Ricerc@Sapienza

Implant therapy is an effective and predictable method to replace missing teeth. Nevertheless, biological complications (peri-implant mucositis and peri-implantitis) due to the local inflammatory reaction of marginal soft tissues to the biofilm may happen. Different strategies in implant surface decontamination have been suggested to reduce the bacterial load and remove biofilm. However, none of these modalities has shown effectiveness in recovering peri-implant health, and there is no consensus on the best available treatment to provide satisfactory implant surface decontamination. Additional researches on the decontamination/detoxification of infected titanium surfaces are needed to identify an effective treatment.
The research project aims to compare, using an ex-vivo model, the efficacy of electrolytic decontamination (recently developed procedure) versus mechanical debridement with sodium bicarbonate and glycine powders and combined mechanical-electrolytic decontamination in the biofilm removal following surgical exposure of implants failed for severe peri-implantitis.
The study design is a single-blind, randomized, controlled, ex vivo investigation with intra-subject control.
Study participants are consecutive patients with at least 4 hopeless implants, in function for >12 months and with progressive bone loss exceeding 50%, which have to be explanted. Implants of each patient are randomly assigned to the untreated control group or one of the three decontamination procedures: electrolytic, mechanical or combined mechanical-electrolytic.
Following surgical exposure, implants selected as control are retrieved, and afterwards, test implants are decontaminated according to allocation and carefully explanted with a removal kit.
Microbiological analysis is expressed in colony-forming units (CFU/ml), and microbial identification is performed for each implant. Scanning electron microscope (SEM) images assess micromorphological surface changes after instrumentation.