Patients with dental implants require proper care and maintenance on a regular basis to prevent peri-implant complications.
There are several reasons justifying implant maintenance care:
- Peri-implant tissues are less efficient against biofilm aggression (they are affected more easily, and if infection sets it, it progresses more rapidly).
- The peri-implant sulcus is deeper and therefore more susceptible to more pathogenic biofilm development.
- Prosthetic restorations can make biofilm control difficult for patients.
- Maintenance at regular intervals reinforces continual patient control.
- Regular maintenance can help detect peri-implant infections early.
- And lastly, the most important reason is that the treatment protocols proposed in the literature yield an unpredictable and very limited success rate.
The objective of this phase is to prevent inflammation and infection of peri-implant tissues and to prevent the formation of pathogenic biofilm, therefore minimising the risk for implant failure.
Mechanical control with specific instruments for implant hygiene is essential, but may not be sufficient in controlling supramucosal plaque and maintaining a healthy implant, as it may be complicated by the design of the prosthesis or by implant placement. Special brushes currently exist that allow for better access to the prosthesis and that enhance mechanical control, but even so, the chemical control approach is fundamental. Use of molecules such as 0.05% chlorhexidine together with 0.05% cetylpyridinium chloride is recommended only in mouthwashes as a supplement to mechanical biofilm control.
Regular oral biofilm control by visiting the dentist and patient motivation in relation to daily oral hygiene are the main pillars for implant maintenance.