The impact of maintenance on peri-implant health

Abstract

Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.

Influence of implant‐specific radiation doses on peri‐implant hard and soft tissue: An observational pilot study

“…By matching data of the individual IMRT/VMAT RT treatment plan with follow‐up radiographic scans including the information for implant positioning, it is possible to overcome uncertainties concerning specific radiation doses to every single implant bed. Furthermore, most studies concentrate solely on implant survival, which insufficiently reflects peri‐implant tissue health and therefore long‐term treatment success, especially because the irradiated jawbone has a relevant risk of developing osteoradionecrosis due to infectious processes (Chrcanovic et al., 2016; Katsura et al., 2008; Korfage et al., 2015; Raguse et al., 2016; Schiegnitz et al., 2014, 2015). Only a few studies, on the other hand, implemented clinical and radiographic evaluation to monitor bone loss and tissue inflammation, and specific differences concerning gender and age have rarely been addressed, still lacking the comprehensive implementation of these factors (Heberer, Kilic, et al., 2011; Koszuta et al., 2015; Landes & Kovacs, 2006; Schoen et al., 2007, 2008).…”

Prevalence of Peri-Implantitis: A Multi-Centered Cross-Sectional Study on 248 Patients

“…Rösing et al in a critical review underlined that replacing compromised teeth with dental implants does not avoid biological complications. Clinicians should be aware that the underlying genetics, microbiology, functional demands and behavioral habits associated with oral diseases are not necessarily modified with the placement of dental implants [ 20 ].…”

Analysis of IL-1β, CXCL8, and TNF-α levels in the crevicular fluid of patients with periodontitis or healthy implants

“…Without any doubt, anatomical factors and appropriate attachment of connective tissue and epithelium to the implant surface in uence the lifespan of the implant and the development of possible in ammatory processes. Another critical contributing factor is the implant surface's quality -its chemical, physical state, and mechanical features [3][4][5]. Periimplantitis has been connected with a Gram-negative anaerobic microbiota, similar to that found in severe periodontitis around natural teeth [6,7].…”