Recommendations for the prevention of peri-implant diseases
Where does the need for this guideline come from? • Implementation of the 2018 classification of peri-implant diseases as well as the availability of defined clinical diagnostic criteria/parameters should facilitate the use of appropriate preventive and therapeutic interventions to prevent and treat peri-implant diseases. The application of this S3-level clinical practice guideline for “Prevention and treatment of peri-implant diseases” will allow a homogeneous and evidence-based approach to maintain peri-implant health, to prevent and treat peri-implant mucositis and peri-implantitis. What do patients need to know? • An essential prerequisite to prevention and therapy of peri-implant diseases is to inform the patient of the diagnosis, including causes of the condition, risk factors, treatment alternatives and expected risks and benefits including explanations regarding consequences of refused treatment. • This discussion should be followed by agreement on a personalized care plan. • The plan might need to be modified during the treatment journey, depending on patient preferences, clinical findings and changes to overall health.
How do we interpret these infographics? Blue colour:
Recommendations in favor of a particular strategy of treatment or specific procedure. Open recommendation in which the clinician is responsible for the final choice of a particular strategy of treatment or specific procedure based on specific patient characteristics. Uncertain recommendation for whose clarification further research is needed. Recommendations against a particular strategy of treatment or specific procedure.
Orange colour:
Red colour:
TABLE Strengh of recommendations: grading scheme (German Association of the Scientific Medical Societies (AWMF) and Standing Guidelines Commision, 2012)
Grade of recommendation a
Description
Syntax
We recommend We recommend not to
A
Strong recommendation
We suggest We suggest not to
B
Recommendation
O
Open recommendation May be considered a If the group felt that evidence was not clear enought to support a recommendation, statements were formulated, including the need (or not) of additional research.
Aim: This infographic presents recommendations for individual interventions used in the prevention and treatment of peri-implant diseases for preserving the health of peri-implant tissues and, thereby, extending the longevity of complication-free survival of dental implants when used to replace missing teeth. It aims to: inform sound preventive approaches peri-implant diseases, and thereby improve the overall quality of peri-implant interventions undertaken in Europe and worldwide; reduce dental implant loss arising due to peri-implantitis; reduce medical and dental costs and improve the quality of life of patients. (i) (ii) (iii)
General recommendations in the management of peri-implant mucositis
Goals/endpoints for treatment of peri-implant mucositis
Recommended interventions
Recommended
Recommended
Recommended
x3 months
Evaluate endpoints 2–3 months after the intervention . When ≥2 BOP sites, or ≥1 site with profuse BOP, or presence of suppuration, re-treatment should be rendered.
Endpoint: ≤1 site with bleeding on probing (BOP) and no suppuration.
Oral hygiene as an adjunct to Professional Mechanical Plaque Removal (PMPR)
Recommended interventions
Open recommendation
Recommended
Open
Recommended
The self-use of oral irrigation devices with water may be considered as an adjunct to PMPR.
Self-performed effective oral hygiene along with professional mechanical plaque removal (PMPR) is recommended.
Professional Mechanical Plaque Removal (PMPR) in peri-implant mucositis: single forms and combinations
Open recommendation
Not suggested
NOT suggested
Open
++
Ultrasonics with plastic coated tips, air-polishing devices with glycine powder, titanium curettes, chitosan brushes may be considered as single modes of professional mechanical plaque removal (PMPR)
It is suggested not to add airpolishing devices or diode lasers to conventional PMPR (curettes, ultrasonics or both).
Recommended interventions
Recommended
Recommended
x3 months
It is recommended to repeat PMPR if the endpoints of therapy have not been achieved within 3 months.
Modifying the implant-supported prosthesis
Not recommended
Recommended interventions
NOT recommended
Recommended
If self-performed oral hygiene (OH) is not possible, it is recommended to clean/remove/modify the implant-supported prosthesis .
Use of adjunctive measures in peri-implant mucositis
Not recommended
NOT recommended
NOT suggested
NOT recommended
NOT suggested
NOT suggested
The use of locally administered antibiotics is not recommneded .
The use of locally administered agents (antiseptics, ‘postbiotics’, desiccant gel) as adjuncts to professional mechanical plaque removal (PMPR) is not suggested .
The use of photodynamic therapy adjunctively to PMPR is not suggested .
Open recommendation
Not recommended
NOT recommended
self-administration
The time-limited self-administration of oral rinse antiseptics (chlorhexidine and herbal-based) or the professionally guided self-administration of probiotics adjunctive to professional mechanical plaque removal (PMPR) may be considered .
It is not recommended to use systemic antibiotics .
This document is a graphic adaptation of the actual clinical practice guidelines and the reader is referred for the correct explanation to the original article: “Prevention and treatment of peri-implant diseases - The EFP S3 level clinical practice guideline” by Herrera and coworkers, Journal of Clinical Periodontology 2023 , https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.13823
www.efp.org
Made with FlippingBook Annual report