Abstract
Professional oral hygiene is fundamental to prevent peri-implant disease. Appropriate instruments should be used in patients with restorations supported by dental implants: they should be effective in deposits removal without damaging the implant components surface. The aim of the present study is to investigate and summarize the results regarding the efficacy of oral hygiene techniques described in the literature in the last 10 years in patients rehabilitated with dental implants not affected by perimplantitis. The present systematic review was conducted according to guidelines reported in the indications of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). The focused question was: “Which are the most effective instruments for professional oral hygiene on implants not affected by perimplantitis?”. The initial database search yielded a total of 934 entries found in PubMed®/MEDLINE and Cochrane Library. After full text review and application of the eligibility criteria, the final selection consisted of 19 articles. The risk of bias of included studies was assessed using the Newcastle Ottawa scale (NOS) and the Cochrane Handbook for Systematic Reviews of Interventions. Curette, scalers and air polishing were the devices most frequently investigated in the included studies. In particular, glycine powder air polishing appeared to be significantly effective in reducing peri-implant inflammation and plaque around implants. The application of the more recent erythritol powder air polishing also yielded good clinical outcomes. Further studies are needed to improve the knowledge on the topic in order to develop standardized protocols and understand the specific indications for different types of implant-supported rehabilitations.
Highlights
Professional oral hygiene, in synergy with daily home oral hygiene, strongly contributes to the prevention of peri-implant disease
Air polishing with glycine powder, ultrasonic device with a polyetheretherketone fibre tip, carbon fibre curettes, sponge floss
In order to help to lead to better biofilm removal and to reinforce proper oral and correct self-care regimens, Swierkot et al compared plaque index after 12 months of sonic vs. manual toothbrushing: the results showed no significant difference. [33]
Summary
Professional oral hygiene, in synergy with daily home oral hygiene, strongly contributes to the prevention of peri-implant disease. It is aimed at maintaining the health of oral tissues by removing plaque and tartar that accumulate over teeth and restorations. The frequency of follow-up appointments is established by the dentist or the dental hygienist on the basis of oral condition, the characteristics of the patient and his/her ability to maintain a good oral hygiene. Different instruments and techniques might be used in a single oral hygiene session: tartar can be fragmented and removed by the scaler which generates high-frequency vibrations. Metal ultrasonic instruments have been reported to damage implant and prosthodontic surfaces while plastic tips might be less effective in deposits removal [4]
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