Rethinking Biofilm Removal Around Dental Implants
Dental implants are an effective option for replacing missing teeth, with long-term success rates exceeding 90% and millions placed worldwide each year.1,2 Despite favorable outcomes in implant placement and long-term preservation of alveolar bone, maintenance is essential for preserving peri-implant tissues and osseointegration, and preventing biological complications. A majority of peri-implant mucositis and peri-implantitis cases are plaque-induced inflammatory conditions that may compromise implant success if left untreated.3 Systematic reviews report the prevalence of peri-implant mucositis at 43% to 46.8% and peri-implantitis at 19.8% to 22%, underscoring the importance of vigilant implant maintenance as a key component of successful implant therapy.2
Implant maintenance requires routine clinical evaluations, patient education, self-care education and reinforcement, professional biofilm and calculus removal to support peri-implant tissue health, and ongoing management of risk factors. Routine clinical evaluations include visual inspection of peri-implant tissues; periodontal probing to assess pocket depths, suppuration, and bleeding; and radiographic evaluation of crestal bone levels and osseointegration.4 In addition, implant maintenance visits involve reviewing self-care routines of patients, the effectiveness of oral hygiene tools recommended, counseling on modifiable risk factors, and performing professional debridement using implant-safe instruments.
While the importance of professional care is well-established, variability exists in clinical approaches and mechanical plaque control techniques for the prevention and management of peri-implant mucositis. The inconsistency in clinical implant maintenance standards highlights the need to identify and validate evidence-based professional approaches to implant care.5 Subgingival air polishing has emerged as a promising adjunctive technique for managing biofilm around implants with minimal surface alteration.6
* References and figures can be found in the original article via the link above.
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