Guidance for the maintenance care of dental implants: clinical review.

As implant treatment becomes part of mainstream dental therapy, dental offices should implement protocols for individualized, systematic and continuous supportive care of the peri-implant tissues. This review article suggests guidelines for maintenance care of dental implants. The preliminary assessment should begin with updating the patient's medical and dental histories. The clinical implant should be examined to evaluate the following: condition of the soft tissues, plaque index, clinical probing depth, bleeding on probing, suppuration, stability of soft-tissue margins, keratinized tissue, mobility and occlusion. If the clinical signs suggest the presence of peri-implantitis, radiography of the site is advisable, to confirm the diagnosis. Appropriate treatment should be pursued according to any diagnosis reached during the examination, including (but not limited to) instructions on oral hygiene, removal of supra- and sub-gingival plaque and calculus, occlusal adjustment, relining of a removable prosthesis or surgery.