AbstractAimThe present study aimed at evaluating the effect of air‐polishing (AP) and a combination of AP and alkaline electrolysed water (AEW) in surface decontamination of explanted peri‐implantitis‐affected implants.Materials and MethodsTwenty‐five patients with 34 dental implants scheduled for explantation due to severe peri‐implantitis were included. Following implant removal, the apical part of each implant was embedded in acrylic blocks. Implants were randomly allocated to surface decontamination using AP with or without AEW. Four implants were left untreated and used as negative controls. Specimens were analysed using scanning electron microscopy (SEM) and energy‐dispersive x‐ray spectroscopy (EDS). Area of residual bacteria was the primary outcome.ResultsSEM analysis revealed that both treatment protocols were effective in biofilm removal and only small proportions of target areas of the implants showed residual bacterial or mineralized deposits. Although differences between the treatment protocols were small, implant thread loci (top/flank/valley), zones of the implant (apical/middle/coronal), implant surface characteristics and gender influenced the results. In addition, EDS analysis showed that zones influenced the atomic% of carbon and calcium and that implant surface characteristics affected the atomic% of titanium.ConclusionsAP, with or without AEW, is an effective method in removing biofilm from peri‐implantitis‐affected implants.