_Article_  
Bioactive Healing Abutment as a Potential Tool for the Treatment of Peri-Implant Disease--In Vitro Study  
[PERSON] 1, [PERSON] 2, [PERSON] 3, [PERSON] 3, [PERSON] 3 and [PERSON] 3,4  
Footnote 1: The Chair and Department of Oral Surgery, Medical University of Lublin, Karmelicka 7, 20-081 Lublin, Poland; [EMAIL_ADDRESS]  
Footnote 2: The Chair and Department of Oral Surgery, Medical University of Warsaw, Binieckiego 6, 02-097 Warsaw, Poland; [EMAIL_ADDRESS]  
Footnote 3: The Chair and Department of Oral Surgery, Medical University of Warsaw, Linewska 14/16, 00-575 Warsaw, Poland;  
Footnotedetected, including red complex bacteria, which is a complex that is predisposed to periodontitis. This may explain the predisposition to peri-implantitis in patients positive for periodontitis [6; 7; 8]. In addition, peri-implantitis has been linked with _Staphylococcus aureus_, _Staphylococcus epidermidis_, _Enterobacter cloace_, _Esherichia coli_, _Helicobacter pylori_, _Petostreptococcus micra_, and _Candida_ sp. [9; 10]. _Staphylococcus_ spp. bacteria are one of the leading causes of implant infections. These bacteria create a biofilm which impedes treatment. The occurrence of _Staphylococcus aureus_ has been confirmed in 80% of bacterial samples from implant area pockets impacted by peri-implantitis. A lack of this micro-organism in the bacterial plaque has been confirmed for 90% of healthy areas [11; 12]. Peri-implantitis treatment is an important clinical challenge with a significant need to control local infection, preserve soft and bone tissue in the area around the implant, and ultimately maintain the aesthetics and stability of the implants. Depending on the implant type and treatment strategy, only 34-79% of peri-implantitis cases are treatable. Prospective studies of peri-implantitis treatments longer than 1 year have shown many recurrences, even up to 100% with regards to certain treatment strategies. Taking this into account, peri-implantitis can be seen as a chronic disease requiring many treatment episodes [13; 14; 15]. Such an approach to peri-implantitis appears to be highly problematic, as the proposed treatment strategies are cumbersome and expensive. Treatment methods used for peri-implantitis can be divided into two main groups: surgical and non-surgical procedures [15; 16]. Non-surgical procedures incorporate oral hygiene instructions and training the patient in teeth and implant dental plaque cleaning techniques. Rinses and irrigation with chlorhexidine, tridosan, or other disinfectants have been used. However, the efficacy of these procedures is restricted to early forms of peri-implantitis (called peri-implant mucositis) and has not provided satisfying results in fully developed peri-implantitis [2; 15; 16]. The main method of treatment for peri-implantitis is manual therapy using a teflon, carbon, plastic, or titanium current, as well as plaque removal procedures using ultrasonic scalers with titanium or plastic tips. It is advised to use pressure sandblasting machines with specially constructed nozzles. The effectiveness of these methods is comparable. Efficacy results for implant surface decontamination in vitro are very promising. Unfortunately, clinical results for the use of mechanical methods are unsatisfying. Peri-implantitis recurrence has been observed after these procedures [15; 16; 17; 18]. Attempts to treat peri-implantitis with biostimulating lasers in photodynamic therapy have led to improved effectiveness, although only when combined with mechanical methods. As independent methods, they do not have a higher effectiveness rate and longer remission duration. However, these methods require specialist equipment and qualified personnel, as well as many repetitions, which raises the treatment cost [19; 20]. One of the non-surgical peri-implantitis treatment methods, referring to the proposed bacterial etiology of this pathology, is systemic or local antibiotic therapy.