Maintenance and monitoring of dental implants in general dental practice

One of the most important factors for long-term success of dental implants is the maintenance of healthy peri-implant tissues. It is important, therefore, that all underlying dental disease is diagnosed, treated or stabilized before implant therapy starts.

This article will look at the long-term maintenance and monitoring of patients who may have had implants carried out within specialist practice, but return to their general practitioner for their ongoing care; a literature search was carried out.

Even though dental implants have been documented to have a high survival rate, it is becoming increasingly evident that successfully integrated implants are susceptible to disease which may lead to implant loss.1 Implant failure can be due to a number of causes that include unstable prosthesis, implant mobility, occlusal trauma, fractured components, pain, inflammation, infection and neuropathy.2

According to the Consensus Statement of the 6th European Workshop of Periodontology, failure has been described as early or late.3 Early failure occurs not long after placement without osseointegration being achieved. Late failure occurs in a successfully integrated implant some time after placement and subsequent restoration. The causes of late failure could be from disease of the marginal tissues of the implant or biomechanical overload.4 However, clinical trials of the ITI system reveals that only a small proportion of failures seem to be associated with occlusal overload.5 This implies that the major cause of late implant failures could be attributed to infection of the peri-implant tissues. It was noted that patients with good oral hygiene tended to keep implants longer.