of Clinical Periodontology showed that titanium that rotates In the surgical treatment of peri-implantitis, brushes are not less effective than implantoplasty.

An inflammatory disorder called peri-implantitis affects the tissues around dental implants, which can cause increasing bone loss and even implant failure. To encourage re-osseointegration and avoid recurrence, effective surface cleaning is essential in its surgical therapy. The ability of implantoplasty and rotating titanium brushes to mechanically remove biofilm and smooth contaminated implant surfaces has drawn interest among other treatments.

While titanium brushes are made to debride implant threads while maintaining their morphology, implantoplasty entails mechanically altering and polishing the exposed implant surface to lessen surface roughness and bacterial adherence. Although both approaches seek to improve the microbiological and clinical results of peri-implantitis surgery, they vary in terms of clinical effectiveness, invasiveness, and impact on implant integrity. Thus, this study assessed the results of treatment after implantoplasty or the use of rotating titanium brushes in the surgical management of peri-implantitis.

This 12-month randomized clinical study with a non-inferiority setup included 30 patients with peri-implantitis who required surgery. Implantoplasty (control group) or titanium brushes (test group) were used for surface cleansing. In addition to patient-reported outcomes (Oral Health Impact Profile-14; OHIP-14), clinical and radiographic indicators were assessed.

At 12 months, 6/15 implants in the test group and 4/15 in the control group had the composite result. As evidence of the test procedure's non-inferiority, probing pocket depth (PPD) values dropped by 3.6 ± 1.5 mm (test) and 3.3 ± 1.2 mm (control). The bone levels of the test group stayed the same (0.0 ± 0.6 mm), however the control group saw more bone loss (0.7 ± 1.2 mm).

Relevant predictors for pocket closure were baseline PPD (p = 0.044) and the existence of a neighboring implant with peri-implantitis (p = 0.033). The test's surface decontamination time (3 min 1 s) was substantially less than that of the control group (5 min 27 s) (p = 0.006). The results of the OHIP-14 were statistically indifferent.

Overall, when compared to implantoplasty, the use of a revolving titanium brush in surgical treatment for peri-implantitis produces non-inferior results. Utilizing the titanium brush was linked to shorter treatment times and improved preservation of peri-implant MBLs.

Source:

Park, S.-H., Kim, D.-B., Kim, D.-M., Sanz-Martin, I., Sanz-Sanchez, I., Derks, J., & Cha, J.-K. (2025). Implantoplasty vs. Rotating titanium brushes in the surgical treatment of Peri-implantitis: A 1-year randomised controlled clinical trial. Journal of Clinical Periodontology. https://doi.org/10.1111/jcpe.70056