Page 10 - Academy of Osseointegration (AO) Academy News Vol 36, No 1 2025

Peri-implantitis: The electrolytic alternative... (continued from page 9
In the first one13, four decontamination methods were compared in vitro for biofilm removal and surface alterations. Except for titanium brushes, all methods, including electrolytic decontamination (Galvosurge) and erythritol-based air abrasion (Perioflow), were similarly effective in reducing colony-forming units from implants. In the second one14, another in vitro comparative study, electrolytic decontamination significantly reduced colony- forming units when compared to all other methods (chitosan brushes and/or 0.2% chlorhexidine). In both studies, implant surface was not altered by the electrolytic process. In the third study, a randomized controlled trial, electrolytic decontamination combined with mechanical instrumentation proved to be a safe and effective treatment modality. When applied, the electrolytic method resulted in a 16% higher rate of disease resolution; however, the differences did not reach statistical significance15.
Fig. 1: Electrolytic decontamination starts when the connector is placed in contact with the implant and maintained in place with finger pressure. The process stops after two minutes.
Overall, electrolytic decontamination is reported to be equal to or superior to currently available techniques. Given that the technique is very simple to use and takes only two minutes, it should be seriously considered when planning peri-implant reconstructive surgery.
AN:
Is electrolytic decontamination truly a simple procedure?
PK: Once the prosthesis is removed, a flap raised and access to the implant obtained, performing
electrolytic decontamination involves placing a small connector in contact with the implant and maintaining
it in place with finger pressure for two minutes (Fig. 1). The solution is automatically dispensed, and the process automatically stops if contact with the implant is lost, resuming when contact is reestablished. The unit halts the procedure when the decontamination process is over.
But the main advantage of this technique is that it makes decontaminating difficult-to-reach areas much easier. No special skill is required, and there is no need to remove bone for access or to use very thin instruments. Electrolysis takes place, detaching the biofilm on all exposed implant surfaces. This is a game changer.
AN: Is implant surface decontamination the key element for treatment success in reconstructive
surgery?
PK: Reconstructive surgery involves different strategies. The implant can either be left non-
submerged with the prosthesis immediately reconnected, or an attempt can be made to submerge the implant
for several weeks with the prosthesis, or at least the intermediate abutment, remaining disconnected. In the latter approach, it is theoretically possible for the entire implant surface to reosseointegrate. However, histological analysis, both in animal and clinical studies, shows that
full reosseointegration is almost never achieved. Only a varying percentage of the previously exposed implant
Fig. 2a
Fig. 2b
Figs. 2a-d: Pre-operative situation showing a severe defect with only one or two threads still osseointegrated. Enhancing the anchorage of this implant through partial re-osseointegration is necessary.
Fig. 2c
Fig. 2d
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