Long-term Implant Maintenance: A Systematic Review of Home and Professional Care Strategies in Supportive Implant Therapy

Abstract The aim of this study is review the efficacy of different techniques of home care and professional care for long-term implant maintenance, when compared with their respective standard procedures (regular brushing or mechanical debridement with curette), in changing clinical parameters, such as bleeding on probing, probing depth, plaque score and gingival index, as reported in randomized clinical trials. Materials and Methods: A systematic literature search of randomized clinical trials was performed using the PubMed (MEDLINE), EMBASE and Cochrane library databases. A qualitative review was conducted to compare all the different techniques of home care and professional care for long-term implant maintenance. Results: Initial search involved a total of 816 articles, 233 via Pubmed (Medline), 306 via the Cochrane Library, and 483 via EMBASE, while an additional 16 articles were collected through manual screening. A total of 29 articles were assessed by full-text read for eligibility and a final count of 13 studies were included in systematic review. The results of the risk of bias assessment for the included RCTs according to the ‘RoB 2’. Results favored glycine powder air-polishing and ultrasonic devices over traditional mechanical debridement with curettes in improving clinical parameters. In at-home care, water flossers with chlorhexidine were able to reduce inflammation. Conclusions: Evidence points towards the use of glycine powder air-polishing and the use of ultrasonic devices for reduction of inflammation around implants, and for home care, many existing techniques seem to be able to control tissue inflammation, but the use of chlorhexidine in water-flossers seems to be a promising strategy.