Peri-implantitis clinical cases — implant surface debridement with the NiTi Brush titanium brush, before and after, CBCT

Clinical case presented by Dr. Roccuzzo Italy

Clinical case by Dr. Mario Roccuzzo using NiTi Brush for peri-implantitis, view 1

Clinical case by Dr. Mario Roccuzzo using NiTi Brush for peri-implantitis, view 2

Implant surface under SEM, before and after

SEM image at ×10,000 of a contaminated implant surface before debridement — Before debridement (×10,000, SEM)

SEM image at ×10,000 of the implant surface after debridement with the NiTi Brush — After debridement and polishing with the NiTi Brush (×10,000, SEM)

Surface after debridement intra-operative

The exposed threads before treatment, and the same implant once the contaminated layer has been removed with the NiTi Brush — the surface returns to a bright, smooth^† finish.

Exposed implant threads with peri-implantitis, before debridement — Exposed threads, contaminated

The same implant after debridement with the NiTi Brush, threads clean and bright — Debrided with NiTi Brush

Three adjacent implants with contaminated, exposed threads before debridement — Three adjacent implants, threads exposed and contaminated

The same three implants after debridement with the NiTi Brush, threads bright and smooth — After debridement with NiTi Brush — bright, smooth^† threads

Posterior site with peri-implant defect before debridement — Posterior site, flap raised

The same posterior site after debridement with the NiTi Brush — After debridement with NiTi Brush

Clinical case presented by Prof. Baek-Soo Lee

Department of Oral and Maxillofacial Surgery, Kyung-Hee University, Seoul, Korea.

CBCT sagittal section before treatment, showing the peri-implant bone defect — **Before** — sagittal section

CBCT 3D reconstruction before treatment, the implant showing through the thin buccal plate — **Before** — 3D reconstruction

CBCT sagittal section after treatment, the implant encased in regenerated bone — **After** — sagittal section

CBCT 3D reconstruction after treatment, with the buccal contour restored — **After** — 3D reconstruction

Before and after, animated 45 seconds, no sound

The CBCT sections and 3D reconstructions above, compared side by side: bone loss around the implant before treatment, and new bone formation after debridement with the NiTi Brush and guided bone regeneration. Plays on this site directly; press play to start.

Treatment protocol More clinical videos

Clinical case 01

Checking the pocket with a probe — Check the pocket

Debridement of the implant surface using the NiTi Brush — Debridement the implant surface using NiTi Brush

GBR sequence

Presented by Dr. Frederick Li Vancouver, Canada

Clinical case 02

Peri-implantitis, clinical presentation — Peri-implantitis

Probing the pocket at the centre — Pocket in the center

Probing the pocket on the left — Pocket in the left

Probing the pocket on the right — Pocket in the right

Debridement using the NiTi Brush with irrigation — Debridement using NiTi brush & irrigation

Finishing using a membrane — Finishing using membrane

Clinical Movie Lab test Literature

#periimplantitis #niti brush #Titanium brush #Titanium brush for peri-implantitis #niti brush for peri-implantitis #R brush #I brush #Rotating titanium brush #peri brush

Note on “smooth”

† Smooth refers to moderately rough implant surfaces (e.g. SLA, RBM). In laboratory studies with the NiTi Brush, surface micro-roughness was reduced by removing protrusions (Kim et al. 2016) and the sharp-edged microstructure was smoothed, brushing continuing until the surface looked uniformly smooth and shiny, as in clinical use (Brunello et al. 2025). A clinical review describes polishing the exposed rough implant surface to a smooth surface with the NiTi Brush (Hiroyasu 2018). The shine seen chairside is the visible sign of this change (HANS Korea performance test).