Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and the bacterial biofilm is eliminated and the rough surface of the implant is smoothened. In general, Implantoplasty refers to the use of rotating instruments to smoothen rough implant surfaces which are exposed to the oral cavity, with the objective of reducing the adherence of plaque and facilitating implant surface cleaning. Various studies have suggested that implantoplasty is a viable treatment of peri-implantitis, though some concerns remain (see: Impact of implantoplasty on strength of the implant-abutment complex where the diameter of implants is mentioned an issue with implantoplasty). The theoretical benefit of implantoplasty is the production of a surface that is less adherent to bacterial colonization and a form of surface decontamination. In Claffey et al.’s 2008 review of surgical treatments of peri-implantitis, he states,”…[implantoplasty] could be of value when treating peri-implantitis and should be considered.”1

1. Claffey N, Clarke E, Polyzois I, Renvert S. Surgical treatment of peri-implantitis. Journal of Clin Perio 35, 316–332.

11 thoughts on: Implantoplasty to Treat Peri-implantitis

  1. Robert Wolanski says:

    Very nice work
    I have been doing this in my office for about 6 years now. It is very predictable and is giving a new lease on life for many implants with exposed threads that come into my office. I do use a microscope to allow me the best finish possible.
    Some presenters show cases of thread cleansing and GBR but there is little evidence to support the predictability of this procedures once the rough thread surface is contaminated. I started doing this based on a paper I read that was published about 10 years ago

  2. DocDragon says:

    So would you leave some granulation tissue behind? Because when looking at the X-ray, there is no practical way to remove that tissue all the way to the apex of the implant by merely using a Rangeur. And after debridement, new granulation tissue should develop if the space is not filled with some sort of bone grafting material.

    While the end result is indeed impressive, it seems like there are too many unknown details. If someone could elaborate a little further, I would appreciate it! 😉

  3. Tomek says:

    Looks great, but i would like to ask about bur, protocol and long term results. Expetienced implantologists – write some details please.

  4. rob rother says:

    I’ve tried and had success with a few approaches over the years.
    1) polishing off micro and macrothreads. This needs a fine flame-shaped tungsten carbide bur with loads of coolant. The narrow diameter instrument is essential to get onto the mesial and distal surfaces. I’d say that you go no deeper than the depths of the threads of the implant. This implant will be weaker than it used to be of course.
    2) the similar shaped Baker-Curson bur in the high speed allows fine polishing..
    3) consider Ti brushes in initial management and for cleaning right up to where the bone laps onto the implant surface. These brushes will clean the implant surface, remove the granulation tissue and debride the bone surface. Also usefiul in this situation when attempting bone repairs following peri-implantitis.
    4) expect to find fine fibres of titanium on follow-up radiographs….

  5. Jawdoc says:

    Looks pretty pointless to me. Bone didn’t regrow. & this case had the benefit of thick soft tissue which covered the originally failing implants just as well anyway. Perhaps the point was to prevent further bone loss. In which case, where r the long term post op X-rays / scans?

  6. Luis Leon says:

    Crear superficie lisa en el implante es importante, no obstante sugiero para el futuro de esta zona ( profilacticamente) colocar injerto de halo plástico y cubrir con membrana de colageno para reducir la posibilidad de que regrese la peri – implantitis y control total de la higiene del paciente.
    Congratulation !!

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