{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:02:50Z","timestamp":1781877770297,"version":"3.54.5"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current peri\u2010implantitis treatment methods are modeled after dental cleaning modalities like abrasive surface cleaning. However, mechanical abrasive cleaning not only inadequately removes implant biofilms but also compromises implant surface integrity with adverse biological effects. The goal of this study was to evaluate a non\u2010abrasive waterjet implant cleaning method to remove biofilm while preserving titanium surface and maintaining its cytocompatibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Dental plaque\u2010derived multispecies biofilms were cultured on acid\u2010etched titanium disks. Biofilm was removed using either mechanical contact abrasive implant cleaning (titanium brush or curette) or a non\u2010contact waterjet irrigator in continuous or pulsed flow setting. Uncontaminated and untreated disks served as negative and positive controls, respectively. Bacterial viability post\u2010treatment was assessed by agar plating and live\u2010dead imaging. Titanium surface integrity was studied by scanning electron microscopy and optical profilometry. Host tissue compatibility was evaluated by human gingival fibroblast proliferation on titanium surface post\u2010cleaning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Non\u2010contact waterjet irrigation significantly reduced viable bacterial counts by \u226590.9% (\u223c100\u2010fold) on titanium surface versus abrasively cleaned and untreated biofilm groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Waterjet treatment maintained titanium surface integrity and roughness similar to pristine titanium. In contrast, abrasive cleaning damaged the microrough titanium surface and left viable bacterial residues. Fibroblast viability was restored (\u223c76.8%) on waterjet\u2010treated titanium to levels comparable to sterile control (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05), whereas titanium brush\u2010 or curette\u2010treated surfaces had significantly lower levels post\u2010cleaning (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010abrasive waterjet cleaning is a superior method for the clinical treatment of peri\u2010implantitis biofilms versus mechanical abrasive cleaning while maintaining titanium implant surface properties necessary for reintegration with peri\u2010implant tissue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Dental implant infections are usually cleaned by scrubbing the implant surface to remove attached bacteria. However, this mode of cleaning can scratch the implant surface and produce tiny pieces of wear or particles which can be toxic and cause the implant to fail. In this study, a new cleaning method using a fast\u2010flowing stream of water, called waterjet cleaning, was tested. The waterjet cleaning was able to remove most bacteria from the implant material, while cleaning by scrubbing left small spots of bacteria on the surface. Additionally, waterjet\u2010cleaned surfaces looked like the original implant material surface, while scrubbing\u2010cleaned surfaces had pieces missing from the surface, which affected human gum tissue cells attachment. Waterjet cleaning is a favorable method to clean dental implant infections without damaging the implant and allow for human tissue to recover and reconnect with the dental implant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.11371","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T04:54:01Z","timestamp":1765428841000},"page":"498-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Biofilm removal capacity and titanium surface integrity in non\u2010abrasive versus abrasive peri\u2010implantitis cleaning interventions"],"prefix":"10.1002","volume":"97","author":[{"given":"Marzieh S.","family":"Jazaeri","sequence":"first","affiliation":[{"name":"Department of Oral Biology Rutgers School of Dental Medicine  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danyal A.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Department of Oral Biology Rutgers School of Dental Medicine  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Wen C.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Periodontics UT Health School of Dentistry  San Antonio Texas USA"},{"name":"Department of Periodontology School of Dentistry Tri\u2010Service General Hospital and National Defense Medical Center  Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Gabel","sequence":"additional","affiliation":[{"name":"Department of Periodontics UT Health School of Dentistry  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Lorenzana","sequence":"additional","affiliation":[{"name":"Department of Periodontics UT Health School of Dentistry  San Antonio Texas USA"},{"name":"Dedman College of Humanities and Sciences Southern Methodist University  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios A.","family":"Kotsakis","sequence":"additional","affiliation":[{"name":"Department of Oral Biology Rutgers School of Dental Medicine  Newark New Jersey USA"},{"name":"Department of Periodontics UT Health School of Dentistry  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Research Nester.Peri\u2010implantitis treatment market size & share statistics report 2024\u20102036.2024. 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