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Implant Maintenance

Dr. Handren Hunar Najeeb

Implant Maintenance

Methods for Patient Oral Hygiene
Before implant osseointegration:
• peri-implant oral hygiene for biofilm control should begin as early as possible after the implant is exposed to the oral cavity.
• A cotton tip, cotton gauze, or soft toothbrush can be used to gently remove biofilm from healing abutments or provisional restorations during the early postoperative phase of healing.
• powered toothbrushes should be avoided.

Implant Maintenance

After implant osseointegration has been achieved and verified:
• brushing with dentifrice can help remove deposits and increase smoothness of exposed implant and restoration surfaces.
• Other dental hygiene aids, such as dental floss, rubber tips, and interdental brushes, can be employed


implant



Methods for patient oral hygiene are shown. (A) Flossing. (B) Bass method of brushing with an extra-soft toothbrush. (C) Interproximal brushing. (D) Removal of biofilm with a rubber tip. Hygiene methods remove biofilm along the gingival margin.

Implant Maintenance

Methods for Professional Recall Maintenance
Removal of dental biofilm and calculus from implant components exposed to the oral environment.
The transmucosal surfaces of implants should be smooth to minimize plaque accumulation and to facilitate oral hygiene practices.
At sites with excellent biofilm control and peri-implant health, the need for professional instrumentation is minimal, and instrumentation should be limited to prevent iatrogenic damage to implant components

All metal instruments, including metal curettes and scalers, and ultrasonic scalers increase the surface roughness of polished titanium.
The use of plastic, Teflon-coated, and carbon and gold-coated curettes and nonmetal ultrasonic tips have been advocated to protect the titanium implant surface


implant


(A) Plastic probe: Colorvue. (B) New Implacare II Barnhart #5-6 cone socket plastic curette tips that screw into an autoclavable stainless steel handle.
A
B


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(A) Micro Mini titanium implant curettes (Paradise Dental Technologies, Missoula, MT). Left to right, Gracey #1-2 Micro Mini, Gracey #11-12 Micro Mini, Gracey #13-14 Micro Mini. (B) Mini-bladed titanium implant curettes (LM Instruments, Parainen, Finland) : Mini universal curette, Mini Gracey #1-2, Mini Gracey #13-14, Mini Gracey #11-12.

Treatment of Peri-Implant Diseases

Begins with patient education about the causes, pathogenesis, and prevention of peri-implant diseases, along with oral hygiene instruction.
Etiologic factors of Peri-Implant Diseases:
• Bacteria.
• Systemic factors (e.g., smoking, poorly controlled diabetes).
• local factors (e.g., residual excess cement, poorly designed restorations.

Peri-Implant Mucositis

Peri-implant mucositis is characterized by inflammation confined to the soft tissue and is reported to affect up to 80% of patients with dental implants.
Effectively treated with nonsurgical mechanical therapy.
Treatment requires complete removal of supramucosal and submucosal biofilm, calculus, and deposits.
Antimicrobials (e.g., chlorhexidine irrigation, mouthrinse).

Peri-Implantitis

Peri-implantitis is characterized by peri-implant inflammation with progressive crestal bone loss beyond the initial remodeling. The prevalence of peri-implantitis among patients is 11.2% to 53%.
The treatment of peri-implantitis includes
nonsurgical
(antimicrobial rinse and irrigation, local antibiotics, ultrasonic debridement, mechanical debridement with air-abrasive devices, and laser therapy).
surgical interventions.
(full-thickness flap elevation for access, followed by degranulation, surface debridement by laser or mechanical instruments, surface decontamination with laser or antimicrobials, and bone augmentation).


Referral of Patients to the Periodontist
Referral to a periodontist should be considered if peri-implantitis or peri-implant mucositis is diagnosed and cannot be resolved with improved oral hygiene and professional maintenance care.



رفعت المحاضرة من قبل: Mustafa Shaheen
المشاهدات: لقد قام 5 أعضاء و 192 زائراً بقراءة هذه المحاضرة








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