Implant Maintenance

Dental implants have improved the quality of life, in particular, oral health-related quality of life, for patients with missing natural teeth (Ali et al., J Prosthet Dent 121(1):59–68.e3, 2019) [1]. Dental implants and supported restorations are placed in a relatively complex environment of the oral cavity surrounded with a highly diverse microbial ecosystem, saliva, masticatory forces, among others. Despite this environment, dental implants have high success and survival rates. However, the high success rate can drop in patients with certain patient-related and clinician-related risk factors. Poor oral hygiene, active periodontal disease, diabetes, and smoking are some common risk factors that contribute to implant complications and failures (Heitz-Mayfield and Salvi, J Clin Periodontol 45(Suppl 20):S237–S245, 2018) [2]. Hence, longevity and success in this environment require regular professional monitoring and maintenance, along with patient measures with risk factor reduction and at-home oral hygiene maintenance (Costa et al., Clin Implant Dent Relat Res 25(2):303–312, 2023) [3]. This chapter will describe clinical rationale for long-term regular implant maintenance for peri-implant health and function by exploring various etiology, biological and prosthetic risk factors, prevention and management of peri-implant diseases, and properly functioning prosthetic components. Clinical evidence and clinical protocols for supportive periodontal and peri-implant therapy including professional in-office maintenance and patient at-home maintenance and professional prosthesis maintenance will be discussed with clinical examples.