W&H Italia
Prevention is the best treatment!
PD Dr. Kristina Bertl, PhD MSc MBA
The 18th European Workshop on Periodontology was held in autumn 2022 and focused on the treatment of peri-implant diseases. The results once again highlighted what a huge challenge the treatment of peri-implant diseases represents. This is why prevention should be a top priority.
Prevention can be broken down into various levels:
- Primordial prevention – This involves the reduction of risk factors for patients who are due to receive an implant in the future.
- Primary prevention – Primary prevention deals with patients who already have an implant and involves reducing risk factors that can encourage peri-implant diseases to develop.
- Secondary prevention – Secondary prevention aims to prevent peri-implant diseases from recurring in patients who have already been diagnosed and treated for such diseases.
- Tertiary prevention – Tertiary prevention deals with chronic diseases and attempts to slow down their progress and prevent complications in the course of the disease.
A French research group (Carra 2023) looked at precisely this topic during the 18th European Workshop on Periodontology. After conducting a systematic review of 48 studies, the group came to the following conclusions as regards primordial and primary prevention of peri-implant diseases:
- Primordial prevention of peri-implant diseases has not yet been examined in a scientific study.
- Primary prevention has been successful in the following areas:
- Diabetes control (11 studies): Diabetics who are managing their condition poorly have a higher risk of peri-implant diseases.
- Supportive implant therapy (14 studies): Regular and individually tailored supportive implant therapy reduces the risk for peri-implant diseases. The main goal here is to stress the importance of these accompanying measures to patients.
- Peri-implant soft tissue (17 studies): A widening of the peri-implant, keratinised mucosa reduces the risk of peri-implant diseases.
- Giving up smoking (4 studies) & oral hygiene habits (3 studies): Further scientific studies are required here in order to draw clear conclusions.
- Bruxism (0 studies): There is no scientific evidence on this.
In short, our goal with regard to peri-implant diseases should be primordial and primary prevention. We need to invest sufficient time in order to prevent subsequent complications that may be difficult to treat.
Reference
- Carra, M. C., Blanc-Sylvestre, N., Courtet, A., & Bouchard, P. (2023). Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis. Journal of Clinical Periodontology, 1–36.
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