Preliminary Clinical Outcomes of an Alternating-Current-Assisted Implant Surface Decontamination Protocol: A Prospective Case Series with 12-Month Follow-Up

Background: Treatment of peri-implantitis remains challenging because biofilm removal from microstructured implant surfaces is often incomplete. The present study is an uncontrolled, prospective feasibility case series involving six patients (six implants), not a controlled clinical trial, in which short-term clinical outcomes following use of a multimodal protocol to decontaminate the titanium implant surface were obtained; consequently, the independent contribution of the Ximplant® device to the observed outcomes cannot be determined. The protocol comprised surgical access, mechanical debridement, chemical conditioning, systemic administration of medication, and cleaning with an alternating-current device (Ximplant®; LED, S.p.A., Aprilia, Italy). Methods: Six adults with peri-implantitis, each contributing one implant, were consecutively treated using the multimodal protocol. Probing depth (PD), bleeding on probing (BOP), plaque index (PI), and suppuration (SU) were determined at baseline, 3 weeks, 6 months, and 12 months. Longitudinal changes were analyzed using repeated-measures analysis of variance and non-parametric tests for categorical variables. Results: Mean total PD decreased from 4.56 ± 0.45 mm at baseline to 3.03 ± 0.44 mm at the 3-week follow-up and remained stable at the 6-month follow-up (3.08 ± 0.35 mm) and at 12-month follow-up (3.19 ± 0.41 mm; p < 0.0001). BOP and SU were absent in all implants at each follow-up visit. PI improved markedly, although the buccal aspect of one implant was PI-positive at the 3-week and the 12-month follow-up. Conclusions: The multimodal protocol used in this study was associated with rapid and sustained clinical improvement over the 12-month follow-up period. A study limitation is that because the individual parts of the protocol were applied concurrently, the independent contribution of any of them to the outcomes determined could not be isolated.