Adjunctive Electrolytic Implant Surface Decontamination in the Reconstructive Surgical Treatment of Peri‐Implantitis—A Randomized Clinical Trial

OBJECTIVES: The aim of this study was to evaluate the adjunctive effect of electrolytic cleaning in the surgical treatment of peri-implantitis. MATERIALS AND METHODS: A total of 40 patients (44 implants) with peri-implantitis-associated intra-bony defects were included in this single-center randomized controlled trial. Surgical decontamination of implant surfaces was initiated by use of a rotating titanium brush. Following random allocation, adjunctive electrolytic cleaning was performed in the test group. Xenogeneic bone substitute and a resorbable collagen membrane were then used in both groups. Clinical parameters including probing pocket depth (PPD), bleeding/suppuration on probing, buccal mucosal recession (REC), and keratinized mucosa were assessed at 6 and 12 months. Radiographic marginal bone levels (MBL) and patient-reported outcomes (PROs) were evaluated at 12 months. The primary outcome was a composite measure including implant survival, complete absence of BoP/SoP, PPD ≤ 5 mm and REC ≤ 1 mm at 12 months. RESULTS: At 12 months, no implants were lost. The composite outcome was complete at 27.3% of control and 40.0% of test implants (p = 0.41). Mean PPD reductions were 4.5 ± 2.6 mm (control) and 3.8 ± 2.3 mm (test), while MBL gains were 1.9 ± 2.4 mm and 2.1 ± 2.0 mm, respectively. No significant intergroup differences were observed for any clinical, radiographic or PROs. Post-surgical complications occurred in the test group. CONCLUSIONS: Clinical, radiographic and patient-reported outcomes of surgical therapy of peri-implantitis were favorable at 12 months. The adjunctive use of electrolytic cleaning provided no added benefit over the use of a rotating titanium brush alone. TRIAL REGISTRATION: ISRCTN17197337 (ISRCTN).