Maintenance care of dental implants: A clinical review

As implant treatment becomes part of the mainstream dental therapy, dental practitioners should become familiar with protocols for individualized, systematic and continuous supportive care of peri-implant tissues. The present review was undertaken to evaluate and prepare guidelines for therapeutic and care techniques after implant placement.
Search strategy: All the relevant articles indexed in Pubmed, Google Scholar and Science Direct databases from 1970 to 2014 were searched. After studying 120 article abstracts, 80 articles whose full texts were accessible were selected. Based on the 2003 recommendations of American Academy of Periodontology, patients should be evaluated at regular intervals to monitor their peri-implant status and the condition of the implant-supported prostheses, for plaque control, for evaluation of occlusion and for oral hygiene. Assessment of patients’ medical and dental histories, soft tissues, plaque index, clinical probing depth, bleeding on probing, presence of keratinized tissue, mobility, occlusion and bone level are recommended during the maintenance period. In cases of peri-implantitis, the mucosal lesion is often associated with suppuration, deepening of the clinical probing depth, bleeding on probing and loss of supporting marginal bone. Care and treatment suggested include proper oral hygiene, removal of supra- and sub-gingival plaque and calculus, occlusal adjustment, relining of prostheses and surgery.
This review outlined a standardized, evidence-based assessment and intervention protocol to assist practitioners in the maintenance care of dental implants. Now that implant therapy has become a part of the mainstream dental treatment, it is important to identify patients at risk for peri-implantitis and to reinstate an appropriate mainten­ance protocol. It is suggested that the presence of implant mucositis lesions be determined due to the possibility of progression of this condition to peri-implantitis.