Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases

Abstract

At the present time, peri-implantitis has become a global burden that occurs with a frequency from 1% to 47% at implant level. Therefore, we aimed herein at assessing the impact of peri-implant maintenance therapy (PIMT) on the prevention of peri-implant diseases. Electronic and manual literature searches were conducted by 3 independent reviewers using several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles up to June 2015 without language restriction. Articles were included if they were clinical trials aimed at demonstrating the incidence of peri-implant diseases under a strict regime or not of PIMT. Implant survival and failure rate were studied as secondary outcomes. A meta-analysis was conducted to evaluate the influence of PIMT and other reported variables upon peri-implant diseases. Thirteen and 10 clinical trials were included in the qualitative and quantitative analysis, respectively. Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. Similarly, significant effects of history of periodontal disease were obtained for peri-implantitis for both implant and patient levels. Furthermore, mean PIMT interval was demonstrated to influence the incidence of peri-implantitis at implant but not patient level. PIMT interval showed significance at both levels. For implant survival, implants under PIMT have 0.958 the incident event than those with no PIMT. Within the limitations of the present systematic review, it can be concluded that implant therapy must not be limited to the placement and restoration of dental implants but to the implementation of PIMT to potentially prevent biologic complications and hence to heighten the long-term success rate. Although it must be tailored to a patient's risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of 5 to 6 mo. Additionally, it must be stressed that even in the establishment of PIMT, biologic complications might occur. Thus, patient-, clinical-, and implant-related factors must be thoroughly explored.

How do peri‐implant biologic parameters correspond with implant survival and peri‐implantitis? A critical review

“…This is confirmed by a meta‐analysis including 13 papers concluding that a more regular, individually tailored peri‐implant maintenance therapy prevents possible biologic complications over time and improves the long‐term outcome of implants (Monje et al., 2016). Recent systematic reviews scrutinized additional patient‐related factors and their association with implant treatment outcome.…”

Survival/Success of Dental Implants with Acid-Etched Surfaces: A Retrospective Evaluation After 8 to 10 Years

“…This association between periodontitis and the prevalence of peri-implantitis could be observed in previous reports (18,25). However, despite the high prevalence of patients who presented chronic periodontitis (45%), only 15% of these patients presented peri-implantitis and this information is not in accordance with a significant number of studies (2,17,24). It is likely that the lack of well-established criteria for the diagnosis of periodontitis and peri-implantitis has led to a large variation in disease indices in the literature.…”

“…A history of periodontitis has been considered a risk factor for peri-implantitis (24,25). The increased susceptibility of these patients occurs due to the inability of their host immune response to face the microbial challenge adequately; thus, patients affected previously by periodontitis may have a higher probability of periimplantitis development.…”

The Effectiveness of Orally Administered Probiotic on Peri-Implant Tissue Condition: A Prospective Study

“…Basic peri-implant maintenance therapy (PIMT) is a crucial component of successful implant treatment, where the suggested reasonable interval is 5 or 6 months. [3] However, this does vary and is hence customized to fit each patient, depending on important clinical factors such as history of periodontal disease. 4 Many therapeutic and adjunctive procedures for implant maintenance, such as mechanical debridement, 5 photodynamic therapy, 5 Er:YAG laser, 6 and sub gingival glycine air polishing 5 have been previously investigated.…”