However, if previous records are available, then the diagnosis can be made with any increase in pocket depth with post remodelling bone loss of greater than 0.5 mm in the presence of bleeding and/or suppuration on gentle probing, A number of studies suggested this inflammatory disease is associated with anaerobic plaque bacteria. It has also been suggested peri-implantitis can also be related to inadequate distribution of the chewing pressure on the tissues surrounding the implant, leading to the loosening of the artificial supports. While plaque is the main risk factor, patients who have history of periodontal disease prior to implant treatment, and those with other risk factors such as poor oral hygiene, smoking or uncontrolled diabetes, also experienced higher rates of peri-implant disease. Additionally, there are also suggestions that peri-implantitis is the result of foreign body reaction.

Common treatment options for peri-implantitis include mechanical debridement (with or without antiseptic application) administration of local and systemic antibiotics or surgical techniques. It is well accepted that altering the affected implant surface is necessary to minimise the establishment of biofilm. Implantoplasty involves mechanically modifying the implanted threads (and the rough surface) that have become exposed in the patient’s mouth, due to bone resorption, by removing the outer surface of the metal with rotary instruments, in situ. The purpose is to reduce the roughness of the surface, and it is a commonly used technique to reduce plaque retention and prevent re-infection of the site.

To the best of our knowledge, the release of particles from implants following implantoplasty procedure and their effect on cells has not been investigated. The purpose of this in vitro study was to assess the size, composition, ionic product release and biological impact of particles released from commonly used commercially pure grade 4 titanium and grade 5 titanium alloy implants following an implantoplasty procedure with diamond burr. This aims to raise the awareness of potential detrimental side effects of implantoplasty and the need for careful consideration of dental implant material.