implants - international magazine of oral implantology

I research Fig. 1_Mounted titanium brush (PeriBrush™, Tigran Technologies). Fig. 2_The titanium brush was designed to match the implant architecture. _Introduction The mechanical debridement of implants as part of peri-implantitis therapy is time-consuming and tedious. The use of rotating brushes with titanium bristles can result in significantly shortened treat- ment times. Compared with mechanical curettage, they ensure a gentler and more even treatment of the exposed portions of the thread. Despite—orbecauseof—thesuccessstoryoforal implantology, peri-implantitis, associated with sig- nificant bone loss, is on the rise. A meta-analysis performed by Berglundh et al. in 2002 (which in- cludedperiimplantmucositis)showedthattheinci- dence of periimplant disease for different implant systems was between 5 and 8 per cent.1 In fact, the prevalenceofperiimplantitisaloneisassumedtobe between 10 and 20 per cent today.2, 3 The biological response to the implant and the implant’s ability to integrate with the surrounding tissue are deter- mined by the structure of the implant surface. Roughened implant surfaces to enlarge the bioac- tivesurfaceareaclinicallyprovenmethodandhave been accepted by all manufacturers as the basis for successfulosseointegrationoftheirimplants.4,5 Ad- vanced periimplantitis invariably leads to bone loss and, hence, to the exposure of implant surfaces, in- cluding threaded parts. One of the most frequently discussed topics in oral implantology today is that offindingtherighttreatmentapproachinthissitu- ation. In cases with pocket depths of more than 6mm, surgical access followed by mechanical cleaning and decontamination of the exposed por- tions of the thread is certainly an option. Following bone loss, the implant surface is generally covered by concrements, necrotic bone and inflammatory tissue. Proper debridement thus requires mechani- cal cleaning of the implant surface to remove con- crements and granulomatous tissue. This mechanical debridement is generally per- formedbyspecificcurettes.Theverticalmovements of these curettes, which have only limited contact with the implant thread, are not very efficient. It stands to reason that rotationally symmetrical, screw-shaped structures like those of most con- temporary implants are more rapidly and more evenlydebridedwithrotaryinstruments(Fig.1).Ro- tatingbrushesarecapableofadaptingmoreclosely Time-saving debridment of implants with rotating titanium brushes Authors_Dr Dirk U. Duddeck, Dr Viktor E. Karapetian & Dr Andrea Grandoch, Germany 20 I implants3_2012 Fig. 1 Fig. 2