Global standard of peri-implantitis treatment protocol
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Frequently asked questions

About the instrument

What is the NiTi Brush?

The NiTi Brush is a single-use rotary dental instrument used to mechanically clean the surface of a dental implant affected by peri-implantitis. Its bristles are made of nickel-titanium (Ni-Ti), a shape-memory alloy. The brush is driven by an implant motor through a 20:1 reduction handpiece and rotated against the exposed implant threads to remove plaque, calculus and other contaminated material, returning the surface to a machined finish. It has been manufactured by HANS Korea Co., Ltd. since 2010.

What is peri-implantitis?

Peri-implantitis is an inflammatory condition affecting the soft and hard tissues around a dental implant, causing progressive loss of the supporting bone. Because bacterial biofilm adheres to the roughened implant surface, surgical treatment usually requires decontaminating that surface before any regenerative procedure can succeed. Mechanical debridement with an instrument such as the NiTi Brush is one of the established approaches to that decontamination step.

Why nickel-titanium rather than titanium or stainless steel bristles?

Ni-Ti has a modulus of elasticity of roughly 28 GPa, against 115 GPa for titanium and 210 GPa for stainless steel — meaning it is about four times more flexible than titanium — while its Vickers hardness (303–362) is comparable to titanium (200–340). The bristle therefore bends into the thread profile instead of cutting across it, removing the contaminated layer with less damage to the implant. Stainless steel, at 600–610 Vickers and far less flexible, is not a suitable material for this purpose. The comparison is charted on the Raw material page.

Does the brush damage or alter the implant?

The intent of the instrument is to remove everything except the original shape of the implant. Under scanning electron microscopy at ×10,000, the treated surface changes from a contaminated, irregular topography to a machined finish while the thread geometry is preserved. Clinically, the operator can see the change with the naked eye: the shade of the implant surface becomes bright and shiny during brushing.

Choosing and using the brush

Which NiTi Brush model should I use?

There are four models, selected by how much access the defect allows:

  • POCKET — standard. Open bristle head with effective access into the pocket. The regular brush for the normal presentation of peri-implantitis, with more than two threads exposed.
  • POCKET SHORT — short pocket. The same bristle head and the same debridement performance as POCKET, on a shortened shaft. For molars, narrow posterior sites, or a patient who cannot open wide enough for the full-length instrument.
  • NANO — precise operation. The finest tip in the range: a tightly bound bristle point for very targeted work where almost no space is available. Initial-stage peri-implantitis, one to two threads exposed.
  • OMEGA — deep pocket. A wide, splayed bristle head that folds around the thread, for the best access to every area even where space is limited. Deep pocket involvement.

The four models share the same shank, so any of them mounts in the same handpiece. See the product line-up for the selection table.

What handpiece and speed should be used?

The NiTi Brush must be driven by an implant motor through a 20:1 reduction handpiece, at 600–1,200 rpm, together with extensive external sterile saline irrigation.

It is not intended for a high-speed turbine, a straight handpiece, or any handpiece that cannot hold this speed range. Refer to the Instructions for Use for the complete procedure.

Brushing time for one implant?

Per implant, as a guide: about 30–40 seconds on premium-brand implants and 1–3 minutes on other brands, until the rough surface has become a machined, smooth surface. The endpoint is visual rather than timed: stop when the implant surface is bright and shiny.

Is the NiTi Brush supplied sterile?

No. The NiTi Brush is supplied non-sterile. It must be sterilised before every use — in a sterile pouch, by autoclave at 134 °C for 15 minutes.

Can the NiTi Brush be reused?

No. The NiTi Brush is a single-use device: one brush per patient, per procedure. It must not be reprocessed or reused.

What is the treatment sequence?

  1. Diagnose the peri-implantitis and measure the depth of the pocket.
  2. Select the brush for the case — NANO for one to two threads, POCKET for more than two, POCKET SHORT for molars.
  3. Sterilise the brush before use (sterile pouch, autoclave, 134 °C / 15 minutes).
  4. Rotate with an implant motor at 600–1,200 rpm under extensive external saline, treating the implant surface and the surrounding tissue at the same time, until the surface is machined and smooth.
  5. Chemical treatment after brushing — for example tetracycline 250 mg in 2.5 cc warm saline applied by syringe, left for three minutes, then rinsed away. Minocycline and other agents are an alternative. The choice of agent and the protocol are a clinical decision: please refer to the published literature rather than treating this example as a recommendation.
  6. Guided bone regeneration, following the reconstructive protocol.

The full sequence, with clinical images at each step, is on the Treatment protocol page. It is an example of practice by experienced clinicians and does not replace the Instructions for Use.

Documentation, evidence and supply

In which languages are the Instructions for Use available?

The Instructions for Use are published in 19 languages: Czech, Danish, Dutch, English, Estonian, Finnish, French, German, Croatian, Hungarian, Italian, Latvian, Lithuanian, Polish, Romanian, Slovak, Slovenian, Spanish and Swedish. All are available as PDF downloads from the Instructions for Use page.

Is there published literature on this treatment approach?

Yes. Sixteen verified peer-reviewed publications in which the NiTi Brush was used as the mechanical decontamination step are listed on the Literature page — including multicentre randomised controlled trials published in Clinical Oral Implants Research, the Journal of Clinical Periodontology, the Journal of Periodontology and Periodontology 2000. Each entry carries the journal, DOI, authors and a link to the original, and the whole list can be downloaded as a single PDF. Sixteen is a floor, not a census: a paper is counted only when the instrument in it is identifiable as the NiTi Brush from HANS Korea, and further papers are added as they are verified.

HANS Korea is not the publisher of these works, holds no copyright in them and has no commercial relationship with the journals.

Which documents can I download?

  • Instructions for Use — 19 languages, on the IFU page.
  • General brochure and leaflet — on the Catalogue page.
  • Clinical evidence overview — all 14 references in one PDF, from the Literature page.
  • Catalogue — please note this is Revision 003, issued in 2018. It is kept for reference and no longer reflects the current product range; the POCKET SHORT model, for example, is not in it. A revised edition is in preparation.

Where can I buy the NiTi Brush?

Through an authorised distributor. The NiTi Brush is currently supplied in 18 countries across Europe, the Middle East, Asia and North America — the Contact page shows them on a map.

We do not publish distributor names or their contact details. Tell us your country using the enquiry form, or email [email protected], and we will put you in touch with the distributor that serves you. For markets not yet covered, and for distribution enquiries, please use the same address.

What is the regulatory status of the device?

The NiTi Brush for Peri-implantitis is a Class IIa medical device carrying the CE mark under Council Directive 93/42/EEC, with validity extended under the transitional provisions of Regulation (EU) 2023/607. In the United States it is covered by FDA establishment registration and device listing and is exempt from premarket notification — registration and listing do not constitute FDA approval or clearance. Full details are on the company page. Regulatory status and availability differ between countries; please confirm the position in your market before ordering.

May I use images or text from this website?

The text, clinical photographs, radiographs, SEM images, illustrations and documents on this site are the copyright of HANS KOREA CO.,Ltd. You are welcome to view and print pages for your own reference, to use the Instructions for Use in your practice, and to link to any page here without asking.

Reproducing, republishing or redistributing our material — including in lectures, catalogues, tender documents or on another website — requires our written permission. We normally grant reasonable requests from clinicians, researchers and authorised distributors. Write to [email protected], and see the legal notice for the full terms.

Who manufactures the NiTi Brush?

HANS KOREA CO.,Ltd., 314Ho, 107 Garam-ro 116beon-gil, Paju-si, Gyeonggi-do 10896, Republic of Korea. Telephone +82-31-977-2809, email [email protected]. The company was established in 2010 and has developed the NiTi Brush as its single focus since then. The instrument is protected by three granted Korean patents, first filed in November 2011.

See the model line-up Treatment protocol Instructions for Use Literature Contact