Cleanability is a must!

PD Dr. Kristina Bertl, PhD MSc MBA

Both when treating peri-implant diseases and after fitting a new implant-supported restoration, our top priority should always be to provide patients with instructions regarding home oral hygiene. However, there is one thing we must not forget: It must be possible for the patient to actually clean their implant-supported restoration!

Of course, it may sound obvious that a prosthesis should be designed in such a way that the patient will subsequently be able to clean it. Nonetheless, dental practices regularly see implant-supported restorations that unfortunately make it very difficult for patients to carry out optimum oral hygiene.

A Spanish research group (Tapia et al. 2019) recently investigated this topic and provided scientific confirmation of the importance of the cleanability of implant-supported restorations.

In total, 48 patients were enrolled in this randomized controlled clinical study. The most important inclusion criterion was that patients with peri-implant mucositis had an implant-supported prosthesis that was very hard to clean as part of home oral hygiene. The patients were then randomly assigned to either a control or a test group. The implant-supported prostheses in the control group remained unchanged, whereas the test group’s implant-supported prostheses were adjusted to facilitate and improve home oral hygiene. Both groups received a professional cleaning and detailed instructions regarding home oral hygiene.

The results showed a significant improvement in the test group, which persisted throughout the entire study period of 6 months. In contrast, although the control group initially also saw an improvement, after 3 months this was then followed by a deterioration (increase in bleeding index). The authors concluded that the effect of non-surgical treatment of peri-implant mucositis can only continue in the long term if the implant-supported prosthesis has been optimized for home oral hygiene.

In short: Cleanability is a must!

Reference

1. de Tapia B, Mozas C, Valles C, Nart J, Sanz M, Herrera D. Adjunctive effect of modifying the implant‐supported prosthesis in the treatment of peri‐ implant mucositis. J Clin Periodontol. 2019;46:1050–1060. doi.org/10.1111/jcpe.13169