Pilot <em>In Vitro</em> Study to Assess Cleaning Ability and Effects of Different Decontamination Methods on Implant Surfaces

An essential component of peri-implantitis treatment is the effective decontamination of implant surfaces. The ideal decontamination technique should safely and efficiently remove biofilm without damaging the implant surface. This pilot study aimed to evaluate the cleaning efficacy and surface alterations associated with three mechanical decontamination protocols. Here, 12 implants were stained with indelible red ink and mounted into acrylic blocks to simulate horizontal peri-implant defects. Surface decontamination was performed for 2 min by the same examiner using one of the following devices: titanium brush (TiB), chitosan brush (ChB), or titanium curette (TiC). No chemical decontamination agents were used in combination with the mechanical tools. Standardized photographs were taken before and after the decontamination from buccal and oral frontal views, as well as at 30° and 60° angulations. The uncleaned implant surface area was calculated digitally. Scanning electron microscopy (SEM) was used to assess surface morphology. None of the tested methods achieved complete removal of the ink stain. Although 75.98% ± 2.42% of the stain remained, TiB showed the highest cleaning efficacy at buccal and oral frontal views (p = 0.027), followed by TiC (80.3% ± 0.86% stain remaining) and ChB (90.34% ± 6.07% stain remaining). Significant differences were observed between the ChB and TiB groups (p = 0.022). SEM analysis revealed that the TiC caused the greatest surface damage, whereas the TiB produced minimal alterations. Within the limitations of this pilot study, TiB demonstrated effective cleaning while preserving implant surface morphology. These findings suggest that titanium brushes may represent a safer and more efficient mechanical decontamination option during peri-implantitis treatment. However, further studies are warranted to evaluate combinations of mechanical and chemical techniques to enhance cleaning efficacy.