Mr Luc Trevisan discusses the importance of patient compliance in dental implant maintenance

Patient compliance is crucial to the implant maintenance process in order to prevent peri-implantitis from developing or recurring in individuals who have already been treated for the disease. The need to educate patients on the detrimental effect of dental plaque on implants cannot be underestimated.

Patients at higher risk of peri-implant complications include those who are diabetic, smoke, or have a history of periodontal disease – generally as a result of substandard oral home care [1].

Poor oral hygiene habits such as these do not foster a successful outcome for the patient’s implant, so instructions should be provided which include detailed verbal guidance on the most appropriate teeth cleaning techniques, supported by visual demonstrations and advice on which dental products the patient should use.

Because implants with a rough surface design are more prone to developing plaque, it is essential practitioners recommend products that will not alter the implant surface and are also safe and effective for daily use [2].

Gingival abrasion

Depending on the individual needs of the patient, twice daily cleaning of an implant to remove the accumulation of bacterial plaque can be accomplished using a soft-bristle manual toothbrush. Electric toothbrushes can also be recommended, particularly as they can facilitate effective interproximal cleaning and are ideal for patients with limited dexterity.

However, patients should be made aware that prolonged, forceful brushing with either a manual or electric toothbrush can cause gingival abrasion, which could lead to inflammation in the periodontal tissue surrounding the implant.

Yet, dental implants necessitate intensive treatment that goes far beyond at-home oral care. Practitioners should employ the most appropriate professional oral hygiene programme in order to maintain optimal health of the peri-implant hard and soft tissues, which play a crucial role in determining the long-term success of an implant.

Removal of calculus and plaque is indicated for implant patients at every hygiene visit, which should be scheduled every 3 to 6 months, according to their risk of peri-implant complications [3].

During scaling or probing, practitioners should avoid using metallic instruments such as stainless steel. These can damage the implant, causing a galvanic reaction at the implant-abutment interface that can make the titanium surface more susceptible to the accumulation of plaque. This increases the possibility of peri-implant inflammation which could put the implant at risk of loss or failure [4].

It is evident that following an effective oral home care routine is as vital as in-practice maintenance protocols, which should be covered during the implant treatment planning stage. Practitioners should also consider using an implant solution that helps facilitate effective maintenance.

For example, TBR’s unique Z1 implant system features a titanium body and a zirconia collar, which is clinically proven to radically reduce bacterial colonisation, protecting both the crestal bone and gingiva from the risk of iatrogenic inflammation or infection.