Prevention and management of peri-implant disease

As more patients choose dental implants as their primary treatment option to restore edentulous ridges or to replace compromised dentition, preventive strategies for peri-implant diseases and complications have become an important topic.

The aim of the review article is to summarize the current available evidence on the potential risk factors/indicators for peri-implant disease development and then focus on the preventive strategies for peri-implant diseases and conditions.

After reviewing the diagnostic criteria and the etiology of peri-implant diseases and conditions, evidence on the possible associated risk factors/indicators for peri-implant diseases were searched and identified. Recent studies were also surveyed to explore the preventive measures for peri-implant diseases.

The possible associated risk factors of peri-implant diseases can be divided into the following categories: patient-specific factors, implant-specific factors, and long-term factors. Patient-specific factors such as history of periodontitis and smoking have been conclusively associated with peri-implant diseases, whereas findings on others, such as diabetes and genetic factors, remain inconclusive. It has been suggested that both implant-specific factors, such as implant position, soft tissue characteristics, and the type of connection used, and long-term factors, such as poor plaque control and a lack of maintenance program, have a strong impact on maintaining the health of a dental implant. Assessment tool for evaluating the risk factors can be a potential preventive measure for peri-implant disease prediction, and it is needed to be properly validated.

Proper maintenance program for early intervention to control peri-implant diseases at the initial stage and pretreatment assessment of the potential risk factors is the best strategy to prevent implant diseases.