The hand-device (Air-Flows EL-308/A; EMS Electro Medical Systems, Nyon, Sweden) was used in a circular motion, from coronal to apical, parallel to the implant surface in a noncontact mode. The operation period time at each aspect (i.e. mesial, distal, vestibular and oral) was limited to 5 s, as suggested by the manufacturer 35. The nozzle was moved with a circumferential movement around the implant to cover the entire exposed implant surface (36).