{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:26:45Z","timestamp":1787851605855,"version":"build-2784847793"},"reference-count":27,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: Treatment of peri-implantitis remains challenging because biofilm removal from microstructured implant surfaces is often incomplete. The present study is an uncontrolled, prospective feasibility case series involving six patients (six implants), not a controlled clinical trial, in which short-term clinical outcomes following use of a multimodal protocol to decontaminate the titanium implant surface were obtained; consequently, the independent contribution of the Ximplant\u00ae device to the observed outcomes cannot be determined. The protocol comprised surgical access, mechanical debridement, chemical conditioning, systemic administration of medication, and cleaning with an alternating-current device (Ximplant\u00ae; LED, S.p.A., Aprilia, Italy). Methods: Six adults with peri-implantitis, each contributing one implant, were consecutively treated using the multimodal protocol. Probing depth (PD), bleeding on probing (BOP), plaque index (PI), and suppuration (SU) were determined at baseline, 3 weeks, 6 months, and 12 months. Longitudinal changes were analyzed using repeated-measures analysis of variance and non-parametric tests for categorical variables. Results: Mean total PD decreased from 4.56 \u00b1 0.45 mm at baseline to 3.03 \u00b1 0.44 mm at the 3-week follow-up and remained stable at the 6-month follow-up (3.08 \u00b1 0.35 mm) and at 12-month follow-up (3.19 \u00b1 0.41 mm; p &lt; 0.0001). BOP and SU were absent in all implants at each follow-up visit. PI improved markedly, although the buccal aspect of one implant was PI-positive at the 3-week and the 12-month follow-up. Conclusions: The multimodal protocol used in this study was associated with rapid and sustained clinical improvement over the 12-month follow-up period. A study limitation is that because the individual parts of the protocol were applied concurrently, the independent contribution of any of them to the outcomes determined could not be isolated.<\/jats:p>","DOI":"10.3390\/bioengineering13090996","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:47:13Z","timestamp":1787849233000},"page":"996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preliminary Clinical Outcomes of an Alternating-Current-Assisted Implant Surface Decontamination Protocol: A Prospective Case Series with 12-Month Follow-Up"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3457-9954","authenticated-orcid":false,"given":"Dorian","family":"Kostandini","sequence":"first","affiliation":[{"name":"Faculty of Dental Medicine, Department of Dentistry, Western Balkans University, 1001 Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-8116","authenticated-orcid":false,"given":"Antonella","family":"Mattei","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5166-9861","authenticated-orcid":false,"given":"Giovanni","family":"Falisi","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9571-3765","authenticated-orcid":false,"given":"Arianna","family":"Viarchi","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Gerardi","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Bruni","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5079-6815","authenticated-orcid":false,"given":"Edra","family":"Qorri","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medical Sciences, Albanian University, 1001 Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8284-0745","authenticated-orcid":false,"given":"Lia A.","family":"Hoz-Rodriguez","sequence":"additional","affiliation":[{"name":"Periodontal Biology and Mineralized Tissue Laboratory, Postgraduate Studies and Research Division, School of Dentistry, National Autonomous University of M\u00e9xico, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Basa\u00f1es","family":"Rivera","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Division of Graduate Studies, Autonomous University of Queretaro, Santiago de Quer\u00e9taro 76010, Quer\u00e9taro, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Rastelli","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Gatto","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3518-130X","authenticated-orcid":false,"given":"Marco","family":"Severino","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Medicine, Odontostomatological University of Perugia, S. Andrea delle Fratte, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Botticelli","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","first-page":"e55360","article-title":"Evaluation of Survival Rates of Dental Implants and the Risk Factors: A Retrospective Follow-Up Study","volume":"16","author":"Jain","year":"2024","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/j.1600-051X.2008.01274.x","article-title":"Definition and prevalence of peri-implant diseases","volume":"35","author":"Zitzmann","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S158","DOI":"10.1111\/jcpe.12334","article-title":"Peri-implant health and disease: A systematic review of current epidemiology","volume":"42","author":"Derks","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/eos.12529","article-title":"Peri-implant diseases","volume":"126","author":"Klinge","year":"2018","journal-title":"Eur. J. Oral Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S286","DOI":"10.1111\/jcpe.12957","article-title":"Peri-implant diseases and conditions: Consensus report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"45","author":"Berglundh","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S278","DOI":"10.1111\/jcpe.12956","article-title":"Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations","volume":"45","author":"Renvert","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/j.1600-051X.2008.01276.x","article-title":"Non-surgical treatment of peri-implant mucositis and peri-implantitis: A literature review","volume":"35","author":"Renvert","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/j.1600-0501.2011.02220.x","article-title":"Reversibility of experimental peri-implant mucositis compared with experimental gingivitis in humans","volume":"23","author":"Salvi","year":"2012","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/j.1600-051X.2011.01819.x","article-title":"Peri-implant disease in subjects with and without preventive maintenance: A 5-year follow-up","volume":"39","author":"Costa","year":"2012","journal-title":"J. Clin. Periodontol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4549","DOI":"10.1007\/s00784-022-04421-0","article-title":"Comparison of decontamination efficacy of two electrolyte cleaning methods with diode laser, plasma, and air-abrasive devices","volume":"26","author":"Zipprich","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_11","first-page":"114","article-title":"Use of electrical field for biofilm implant removal","volume":"27","author":"Bernardi","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Rodrigues, F., Pereira, H.F., Pinto, J., Padr\u00e3o, J., Zille, A., Silva, F.S., Carvalho, \u00d3., and Madeira, S. (2024). Zirconia dental implant surface electric stimulation impact on Staphylococcus aureus. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25115719"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1111\/clr.14167","article-title":"Evaluation of the adjunctive use of Er:YAG laser or erythritol powder air-polishing in the treatment of peri-implant mucositis: A randomized clinical trial","volume":"34","author":"Clementini","year":"2023","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"36","DOI":"10.56936\/18290825-2026.20v.2-36","article-title":"AI-guided personalized drug-delivery nanoparticles for precision treatment of peri-implantitis: A multicenter evaluation","volume":"20","author":"Tuenkar","year":"2026","journal-title":"New Armen. Med. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"391","DOI":"10.3934\/microbiol.2024020","article-title":"Characterization and morphological methods for oral biofilm visualization: Where are we nowadays?","volume":"10","author":"Gerardi","year":"2024","journal-title":"AIMS Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/ID.0000000000000190","article-title":"Treatment of peri-implant mucositis: A systematic review of randomized controlled trials","volume":"24","year":"2015","journal-title":"Implant Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"487903","DOI":"10.1155\/2014\/487903","article-title":"Treatment alternatives to negotiate peri-implantitis","volume":"2014","author":"Machtei","year":"2014","journal-title":"Adv. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Chun Giok, K., and Menon, R.K. (2023). The microbiome of peri-implantitis: A systematic review of next-generation sequencing studies. Antibiotics, 12.","DOI":"10.3390\/antibiotics12111610"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"241","DOI":"10.2217\/fmb-2023-0127","article-title":"Antimicrobial therapy using VIS plus water-filtered infrared-A as an alternative method to treat oral diseases","volume":"19","author":"Bernardi","year":"2024","journal-title":"Future Microbiol."},{"key":"ref_20","first-page":"5","article-title":"Use of an electrical device on bacterial biofilm on dental implants: A preliminary in vitro study","volume":"21","author":"Botticelli","year":"2025","journal-title":"Bull. Stomatol. Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Botticelli, G., Falisi, G., Rastelli, S., Iacomino, E., Bruni, A., Gerardi, D., Di Fabio, G., Severino, M., and Bernardi, S. (2025). A morphological evaluation of the antibiofilm activity on an implant surface using a new electric device: An in vitro study. Dent. J., 13.","DOI":"10.3390\/dj13040140"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.11607\/jomi.3168","article-title":"The effect of subgingival ozone and\/or hydrogen peroxide on the development of peri-implant mucositis: A double-blind randomized controlled trial","volume":"28","author":"McKenna","year":"2013","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/jcpe.13264","article-title":"Adjunctive effect of systemic antimicrobials in periodontitis therapy: A systematic review and meta-analysis","volume":"47","author":"Teughels","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/idj.12490","article-title":"Diagnosis and non-surgical treatment of peri-implant diseases and maintenance care of patients with dental implants\u2014Consensus report of Working Group 3","volume":"69","author":"Renvert","year":"2019","journal-title":"Int. Dent. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/idh.12184","article-title":"Effect of a chlorhexidine-containing brush-on gel on peri-implant mucositis","volume":"15","author":"Lindgren","year":"2017","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1111\/clr.12689","article-title":"Two-year clinical outcomes following non-surgical mechanical therapy of peri-implantitis with adjunctive diode laser application","volume":"27","author":"Mettraux","year":"2016","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e65128","DOI":"10.2196\/65128","article-title":"Smartphone-Based Telemonitoring for Better Oral Health with Toothbrushes: 6-Month Randomized Controlled Trial","volume":"27","author":"Choi","year":"2025","journal-title":"J. Med. Internet Res."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/9\/996\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:00:42Z","timestamp":1787850042000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/9\/996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["bioengineering13090996"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering13090996","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]}}}