Efficacy of Instruments for Professional Oral Hygiene on Dental Implants: A Systematic Review

Abstract

Professional oral hygiene is fundamental to prevent peri-implant disease. Appropriate instruments should be used in patients with restorations supported by dental implants: they should be effective in deposits removal without damaging the implant components surface. The aim of the present study is to investigate and summarize the results regarding the efficacy of oral hygiene techniques described in the literature in the last 10 years in patients rehabilitated with dental implants not affected by perimplantitis. The present systematic review was conducted according to guidelines reported in the indications of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). The focused question was: “Which are the most effective instruments for professional oral hygiene on implants not affected by perimplantitis?”. The initial database search yielded a total of 934 entries found in PubMed®/MEDLINE and Cochrane Library. After full text review and application of the eligibility criteria, the final selection consisted of 19 articles. The risk of bias of included studies was assessed using the Newcastle Ottawa scale (NOS) and the Cochrane Handbook for Systematic Reviews of Interventions. Curette, scalers and air polishing were the devices most frequently investigated in the included studies. In particular, glycine powder air polishing appeared to be significantly effective in reducing peri-implant inflammation and plaque around implants. The application of the more recent erythritol powder air polishing also yielded good clinical outcomes. Further studies are needed to improve the knowledge on the topic in order to develop standardized protocols and understand the specific indications for different types of implant-supported rehabilitations.

Epithelial necrotic cells provoke exacerbated inflammatory response in gingival fibroblasts

“…Ongoing mechanical damage, via induction of IL6 from epithelial cells, tailored effector T cell function, promoting increases in gingival Th17 cell numbers; in other words, mechanical injury triggers immune responsiveness [9]. In this sense, apart from the physiological mechanical damage from mastication, injuries affecting the oral epithelium may be caused by prostheses maladaptation [10], implant drilling [11], teeth preparation [12], or even due to the use of curettes, scalers, sonication, or air polishing for teeth cleaning [13]. Furthermore, some oral pathologies, such as oral carcinoma, may produce epithelial cell fragmentation [14].…”

Customized Minimally Invasive Protocols for the Clinical and Microbiological Management of the Oral Microbiota

“…They have the capacity to decrease the incidence of bacteria present (both orange and red complexes, formed by the four oral bacteria, Aggregatibacter actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis, and Treponema denticola, responsible for the severe clinical manifestation of periodontal disease), to reduce the indication of periodontal disease, and to act as a double action in lowering the carioreceptive pathogenic load [5]. The effectiveness of both glycine [6] and erythritol-based powders [7] should not be excluded to maintain a minimally invasive standard, respecting the hard and the soft oral tissues and reducing the bacterial load of the red complex, with a higher percentage of reductions in Porphyromonas gingivalis in periodontal and implantological patients. The ozone therapy falls within the range of dental multidisciplinarity, oxygenating the hard and soft tissues.…”