Self‐administered proximal implant‐supported hygiene measures and the association to peri‐implant conditions

• Published in: Journal of periodontology (1970) 2021-03, Vol.92 (3), p.389-399
• Main Authors: Pons, Ramón, Nart, José, Valles, Cristina, Salvi, Giovanni E., Monje, Alberto
• Format: Article
• Language: English
• Subjects: Cross-Sectional Studies; Dental Implants - adverse effects; Humans; Hygiene; implantology; Oral Hygiene; Peri-Implantitis - epidemiology; Peri-Implantitis - etiology; plaque control; prosthodontics; risk factor(s); toothbrushing
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1002/JPER.20-0193

Background Dental plaque biofilm is considered to be the underlying cause of peri‐implant diseases. Moreover, it has been corroborated recently the association between the presence of these diseases and deficiently designed implant‐supported prostheses. In this regard, professional‐administered oral hygiene measures have been suggested to play a dominant role in prevention. Methods A cross‐sectional study was conducted in dental implant patients according to accessibility for self‐performed oral hygiene using a 0.5 mm interproximal brush. Periodontal and peri‐implant status were assessed based on clinical and radiographic variables to determine the prevalence of peri‐implant diseases. In addition, the participants completed a questionnaire on the efficiency and accessibility for self‐performed proximal hygiene. Associations of descriptive data were analyzed using the chi‐squared test and Mann‐Whitney U‐test. Correlations of the variables with the primary outcome (accessibility) were assessed by means of generalized estimation equations and multilevel logistic regression models. Results Based on an a priori power calculation, a total of 50 patients (171 implants) were consecutively recruited. From these, 46% of the prostheses allowed proper access for performing proximal hygiene whereas 54% of the prostheses precluded proper access. Poor access for proximal hygiene displayed tendency towards statistical significance with peri‐implant disease (OR = 2.31; P = 0.090), in particular with peri‐implant mucositis (OR = 2.43; P = 0.082) when compared to good access. In addition, an association was observed to increased levels of mucosal redness (P = 0.026) and the full‐mouth bleeding score (P = 0.018). On the other hand, the presence of peri‐implant disease was related to self‐reported assessment of oral hygiene measures (P = 0.015) and to patient perception of gingival/mucosal bleeding when performing oral hygiene (P = 0.026). In turn, the diagnosis of peri‐implant disease was significantly associated to the quantity and quality of information provided at the time of implant therapy (P = 0.004), including the influence of confounders upon disease occurrence (P = 0.038) Conclusions To a certain extent, accessibility for self‐performed proximal hygiene is associated to the peri‐implant condition. On the other hand, the information received by the patient from the dental professional is essential for self‐monitoring of the peri‐implant conditions and for alerting to