Global standard of peri-implantitis treatment protocol
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Treatment protocol

NiTi Brush for peri-implantitis example of protocol

The sequence below is an example of how the NiTi Brush is used in surgical peri-implantitis therapy, as practised by experienced clinicians. It is published by HANS Korea for orientation and is not a substitute for the Instructions for Use. Treatment decisions remain with the treating clinician.

  1. Diagnosis

    Diagnose peri-implantitis and measure the depth of the pocket.

    Probing the peri-implant pocket, with the corresponding radiograph

  2. Select the brush for the case

    • NANO — for 1 to 2 thread(s) exposure
    • POCKET — for more than 2 threads exposure
    • POCKET SHORT — for molars
    The NiTi Brush models drawn at the same scale, each marked on the shank

    Technical illustrations. The appearance of the delivered product may differ.

  3. Sterilise before use

    • The NiTi Brush is supplied non-sterile — sterilise before every use
    • Use a sterile pouch and autoclave
    • 134 °C for 15 minutes
    Packing the NiTi Brush into a sterile pouch and autoclaving

  4. Rotate the NiTi Brush — polishing the surface

    Debridement & decontamination.

    • Use an implant motor
    • Rotating speed 600–1,200 rpm
    • Extensive external saline irrigation during brushing
    • Make the rough surface into a machined, smooth surface
    • Treat the implant surface and the surrounding tissue at the same time — no more curetting

    Brushing time

    • Premium-brand implants: 30–40 seconds
    • Other brands: 1–3 minutes or so
    NiTi Brush mounted in an implant-motor handpiece with saline irrigation Implant surface before and after brushing — clinical, macro and SEM views

    Before (left) and after (right) — clinical, macro and SEM

  5. Chemical treatment — after brushing

    • Open a tetracycline 250 mg capsule
    • Place the tetracycline 250 mg in 2.5 cc warm water (saline)
    • Using a syringe, sprinkle it onto the brushed surface and tissue
    • Wait 3 minutes, then wash the tetracycline away with saline
    • Another chemical treatment is an alternative choice (for example minocycline)

    The agent and the protocol are a clinical decision. Please refer to the published literature rather than treating this example as a recommendation.

    Applying the tetracycline solution to the debrided implant surface with a syringe

  6. GBR — after chemical treatment

    Guided bone regeneration follows the decontamination and chemical steps. Refer to the references and literature for the reconstructive protocol.

    Clinical evidence
    Complete case sequence — probing and radiograph at diagnosis, the exposed implant, debridement with the NiTi Brush, bone graft, suture, and probing and radiograph at follow-up

    One case from start to finish — diagnosis, debridement, graft and suture (top row), then the healed result at follow-up (bottom row)

    CBCT sagittal sections and 3D reconstructions of the same implant before and after treatment

    CBCT of the same implant — sagittal section (top) and 3D reconstruction (bottom)

Drive with an implant motor

The NiTi Brush must be driven by an implant motor through a 20:1 reduction handpiece at 600–1,200 rpm, with continuous external sterile saline irrigation. It is not intended for a high-speed turbine or any drive that cannot hold this speed range.

Non-sterile · single use

Supplied non-sterile — autoclave at 134 °C for 15 minutes before every use. Single use only, do not reuse. This page is an example protocol and does not replace the Instructions for Use; always read the IFU applicable to your market before treatment.

Instructions for Use — 19 languages Download the protocol (PDF) Model line-up