OBJECTIVE: To evaluate the impact of implant surface and instrumentation time on the efficacy of two air powder water-jet (APWJ) devices in cleaning the implant surface in a simulation of non-surgical peri-implantitis treatment.

MATERIALS AND METHODS: Turned and modified surface implants (28 each) were coated with a biofilm imitation and mounted on resin models replicating peri-implant intra-osseous defects, including a soft tissue replica. The entire implant periphery was instrumented for 5 or 15s per implant sextant (i.e., in total 30 or 90s per implant), with one of two different APWJ devices using either a glycine or an erythritol powder. Residual biofilm imitation was automatically assessed on standardized photographs and expressed as percentage of the exposed implant surface.

RESULTS: Implant surface (ε2:0.253, p < 0.001) and instrumentation time (ε2:0.044, p = 0.036) had a moderate and small effect, respectively, on the outcome, that is, instrumenting turned compared to modified surface implants as well as using a longer compared to a shorter instrumentation time resulted in less residual biofilm imitation. Complete biofilm imitation removal was achieved only in four turned implants, treated for 15s per sextant. Every second turned implant presented with a maximum of 5% residual biofilm imitation, while only two modified implants achieved this level of cleanliness.

CONCLUSION: In a non-surgical peri-implantitis treatment simulation with APWJ devices, superior biofilm imitation removal was achieved at turned implants, and a longer instrumentation time resulted in less residual biofilm imitation. Modified implants had high chances of incomplete biofilm imitation removal, especially at the apical part of the defect. Complete biofilm imitation removal was in general largely unpredictable.