title: Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Non-surgical Methods.
abstract: OBJECTIVE
  The aim of this review is to summarize the findings of studies that have evaluated non-surgical approaches for detoxification of implant body surfaces in vitro and in vivo, and to evaluate clinical trials on the use of these methodologies for treating peri-implant disease.
  
  
  METHODS
  A literature search was conducted using MEDLINE (Pubmed) from 1966 to 2013. In vitro and in vivo studies as well as clinical trials on non-surgical therapy were evaluated. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters including probing depth, clinical attachment levels, bleeding on probing; radiographic bone fill and histological re-osseointegration.
  
  
  RESULTS
  From 134 articles found 35 were analyzed. The findings, advantages and disadvantages of using lasers as well as mechanical and chemical methods are discussed. Most of the in vivo and human studies used combination therapies which makes determining the efficacy of one specific method difficult. Most human studies are case series with short term longitudinal analysis without survival or failure reports.
  
  
  CONCLUSIONS
  Complete elimination of the biofilms is difficult to achieve using these approaches. All therapies induce changes of the chemical and physical properties of the implant surface. Re-osseointegration may be difficult to achieve if not impossible without surgical access to ensure thorough debridement of the defect and detoxification of the implant surface. Combination protocols for non-surgical treatment of peri-implantitis in humans have shown some positive clinical results but long-term evaluation to evaluate the validity and reliability of the techniques is needed.
authors.affiliation: Department of Periodontics, Texas A & M University, Baylor College of Dentistry, Dallas, Texas 3302 Gaston Avenue, Dallas Texas 75246.
authors.forename: Pilar
authors.initials: P
authors.lastname: Valderrama
authors.affiliation: Department of Periodontics, Texas A & M University, Baylor College of Dentistry, Dallas, Texas 3302 Gaston Avenue, Dallas Texas 75246.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Blansett
authors.affiliation: Universidad de Panama, Facultad De, Odontologia Estafeta Universitaria Apartado 3366, Panama City, Panama, 3366.
authors.forename: Mayra G
authors.initials: MG
authors.lastname: Gonzalez
authors.affiliation: Universidad Autonoma de Nuevo Leon, Dr. Eduardo Aguirre Pequeno Street, Mitras Centro Monterrey, Mexico 64460.
authors.forename: Myrna G
authors.initials: MG
authors.lastname: Cantu
authors.affiliation: Private Practice of Periodontics, 5465 Blair Rd, Ste 200, Dallas Texas 75231.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Wilson
keywords: Detoxification; lasers; local drug delivery; non-surgical periodontal therapy; peri-implantitis.