Background: Biofilm induced implant diseases have been reported to occur between 19-65% of all implants placed worldwide. Despite the high prevalence of these diseases, currently there is not a universally accepted and reliable treatment modality. Peri-implantitis is an inflammatory reaction which can cause bleeding, suppuration and the pathological loss of bone around dental implants, resulting in a saucer shaped bone defect. This inflammatory process can occur some years after implant placement, and can lead to eventual loss of the implant. The major contributing factors to peri-implantitis are patient susceptibility (i.e. a previous history of periodontitis and systemic modifying factors), the formation of a biofilm on the surface of the implant abutment and subsequently on the surface of the implant fixture itself. While regular professional and home care can maintain health peri-implant tissues, once a mature biofilm has established itself on the subgingival implant surface, it becomes problematic because the surface is microscopically rough and notoriously difficult to clean. Despite a range of studies into various debridement techniques, most studies report varying clinical results. Aims: The overall aims of this PhD project were to explore how biofilm can be removed from textured implant surfaces using a variety of methods for closed (non-surgical) debridement, without causing surface damage or other undesirable modifications.Different in vitro models were used to assess the performance of conventional and novel methods of surface debridement. Methods: Titanium discs with various degrees of surface roughness and topographies were utilised to simulate the same textured surfaces as exist on commercial implants. Samples were generated with smooth surfaces, abraded surfaces, and surfaces which had been both abraded and etched (SLA) to resemble existing implant systems. The performance of various conventional debridement techniques was assessed, testing them against each type of surface, first without a biofilm present - to assess surface damage, and then with a biofilm present, to assess biofilm removal and accompanying surface damage. Surfaces were characterised by scanning electron microscopy (SEM) and by laser profilometry, while biofilm removal was assessed numerically using assays (crystal violet and XTT), and qualitatively by SEM and confocal scanning laser microscopy. The studies were designed to test how complex mixed biofilms of natural origin (produced from human saliva as the inoculum) were removed by the various methods. In later chapters, the performance of novel techniques such as fluids agitated by middle infrared pulsed lasers, and electrochemical methods are explored. Findings: A number of debridement methods were tested on different type of implant surfaces, and it appears that modifications to surface risk is technique dependent. Biofilm removal is also technique dependent. Mechanical instruments such as hand curettes, ultrasonics and brushes appeared to have a limited effect in removing biofilm but was at high risk for creating a surface smear layer thus should not be recommended on rough surfaces, irrespective of the type of material of construction. It appears that Er:YAG laser used with water, abrasive particles (air polishing) with glycine powder, application of citric acid and electrolysis at a low current are moderately effective at removing or inactivating the biofilm while preserving the integrity of the original surface. Electrolysis appears to be promising for inactivating biofilm but did not give physical removal, unlike laser or air polishing methods. These are promising areas to explore further, since these treatments are likely to either enhance biocompatibility, or at the very least, will not lower the surface energy, while different debridement approaches have been shown to give varying effects on different surfaces, additional work is needed to test if a combination approach would be a better than a single debridement method.