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Posted on July 1, 2020 | Categories: Dental Implants
They are not, the differences in the supporting structure of the implant make them more susceptible to inflammation and bone loss when plaque accumulates as compared to the teeth. Therefore, a comprehensive maintenance protocol should be followed to ensure the longevity of the implant. (Fig1)
Good oral hygiene must take place before, during, and after placement of dental implants to ensure the health of the implant. Patients are concerned about what kind of maintenance their implants will require.
There are many types of floss on the market, and generally it is highly recommended to use unwaxed tape or implant-specific floss in order to protect the tissue surrounding the implant. Alternatively for a bar-retained prostheses, full fixed retained prostheses, or wider interproximal spaces, a floss threader or a specialized floss that has a built-in threader is necessary.
To floss the implant, use dental tape and insert the floss in contacts on both sides of the implant. Wrap in a circle and crisscross in front, switch hands, and move in a shoe-shine motion into the peri-implant crevice, which is highly susceptible to inflammation/peri-implant disease due to biofilm1 (See Fig3. EX: Oral-B Glide
In addition, antimicrobial mouth rinses may be recommended, especially if inflammation is present or if the patient has dexterity problems, and difficult-toreach areas. If the patient is prone to inflammation, the use of an antimicrobial rinse, in conjunction with a rubber tip stimulator, may be recommended to inactivate bacteria substantive.
Oral irrigators/Water Flossers
It is highly recommended for patients to use oral irrigators for the reduction of plaque/biofilm, inflammation, and hard-to-reach emergence profiles around implants13,14 (see Figure 6a). Instruct the patient to use a nonmetal tip one to two times daily, and, if inflammation is present, add a diluted non-alcohol antimicrobial rinse (chlorine dioxide or chlorhexidine gluconate).
Studies using oral irrigators with implants for oral hygiene reveal that Waterpik Water Flosser is the only oral irrigator to date to be proven safe and effective with dental implants. Research also shows that the use of oral irrigation and floss revealed that the Waterpik Water Flosser with the standard tip with three bristle filaments (Plaque Seeker Tip) used at medium pressure around implants was 81% more effective in bleeding reduction compared to 33% using floss. These pecialized tips are very effective for implants and to deliver anti-microbial rinse around difficult-to-reach prostheses (All-on-4, full-fixed prosthesis, for example) in
a prevention of peri-implant disease. (See video link attached)
Stimulators are coming back into vogue with implants and regenerative
procedures. Remember healthy keratinized tissue is the key to a healthy peri mucosal seal surrounding the implant. Stimulators are the ticket to achieve this, particularly in full-fixed, supra-structure implants, as well as implants that retain over-dentures (bar-retained implants). Examples of stimulators are rubber tip stimulators produced by multiple manufacturers and Soft Picks by Sunstar America.
Instruct the patient to place the tip of the rubber-tip stimulator so it lays flat against the gum tissue, not poking in the tissue, with pressure roll to massage and stimulate the tissue. The tissue will blanch or change to a lighter color when the correct pressure is applied.
SUMMARY OF GUIDELINES
Implant Home-Care Guidelines