What the investigators applied after the NiTi Brush protocols reported in the peer-reviewed literature
Clinicians often ask what should follow mechanical decontamination with the NiTi Brush. This page does not answer with a recommendation. It lists, study by study, what the authors of published clinical reports did after brushing — the agent, its concentration, how long it was applied and what they reported afterwards — so that you can weigh the evidence and read the original papers.
A literature summary, not a treatment recommendation
This page is prepared by HANS Korea from the Methods and Results of the papers cited. It is not part of the Instructions for Use. The choice of any chemical or pharmacological adjunct, its concentration and its duration is a clinical decision for the treating dentist, made in accordance with local regulations and the product information of the agent concerned. Where this page and the Instructions for Use differ, the Instructions for Use prevail.
Concentrations, application times and outcome figures are transcribed from the papers — verify them against the original publication, linked with each entry, before clinical use. HANS Korea holds no copyright in the papers, has no relationship with their authors or journals, and has paraphrased them in its own words.
Revision 0 · 7 September 2026. Fourteen clinical reports; the list is a floor, not a census, and is revised when a further paper naming the instrument is verified.
At a glance fourteen clinical reports, four approaches
| Approach | After brushing | Reports | Note |
|---|---|---|---|
| A | Saline irrigation only — no chemical agent on the surface | 6 · three RCT-based (Gothenburg / Bilbao), two cohorts (Frankfurt), one case report | All combined with a systemic antibiotic and/or a post-operative chlorhexidine mouthwash |
| B | Hydrogen peroxide 3 % for 2 min, then saline | 3 · Monje et al. (Barcelona) | Also the control arm of the two electrolytic trials in D |
| C | Chlorhexidine as the adjunct (0.12 % irrigation or 2-min rinse; 0.2 %) | 3 | Once after H2O2, once after glycine air-polishing, once QLF-guided |
| D | Electrolytic decontamination for 2 min, then saline | 2 · multicentre RCT vs H2O2; case series adding rhPDGF-BB | Disease resolution 87.5 % vs 64.5 % with H2O2 (p = 0.08) |
Common to every report: a full-thickness access flap, complete removal of granulation tissue, mechanical decontamination with the NiTi Brush (600 rpm for 2–3 minutes in the Barcelona studies; ≤ 1,200 rpm under continuous saline in the Gothenburg/Bilbao and Frankfurt studies) and saline irrigation before grafting or closure. Where reported, the model was NANO (Gothenburg/Bilbao), ICT Micro and ICT Nano (Marseille) or OMEGA (Makkah).
A · Saline only no chemical agent on the surface
| Study | Design | After brushing | Systemic / post-operative | Reported outcome |
|---|---|---|---|---|
| Derks J, Ortiz-Vigón A, Guerrero A, et al. Clin Oral Implants Res 2022. 10.1111/clr.13972 | Multicentre RCT · 138 patients / 147 implants · 12 months | None. NANO NiTi Brush at ≤ 1,200 rpm under continuous saline. | Amoxicillin 750 mg twice daily for 10 days from 3 days pre-op | PPD −3.7 mm and bone gain ≈1.0 mm in both arms; BOP −45–50 %; bone substitute added no clinical benefit |
| Alibegovic L, Trullenque-Eriksson A, et al., Derks J. Clin Oral Implants Res 2025. 10.1111/clr.14393 | Same trial, 3-year follow-up · 120 patients / 127 implants | None. | As above | PPD −3.2–3.5 mm, bone gain 1.1–1.3 mm; disease resolution 39 %; 11 % of implants lost |
| Regidor E, Ortiz-Vigón A, Romandini M, Dionigi C, Derks J, Sanz M. J Clin Periodontol 2023. 10.1111/jcpe.13796 | RCT · 43 patients · 12 months | None on the surface. NANO NiTi Brush ≤ 1,200 rpm under saline. (Pre-surgical air-polishing with erythritol + 0.3 % chlorhexidine.) | Amoxicillin 750 mg × 2/day, 10 days; post-op 0.12 % CHX + 0.05 % CPC rinse | No implant lost; success 36.8 % (membrane) vs 45.0 %; membrane added time, pain and complications |
| Schwarz F, et al. J Clin Periodontol 2021. 10.1111/jcpe.13335 | Prospective pilot · 20 patients · 6 months | None on the surface. Titanium brush (HANS Korea); implantoplasty under sterile saline. | Single pre-op amoxicillin 2 g; 0.12 % CHX mouthwash 5 days | Soft-tissue contraction 7.9 % (1 month) and 18.5 % (6 months), linked to narrow keratinised mucosa |
| Schwarz F, et al. Clin Oral Implants Res 2023. 10.1111/clr.14057 | Retrospective · 36 patients / 40 implants · 12 months | None on the surface. Titanium brush (HANS Korea); implantoplasty under sterile saline. | 0.12 % CHX mouthwash 5 days | Median BOP −58–67 %, PD −0.8–2.0 mm; 100 % survival |
| Babgi W, Felemban B. J Umm Al-Qura Univ Med Sci 2024. 10.54940/ms75920247 | Case report · 2 patients | None on the surface. NiTi Brush OMEGA; saline irrigation. | Amoxicillin 500 mg for 1 week; CHX mouthrinse 1 week | Peri-implant health re-established in both early-complication cases |
B · Hydrogen peroxide 3 % for 2 minutes, then saline
| Study | Design | After brushing | Systemic / post-operative | Reported outcome |
|---|---|---|---|---|
| Monje A, Pons R, Vilarrasa J, Nart J, Wang H-L. J Periodontol 2023. 10.1002/JPER.22-0511 | RCT · 33 patients / 48 implants · 12 months | Hydrogen peroxide 3 % for 2 min, then saline. NiTi brushes 2–3 min at 600 rpm beforehand. | Not the subject of the report | Disease resolution 77.1 %; membrane did not raise the odds of resolution; plaque index and keratinised mucosa did |
| Monje A, Pons R, Sculean A, Nart J, Wang H-L. Clin Implant Dent Relat Res 2023. 10.1111/cid.13244 | Secondary analysis of the RCT above | Hydrogen peroxide 3 % for 2 min, then saline. | As above | Mean bone gain 1.85 mm; defect angle < 57° predicted ≥ 1 mm gain, < 30° predicted ≥ 2 mm |
| Monje A, Pons R, Peña P. Int J Periodontics Restorative Dent 2025. 10.11607/prd.7151 | Single-centre arm of a multicentre RCT · 19 patients / 23 implants · 12 months | Control: hydrogen peroxide 3 %. Test: electrolytic method (D). Both then saline. | Not the subject of the report | No significant difference between adjuncts; resolution about 16 % higher with the electrolytic method (about 91 %), not significant |
C · Chlorhexidine as the adjunct
| Study | Design | After brushing | Systemic / post-operative | Reported outcome |
|---|---|---|---|---|
| Monje A, Pons R, Amerio E, Wang H-L, Nart J. J Periodontol 2022. 10.1002/JPER.21-0103 | Retrospective · 43 patients / 135 implants · about 24 months | Hydrogen peroxide 3 % for 2 min, then irrigation with chlorhexidine 0.12 %. (Non-surgical phase: sub-mucosal 0.12 % CHX irrigation.) | Not the subject of the report | Survival 97.8 %; success 66 % (strict) / 79.5 % (flexible); apically positioned flap groups resolved disease most efficiently |
| Brincat A, Antezack A, Sadowski C, Faure-Brac M, Ohanessian R, Monnet-Corti V. Applied Sciences 2023 (open access). 10.3390/app13127224 | Case series · 57 patients / 91 implants · 12–42 months | Chlorhexidine 0.12 % rinses for 2 min, then profuse sterile saline (after NiTi ICT Micro/Nano brushes and glycine air-polishing). | Amoxicillin 2 g/day 7 days; prednisolone 3 days; CHX 0.2 % 7 days then 0.12 % 7 days, 0.2 % gel 10 days | Absence of progressive bone loss at 96.7 % of implants; 3 implants removed |
| Yun J-H, et al. J Korean Dent Assoc 2025;63(6):181–189 (Korean, CC BY-NC-ND). 10.22974/jkda.2025.63.6.001 | Case report · 2 cases · QLF-guided | Chlorhexidine 0.2 % after decontamination (NiTi brush, ultrasonic tips, air-powder abrasion; QLF used to find residual biofilm). | Not reported | QLF revealed biofilm invisible to the eye and guided additional cleaning; inflammation controlled |
D · Electrolytic decontamination head-to-head with hydrogen peroxide, and with a biologic
| Study | Design | After brushing | Systemic / post-operative | Reported outcome |
|---|---|---|---|---|
| Monje A, Navarro-Mesa S, Soldini C, Zappalá G, Peña P, Navarro JM, Pons R. Clin Implant Dent Relat Res 2025 (open access). 10.1111/cid.70075 | Multicentre RCT · 58 patients · 12 months | Test: electrolytic method for 2 min, then saline. Control: hydrogen peroxide 3 % for 2 min, then saline. NiTi brushes 600 rpm, 2–3 min in both arms. | Not the subject of the report | All indices and bone level improved in both arms; disease resolution 87.5 % (electrolytic) vs 64.5 % (H2O2), p = 0.08; no major complications |
| Monje A, Pons R, Barootchi S, Saleh MHA, Rosen PS, Sculean A. Int J Oral Implantol 2025;18(1):47–57. PubMed 40047362 | Prospective case series · 10 patients / 13 advanced defects · 12 months | Electrolytic method for 2 min, then saline, then rhPDGF-BB applied to the surface before grafting. NiTi brushes 2–3 min at 600 rpm beforehand. | Not the subject of the report | Survival 100 %; mean pocket depth −4.5 mm; defects narrower and shallower; resolution 61.5 % |
Background reading reviews and laboratory work
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Minimal invasiveness in the reconstructive treatment of peri-implantitis defects
Describes a flapless technique that combines chemical decontamination with hydrogen peroxide and mechanical decontamination with a titanium brush, and tabulates the agents used across the clinical literature (hydrogen peroxide 3 %, chlorhexidine 0.2 %, tetracycline, enamel matrix derivative, electrolytic cleaning).
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The effect of NiTi brush, polishing brush and chemical agent on the dental implant surface morphology and cytocompatibility
Titanium discs treated with NiTi brushes, diamond polishing brushes or a phenol/sulfuric-acid gel. The gel did not alter surface morphology whereas both brushes did; cell viability after 7 days was highest on NiTi-brushed discs stored in saline; operative time was shorter for NiTi than for the polishing brush.
How this summary was prepared
- Inclusion. A paper is listed only when its Methods identify the mechanical instrument as the NiTi Brush of HANS Korea and describe what was applied to the surface afterwards. Studies using other titanium brushes are not included, even where the protocol is similar.
- Wording. Every line is written by HANS Korea from the paper’s Methods and Results. Nothing is quoted or reproduced; figures and tables of the papers are not copied.
- Verification. Concentrations, times and outcome figures are transcribed as the authors reported them and must be checked against the original before clinical use.
- Scope. Non-surgical protocols, grafting materials, membranes and maintenance schedules are outside the scope except where they bear directly on the surface adjunct.