Background: The objective of this study is to evaluate micro and nano-hydroxyapatite (NHA) blended clot adhesion to citric acid–conditioned peri-implantitis–affected surfaces.

 Methods: Forty hopeless implants with peri-implantitis designated for removal were included in this study. Implants were divided into eight groups of five each: group 1 (G1) test areas were coated with hydroxyapatite of a microparticle size (MHA) group 2 (G2) test areas were coated with NHA group 3 (G3) implants were coated with MHA after surface conditioning using citric acid group 4 (G4) samples were treated in the same manner as in G3 except for the use of NHA group 5 (G5) samples were coated without surface treatment with MHA mixed with whole human blood group 6 (G6) implant samples were treated in the same manner as in G5 except for the use of NHA group 7 (G7) implant samples were treated in the same way as in G5 plus surface conditioning using citric acid and group 8 (G8) samples were treated in the same manner as in G7 except for the use of NHA. All implants in all groups were agitated for 3 minutes in phosphate-buffered saline. All samples were prepared for scanning electron microscopy evaluation.

 Results: G1 and G2 non-etched implants coated with MHA or NHA sizes were devoid of any bone particle adhesion to the peri-implantitis–affected surfaces. Contrary to the lack of microparticle adhesion to the root surface that was seen in G3, G4 acid-treated and NHA-coated samples revealed nearly complete coverage of the peri-implantitis–affected parts by the graft material. G5 non-etched, clot-blended MHA showed some areas of clot-blended graft adhesion covering 6.7% of the examined surfaces. G6 non-etched, clot-blended NHA showed NHA retention within the fibrin strands in areas where the implant surface pores were exposed (24.3%). G7 acid-treated and clot-blended MHA-treated implant surfaces showed partial coverage of the implant surface with detached fibrin clot–blended graft material (31.4%). G8 acid-treated and NHA clot-blended graft-coated implants showed complete coverage of the implant surface by the clot-blended graft material (93.4%).

 Conclusion: Peri-implantitis–affected surface conditioning with citric acid improves NHA-blended clot adhesion to titanium implant surfaces.

 Source: Journal of Periodentology

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