Prevention of Peri-Implant Disease

The prevention of peri-implant diseases, such as peri-implant mucositis and peri-implantitis, hinges on the same fundamental principles as the prevention of gingivitis and periodontitis: rigorous oral hygiene maintained by the patient. As a clinician, it's imperative to emphasise that self-care is the cornerstone of implant maintenance. Given that dental implants and their prosthetic components can complicate oral hygiene practices, you should provide your patients with customised oral hygiene instructions tailored to their specific prosthetic design and individual needs. It's crucial to stress the importance of minimizing bacterial plaque around the gum line to prevent inflammation, disease progression, and the potential for implant failure.

Patients with a history of periodontitis are at a heightened risk for peri-implantitis, and thus require more frequent monitoring for early signs of inflammation and peri-implant bone loss. Smoking cessation should be strongly encouraged, as smoking significantly increases the risk of peri-implant diseases and can undermine implant success. Annual radiographs are recommended to monitor for early bone loss, as peri-implantitis can develop as early as two to three years post-placement.

Regular professional maintenance is essential for the long-term success of implants. Ensure that your patients understand the importance of regular follow-up appointments for professional cleaning and examination. During these visits, evaluate the prosthesis design to confirm it allows for adequate cleaning. Fixed prostheses may occasionally need to be removed to facilitate thorough cleaning and inspection of the underlying implants.

A proactive approach involving regular dental hygiene appointments is critical for maintaining optimal plaque control. As a clinician, you should support your patients with personalised self-care strategies, recommending specific tools such as interdental brushes, floss, and other adjuncts tailored to their prosthetic and anatomical situation.

For patients with implant-retained dentures, emphasise the importance of meticulous denture care. These patients must be aware that the material of their dentures can harbour bacterial plaque, especially around the implant sites that may be concealed beneath the denture. Develop and communicate a care regimen based on the specific materials used in their prostheses.

Finally, educate your patients on the importance of prompt action if they notice any signs of inflammation around their implants. Early detection and intervention are key to preventing the progression of peri-implant diseases and ensuring the long-term success of the implants you place. Regular monitoring and tailored patient education are essential components of maintaining the health and longevity of dental implants.

 

We would like to acknowledge Dr. Manraj Kalsi for his insights and contributions to this page