Maximising the longevity of implants
Featured Products Promotional FeaturesPosted by: Dental Design 26th July 2023
Implant therapy has become an increasingly popular treatment option for both dentists and patients alike over the past decade. According to the Association of Dental Implantology around 130,000 individual implants are placed each year in the UK, [i] providing life-enhancing functional and aesthetic benefits to edentulous patients.
Successful implant therapy is defined not only by the immediate achievement of the therapeutic goal, but, importantly, by the maintenance of a functional, stable, and aesthetically acceptable tooth replacement for the patient. [ii] It is, therefore, clear that longevity plays a central role in evaluating implant treatment.
It has proven complicated to ascertain an accurate measure of the average longevity of implant treatment, with some studies deeming “success” as “survival”, with even “ailing” or “failing” implants considered successful. ii However, to give some indication, Hartog and co-workers reported a survival rate of 95.5% after one year of follow-up, ii and even a study providing 20-year data on implants reported a success/survival rate of 75.8%/89.5%. ii
So, while the success rate is generally positive, there is clearly potential for clinicians to help in maximising the longevity of implants for their patients, thus avoiding further destruction of oral health, or costly surgical replacement of a failed implant.
Avoid infection and improve healing
There are a myriad of factors affecting the longevity of dental implants, including infection management, which remains an important area of concern for clinician and patient throughout the treatment journey.
Early treatment failure rates are often attributed to failed osseointegration within several weeks to months, usually due to bacterial infection, bone necrosis, surgical trauma, inadequate initial stability, or premature occlusal loading. [iii] As we know, it’s vital to assess a patient’s mouth for any active gingival disease in advance of treatment as untreated infection could spread and develop around the implant, resulting in implant failure. iii While bacterial infection can occur at any time during the implant process, it is of particular concern in the early healing period. [iv]
Late failure also often occurs because of infection. iii Jemt et al. reported that a history of periodontitis was closely linked with inflammation at the implant site that could cause peri-implantitis, which may be because of the transmission of periodontal pathogens from the teeth to the implant. [v]
Although it is suggested that smoking alone does not increase the incidence of late implant failure, v it is advisable to make patients aware of the potential impact of smoking on the success and longevity of their dental implant treatment, in addition to the implications on their wider health. For example, a study by Queiroz et al. found an increased presence of salivary arginase activity in smokers with dental implants that results in an increased susceptibility to bacterial infection and implant failure. [vi]
Thanks to the factors mentioned above, it is clear that infection management should be a consistent focus for the clinician and patient before, during and after implant treatment. Patients should be made aware of the importance of good oral hygiene as an integral part of infection prevention and management, and to ensure the long-term survival of their implant(s).
Ensure excellent oral hygiene
There are a number of at-home implant care methods a clinician can share to improve and maintain a patient’s oral hygiene.
Twice daily cleaning around implants using a soft bristled toothbrush or gentle power brush is recommended to remove bacterial plaque accumulation. [vii] For those patients prone to occasional tissue inflammation, daily cleansing with chemotherapeutic agents like rinses, gels, or solutions, can help further. ix
Interdental cleaning is also important in optimising gingival health and preventing oral disease, thereby creating a healthy site primed for successful dental implant treatment. A study by Marchesan et al. found that interdental cleaning is associated with less periodontal disease, and a higher frequency of interdental cleaning (4–7 times per week) was also linked with less interproximal periodontal disease. [viii]
With this in mind, why not recommend the innovative and easy-to-use Waterpik® Water Flosser with the Plaque Seeker™ tip to help patients clean around implants and promote healthy gums. Clinically proven to be twice as effective as string floss for dental implant patients, [ix] never has it been so easy for patients to improve their oral health and enjoy the cleanest, freshest mouth possible from home.
Oral hygiene and healing
The relationship between oral hygiene and soft tissue healing and maintenance around implants is a tightly woven one. By promoting the benefits of a healthy oral status, and the products and methods to achieve and maintain this, clinicians will be able to support dental implant patients and help them enjoy the benefits of their treatment long into the future.
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Join the 3,000+ dental teams who have already benefitted from a professional Waterpik® Lunch & Learn. Book your free session for 1 hour of verifiable CPD and a free Waterpik® Water Flosser – available either face to face or as a webinar – at www.waterpik.co.uk/professional/lunch-learn/.
Anne Symons is a Dental Hygienist currently working in a Specialist Periodontal/implant practice and also a busy NHS surgery. She has previously worked in a Max Fax unit, and also taught Oral Health care to staff in Nursing and Residential homes. Anne is also a Professional Educator for Waterpik
[i] Association of Dental Implantology. (2012) A Dentist’s Guide to Implantology. Available at: https://issuu.com/adidental/docs/adi-dentist-guide [Last accessed 11.08.2021].
[ii] Setzer FC, Kim S. Comparison of long-term survival of implants and endodontically treated teeth. J Dent Res. 2014;93(1):19-26. doi:10.1177/0022034513504782. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872851/ [Last accessed 11.08.2021].
[iii] Raikar S, Talukdar P, Kumari S, Panda SK, Oommen VM, Prasad A. Factors Affecting the Survival Rate of Dental Implants: A Retrospective Study. J Int Soc Prev Community Dent. 2017;7(6):351-355. doi:10.4103/jispcd.JISPCD_380_17. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774056/ [Last accessed 11.08.2021].
[iv] Mohajerani H, Roozbayani R, Taherian S, Tabrizi R. The Risk Factors in Early Failure of Dental Implants: a Retrospective Study. J Dent (Shiraz). 2017;18(4):298-303. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702435/. [Last accessed 11.08.2021].
[v] do, Thanh An & Le, Son & Shen, Yen & Huang, Heng Li & Fuh, Lih-Jyh. (2020). Risk Factors related to Late Failure of Dental Implant-A Systematic Review of Recent Studies. International Journal of Environmental Research and Public Health. 17. 10.3390/ijerph17113931. Available at: https://www.researchgate.net/publication/341822410_Risk_Factors_related_to_Late_Failure_of_Dental_Implant-A_Systematic_Review_of_Recent_Studies [Last accessed 11.08.2021].
[vi] V Kasat, R Ladda. Smoking and dental implants. Journal of International Society of Preventative & Community Dentistry. DOI: 10.4103/2231-0762.109358. Available at: https://www.jispcd.org/article.asp?issn=2231-0762;year=2012;volume=2;issue=2;spage=38;epage=41;aulast=Kasat. [Last accessed 11.08.2021].
[vii] Gulati M, Govila V, Anand V, Anand B. Implant Maintenance: A Clinical Update. Int Sch Res Notices. 2014;2014:908534. Published 2014 Jul 9. doi:10.1155/2014/908534. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897104/ {Last accessed 11.08.2021].
[viii] Ng E, Lim LP. An Overview of Different Interdental Cleaning Aids and Their Effectiveness. Dent J (Basel). 2019;7(2):56. Published 2019 Jun 1. doi:10.3390/dj7020056. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630384/ [Last accessed 11.08.2021].
[ix] Waterpik UK. Dental Implant Care. Available at: https://www.waterpik.co.uk/oral-health/dental-needs/dental-work/implants/ [Last accessed 11.08.2021].
