Why Are Plaque Control Measures Necessary in Dental Implants?
In the last three decades of implant dentistry, recent surgical innovations, modification of dental implants, and various prosthetic techniques have resulted in improved efficiency and function of dental implants. The long-term performance of dental implants in patients has always been the main aim of every implantologist to achieve in clinical practice.
Though several studies have been proposed concerning a good prognosis with dental implants, the individual's oral and systemic health factors are crucial to the implant's success. Several postoperative complications are associated in relation to implants such as the patient’s age, implant stability, functionality, etc. Research shows an approximate prevalence of 43 percent peri-implant mucositis and 22 percent peri-implantitis following the implant procedure. Dentists, in order to prevent the development of peri-implant diseases, consider professionally administered plaque control measures along with recommending basic oral hygiene measures that can be implemented by the patient. It is especially required in patients susceptible to infections, systemic drug therapies, or underlying systemic conditions. According to the European workshop on periodontology report, both patient-based oral hygiene measures and professionally employed plaque control approaches have been deemed necessary for the long-term maintenance and health of peri-implant tissues.
What Are the Plaque Control Measures That Can Be Followed by Implant Patients?
Plaque control measures that can be employed by implant patients include:
Manual and Powered Toothbrushes: Toothbrushing is an effective tool for improving oral health without any adverse effects on the mucosa of the peri-implant tissues. According to implant-based research, reports revealed a 75 percent decline in the bleeding index in patients who brush manually versus an 81 percent decline in patients who use powered toothbrushes over the initial six-week period after dental implantation and prosthetic therapy completion.
Interdental Aids: A waxed floss or string floss, compared to water flossers, is shown to reduce the bleeding on probing (BOP). Most patients showed improvement in their peri-implant tissues owing to their inability to clean in between the teeth and the implant prosthesis and also remove any minor food deposits that would inflame or eventually damage the peri-implant tissues. However, dental floss fibers, especially waxed dental floss that tend to get trapped within the peri-implant sulci, may act as a site of infection and cause inflammation resulting in bone loss around the implant. Hence a dentist must be consulted before the use of interdental aids.
Mouthwashes, Gels, and Self-irrigation: Oral disinfection methods regularly followed at home alongside toothbrushing, or interdental aids are effective in plaque control and lessen the possibility of frequent plaque accumulation. Chlorhexidine mouthwash, essential oil mouthwashes, chlorhexidine gels, and triclosan-containing toothpaste are usually recommended by implant dentists for preventing peri-implant tissue inflammation.
What Are the Professionally Administered Plaque Control Measures for Implants?
Professionally administered plaque control measures performed by a dental surgeon in a clinic or hospital help maintain oral health. These include:
Mechanical Instrumentation: The use of titanium brush instruments, diode lasers, non-metal instruments, rubber cups, etc., may be efficaciously implemented for improving soft tissue health around the implant in patients with local or systemic inflammatory conditions.
Air Polishing: This is done by the dentist with glycine powder and is used as an adjunct to mechanical therapy for reducing the bleeding on probing (BOP).
Antimicrobial Therapies: These comprise the use of 35 percent phosphoric acid gel along with mechanical instrumentation. Different antimicrobial therapies, like a combination of ozone, ozone with saline, air with hydrogen peroxide, etc., have been shown to reduce microbial colonization and bleeding on probing, which is increased in peri-implant soft tissue inflammation.
Research indicates a detailed insight into the comprehensive benefits of professionally administered plaque control measures to be more effective than the personal oral hygiene measures employed by the patient. Therefore, professionally administered plaque control is considered the gold standard for the control of peri-implant inflammation.
Patient compliance and peri-implant health maintenance are considered the most important factors in preventing postoperative or biological complications that occur in dental implant cases. Plaque control measures must be strictly implemented by patients, along with regular follow-up and professional therapies, to help reduce plaque accumulation, maintain oral health, and ensure the long-term success of implants.