Quality Resource Guide –

Maintenance for Patients with Implant-Supported Dental Restorations

www.metdental.com

Page 4

Lastly, systemic conditions such as diabetes and

osteoporosis have been investigated in the context

of peri-implant diseases.

50-52

However, the literature

is not clear on the specific influence on incidence

and progression of peri-implant problems in patients

affected by chronic systemic diseases.

As a general rule, the maintenance interval for higher

risk patients (smokers, the elderly, bruxers and

patients with periodontal diseases, with or without

systemic associated chronic conditions) may need

to be initially modified to 2 to 4 months. The 7th

European Workshop on Periodontology proposed

that baseline clinical parameters and radiographs

should be established at the time of prosthesis

installation for all patients

to facilitate monitoring

of disease incidence and progression. This can be

particularly critical in high-risk patients.

A patient may need a custom maintenance protocol

based on the type of restoration that has been

placed. Fixed or removable prostheses may need

professional removal, cleaning and change of parts.

Restorations with deep restorative margins may need

to be removed for professional debridement of the

region at a maintenance appointment. There is not a

recommended difference in maintenance protocols

for cemented vs. screw-retained restorations.

However, if there is evidence of crown loosening, the

restoration must be re-evaluated for loading issues

and the screws replaced. This is also applicable to

multiple units.

In summary, a maintenance interval and protocol

must be established based on restoration and peri-

implant status, and consideration of systemic and/or

local conditions that could modify a patient’s risk for

peri-implantitis. Oral hygiene is also a major factor in

shortening or extending recall intervals.

References

Jung RE, Pjetursson BE, Glauser R, Zembic A,

Zwahlen M, Lang NP. A systematic review of the

5-year survival and complication rates of implant-

supported single crowns. Clinical oral implants

research. 2008;19(2):119-130.

Rasperini G, Siciliano VI, Cafiero C, Salvi GE,

Blasi A, Aglietta M. Crestal bone changes at

teeth and implants in periodontally healthy and

periodontally compromised patients. A 10-year

comparative case-series study. Journal of

periodontology. 2014;85(6):e152-159.

Zitzmann NU, Berglundh T. Definition and

prevalence of peri-implant diseases. Journal of

clinical periodontology. 2008;35(8 Suppl):286-291.

Atieh MA, Alsabeeha NH, Faggion CM, Jr.,

Duncan WJ. The frequency of peri-implant

diseases: a systematic review and meta-analysis.

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Derks J, Tomasi C. Peri-implant health and

disease. A systematic review of current

epidemiology. Journal of clinical periodontology.

2015;42 Suppl 16:S158-171.

Jepsen S, Berglundh T, Genco R, et al. Primary

prevention of peri-implantitis: managing

peri-implant mucositis. Journal of clinical

periodontology. 2015;42 Suppl 16:S152-157.

Monje A, Aranda L, Diaz KT, et al. Impact of

Maintenance Therapy for the Prevention of

Peri-implant Diseases: A Systematic Review

and Meta-analysis. Journal of dental research.

2016;95(4):372-379.

Ma S, Fenton A. Screw- versus cement-retained

implant prostheses: a systematic review of

prosthodontic maintenance and complications.

The International journal of prosthodontics.

2015;28(2):127-145.

Staubli N, Walter C, Schmidt JC, Weiger R,

Zitzmann NU. Excess cement and the risk of peri-

implant disease - a systematic review. Clinical oral

implants research. 2016.

10. Bidra AS, Daubert DM, Garcia LT, et al. A

Systematic Review of Recall Regimen and

Maintenance Regimen of Patients with Dental

Restorations. Part 2: Implant-Borne Restorations.

Journal of prosthodontics : official journal of the

American College of Prosthodontists. 2016;25

Suppl 1:S16-31.

11. Bidra AS, Daubert DM, Garcia LT, et al. Clinical

practice guidelines for recall and maintenance of

patients with tooth-borne and implant-borne dental

restorations. Journal of the American Dental

Association (1939). 2016;147(1):67-74.

12. Wang Y, Zhang Y, Miron RJ. Health, Maintenance,

and Recovery of Soft Tissues around Implants.

Clinical implant dentistry and related research.

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13. Berglundh T, Lindhe J, Ericsson I, Marinello CP,

Liljenberg B, Thomsen P. The soft tissue barrier at

implants and teeth. Clinical oral implants research.

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14. Berglundh T, Abrahamsson I, Welander M, Lang

NP, Lindhe J. Morphogenesis of the peri-implant

mucosa: an experimental study in dogs. Clinical

oral implants research. 2007;18(1):1-8.

15. Pontes AE, Ribeiro FS, Iezzi G, Piattelli A, Cirelli

JA, Marcantonio E, Jr. Biologic width changes

around loaded implants inserted in different levels

in relation to crestal bone: histometric evaluation

in canine mandible. Clinical oral implants

research. 2008;19(5):483-490.

16. Welander M, Abrahamsson I, Berglundh T.

The mucosal barrier at implant abutments of

different materials. Clinical oral implants research.

2008;19(7):635-641.

17. Schwarz F, Mihatovic I, Becker J, Bormann KH,

Keeve PL, Friedmann A. Histological evaluation

of different abutments in the posterior maxilla

and mandible: an experimental study in humans.

Journal of clinical periodontology. 2013;40(8):807-

815.

18. Esposito M, Maghaireh H, Grusovin MG, Ziounas

I, Worthington HV. Soft tissue management

for dental implants: what are the most

effective techniques? A Cochrane systematic

review. European journal of oral implantology.

2012;5(3):221-238.

19. Kan JY, Rungcharassaeng K, Lozada

JL, Zimmerman G. Facial gingival tissue

stability following immediate placement

and provisionalization of maxillary anterior

single implants: a 2- to 8-year follow-up. The

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The following MetLife QRGs provide

additional information about dental

implants: Managing Peri-implantitis 1st

Ed 2016; Introduction to Dental Implant

Therapy 3rd Ed 2015; Implant Placement

by the General Dentist 3rd Ed 2016;

Immediate Dental Implants 1st Ed 2014.