Mehanička i kemijska dekontaminacija površine implantata

Dental implants are biocompatible and alloplastic materials used in dentistry for the treatment of completely or partially edentulous patients. Their rough surfaces are suitable for the formulation of a biofilm. Maturation of the biofilm on the implant surface is clinically manifested by the appearance of either peri-implant mucositis or peri-implantitis. The progression of the inflammation also correlates with the anatomical structure of the periimplant tissue, which is different from the periodontal tissue of a tooth, but also has its similarities. To prevent further progression of the inflammation and the destruction of the periimplant tissue as well as to enable the re-osseointegration of the implant, it is necessary to decontaminate the implant surface, which can be done by using various chemical and mechanical agents. The infection control can be done by mechanical cleaning, for which we can use curettes, sonic and ultrasonic instruments, air-powder abrasive instruments, turbine machine instruments (diamond drills), and micro motor machine instruments (titanium brushes). Chemical action can be divided into antiadhesive, antimicrobial, antipathogenic and plaque remover. For decontamination of implant surfaces we can use 3 % hydrogen peroxide, chlorhexidine, antibiotics and acids such as citric acid and 35 % phosphoric acid. There are other agents used in periodontology for the treatment of periimplantitis, and these include many lasers that are available in the market. However, in this paper Er:YAG laser (erbium-doped yttrium aluminium garnet laser) and antimicrobial photodynamic therapy (aPDT) will be reviewed.