A Systematic Review of Recall Regimen and Maintenance Regimen of Patients with Dental Restorations. Part 2: Implant‐Borne Restorations

Abstract

Purpose To evaluate the current scientific evidence on patient recall and maintenance of implant‐supported restorations, to standardize patient care regimens and improve maintenance of oral health. An additional purpose was to examine areas of deficiency in the current scientific literature and provide recommendations for future studies. Materials and Methods An electronic search for articles in the English language literature from the past 10 years was performed independently by multiple investigators using a systematic search process. After application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed to meet the objectives of this review. Results The initial electronic search resulted in 2816 titles. The systematic application of inclusion and exclusion criteria resulted in 14 articles that satisfied the study objectives. An additional 6 articles were added through a supplemental search process for a total of 20 studies. Of these, 11 were randomized controlled clinical trials, and 9 were observational studies. The majority of the studies (15 out of 20) were conducted in the past 5 years and most studies were conducted in Europe (15), followed by Asia (2), South America (1), the United States (1), and the Middle East (1). Results from the qualitative data on a combined 1088 patients indicated that outcome improvements in recall and maintenance regimen were related to (1) patient/treatment characteristic (type of prosthesis, type of prosthetic components, and type of restorative materials); (2) specific oral topical agents or oral hygiene aids (electric toothbrush, interdental brush, chlorhexidine, triclosan, water flossers) and (3) professional intervention (oral hygiene maintenance, and maintenance of the prosthesis). Conclusions There is minimal evidence related to recall regimens in patients with implant‐borne removable and fixed restorations; however, a considerable body of evidence indicates that patients with implant‐borne removable and fixed restorations require lifelong professional recall regimens to provide biological and mechanical maintenance, customized for each patient. Current evidence also demonstrates that the use of specific oral topical agents and oral hygiene aids can improve professional and at‐home maintenance of implant‐borne restorations. There is evidence to demonstrate differences in mechanical and biological maintenance needs due to differences in prosthetic materials and designs. Deficiencies in existing evidence compel the forethought of creating clinical practice guidelines for recall and maintenance of patients with implant‐borne dental restorations.

Clinical practice guidelines for recall and maintenance of patients with tooth-borne and implant-borne dental restorations

“…Given the resources required to treat patients with complex dental needs, an appropriate patient recall regimen, professional maintenance regimen, and at-home maintenance regimen are paramount for long-term success. 13,14 Furthermore, it is likely that the professional and at-home maintenance protocols in healthy adult patients with tooth-and implant-borne restorations may be significantly different when compared to patients with no restorations, or patients with acute or chronic oral and systemic diseases. For toothborne restorations, guidelines on the options and relative merits of professional and at-home maintenance protocols to predictably achieve stable results are lacking.…”

“…The detailed methodology for the search processes are described in the respective systematic review articles. 13,14 For tooth-borne restorations, 16 studies were identified in the systematic review that reported data on a combined 3569 patients. Of these, nine were randomized controlled clinical trials (RCT), and seven were observational studies.…”

“…Two separate systematic reviews of the literature were conducted to evaluate the recall and maintenance regimens for tooth-and implant-borne restorations. 13,14 The systematic review on tooth-borne restorations included articles published from January 1, 1999 to December 31, 2014. The systematic review on implant-borne restorations included articles published from January 1, 2004 to December 31, 2014.…”

Double Full‐Arch Fixed Implant‐Supported Prostheses: Outcomes and Complications after a Mean Follow‐Up of 5 Years

“…Hence, knowing the incidence, type, and rate of complications with each treatment modality is necessary, especially when the treatment cost is increased . Ultimately, the selection of a treatment option from the financial and effectiveness viewpoints relies on the longitudinal efficacy of the option coupled with the associated cost and maintenance when complications occur …”

A Call for a Continuing Dialogue on Recall and Maintenance of Patients with Tooth‐Borne and Implant‐Borne Restorations

“…The response to the publication of our recent systematic reviews and clinical practice guidelines (CPGs) has been encouraging. Soon after the release of the Journal of Prosthodontics supplement, Yahoo Finance, Econotimes.com, and other national media outlets picked it up.…”