Impact of Biofilm Decontamination Methods on Implant-Abutment Surface Integrity: A Systematic Review of Quantitative Studies

Background and Aim: To systematically analyze the impact of biofilm disruption and decontamination methods on the surface of dental implants and abutments. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted in September 2024. Only quantitative studies analyzing surface alterations caused by physical, mechanical, and chemical decontamination procedures were included. The risk of bias was assessed. Results: Twenty-nine studies, all in vitro, were selected. Surface alterations were assessed using profilometer and microscope and were reported through Ra, Rz, and Sa roughness parameters. Differences in surface roughness between control and test groups were evaluated. For titanium machined surfaces, the surface roughness increases or decreases in 96% of cases for Ra and 100% for Sa and Rz, with no consistent pattern. Titanium modified surfaces generally show a reduction trend in roughness parameters following decontamination, though the extent and consistency of this reduction vary across studies. Few studies on zirconia reported minimal surface alteration, with Ra changes between −0.05 and 0.06 and Sa between 0.2 and 0.8 μm. Overall, due to methodological variability, no universally safe tool for maintaining surface integrity could be clearly identified. Conclusions: The inconclusive and heterogeneous nature of the findings suggests that surface alterations should be considered alongside other factors, rather than as a stand-alone determinant, when selecting implant surface decontamination methods. Clinical trials are suggested to assess the impact of these alterations on clinical outcomes, such as bacterial growth and biological complications.