Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT

Hentenaar, D. F. M., De Waal, Y. C. M., Strooker, H., Meijer, H. J. A., Van Winkelhoff, A-J. & Raghoebar, G. M., 17-Jul-2017, In : International journal of implant dentistry. 3, 9 p., 33.

Research output: Contribution to journalArticleAcademicpeer-review

BACKGROUND: Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled trial is to evaluate the microbiological and clinical effectiveness of phosphoric acid as a decontaminating agent of the implant surface during surgical peri-implantitis treatment.

METHODS: Peri-implantitis lesions were treated with resective surgical treatment aimed at peri-implant granulation tissue removal, bone recontouring, and pocket elimination. Fifty-three implant surfaces in 28 patients were mechanically cleaned and treated with either 35% phosphoric etching gel (test group) or sterile saline (control group). Microbiological samples were obtained during surgery; clinical parameters were recorded at baseline and at 3 months after treatment. Data were analyzed using multi-variable linear regression analysis and multilevel statistics.

RESULTS: Significant immediate reductions in total anaerobic bacterial counts on the implant surface were found in both groups. Immediate reduction was greater when phosphoric acid was used. The difference in log-transformed mean anaerobic counts between both procedures was not statistical significant (p = 0.108), but there were significantly less culture-positive implants after the decontamination procedure in the phosphoric acid group (p = 0.042). At 3 months post-surgery, 75% of the implants in the control group and 63.3% of the implants in the test group showed disease resolution. However, no significant differences in clinical and microbiological outcomes between both groups were found.

CONCLUSIONS: The application of 35% phosphoric acid after mechanical debridement is superior to mechanical debridement combined with sterile saline rinsing for decontamination of the implant surface during surgical peri-implantitis treatment. However, phosphoric acid as implant surface decontaminant does not seem to enhance clinical outcomes on a 3-month follow-up.

TRIAL REGISTRATION: Netherlands National Trial Register, NTR5185 (

Original languageEnglish
Article number33
Number of pages9
JournalInternational journal of implant dentistry
Publication statusPublished - 17-Jul-2017


  • Journal Article

Download statistics

No data available

ID: 46676660