Dr. F. asks:
I have been trying to find out more about disinfecting the implant surface in cases of peri-implantitis. I have seen references and heard speakers recommend citric acid and tetracycline. But what concentration of citric acid and how long do I leave it on the implant surface? Do I repeat the process? After rinsing off the citric acid do I need to apply anything else to the implant surface? What concentration of tetracycline do I use? I have heard speakers recommend mixing a capsule of tetracycline with sterile water. How much tetracycline and how much water and how long do I leave this solution of the implant surface?
Treating Peri-Implantitis: How Do I Disinfect the Implant Surface?
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The regimen we use is to expose the area, remove as much granulation tissue as possible, paint the whole surface that is exposed with a laser set at “coagulation” strength, place a 2X2 soaked with gentamycin opthalmic solutiom for about 3 minutes. we then graft the hard tissue defect with calcium sulfate (sterile plaster of paris) into which cancelous bone powder has been incorporated. the plaster is bacteriostatic and acts as a membrane. then we close.
This works quite well in our hands.
There is also another thread on this site that discussed this at great length. No firm consensus of course, but Dr. DiBona’s method fits neatly within those ideas and IMHO uses the better ideas of the bunch. I especially like using the CaSO4 w/bone to graft the site for ease of use, thus sealing the threads under bone again for long-term predictablilty.
tecniques after debridement of gran tissue:
1- citric acid etch of implant surgace x3-5min
2- OR: regular acid etch
3- dentifrices implant surface debride
be happy to listen to others comments