How often should implant-supported full-arch dental prostheses be removed for supportive peri-implant care to maintain peri-implant health? A systematic review

PURPOSE

To systematically screen and summarise the available literature on when and how often it is advisable to perform supportive peri-implant care on implant-supported full-arch dental prostheses to maintain peri-implant health.

MATERIALS AND METHODS

The authors employed the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the Population, Intervention, Comparison and Outcomes tool. A literature search was conducted on PubMed for randomised controlled trials, controlled clinical trials and cohort studies, reporting results on supportive peri-implant care for full-arch dental prostheses with a follow-up period of at least 1 year. The studies were selected in a blind process with an agreement rate of 100%. For all the included studies, quality assessment was performed according to the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS

The application of the search terms on PubMed led to the selection of 915 results. Only 11 studies were included in the review. Eight of these reported the frequency of supportive peri-implant care, and three detailed the procedures adopted. The number of patients included ranged from 15 to 85, with a mean age from 60.4 to 68.4 years. None of the included studies were judged to be at low risk of bias.

CONCLUSIONS

Removal of implant-supported prostheses is a crucial aspect in the long-term care of patients rehabilitated with full-arch restorations. Although no specific indications can be drawn with respect to the frequency at which supportive peri-implant care should be delivered and the regime used to do so, practitioners should consider performing professional oral hygiene measures every 6 months and removing prostheses at least once per year. All interventions should be tailored to the patient's risk profile and characteristics.

Comparison of two electric toothbrushes: evaluation on orthodontic patients

BACKGROUND

The effectiveness of different types of electric toothbrushes in terms of removing bacterial plaque is still a debated issue. The aim of the study was to compare the plaque removal after a single use of two types of electric toothbrushes, sonic and roto-oscillating, in patients with fixed orthodontics.

METHODS

Twenty-five subjects with fixed multibrackets appliances were randomly selected. Plaque scores were detected using a fluorescein-based detector. After using the sonic toothbrush with a surfactant-free toothpaste, the plaque scores were detected again. After 3 months, the procedure is performed again following the same methods, using the roto-oscillating toothbrush. For the statistical analysis a Student's t-test using Microsoft Excel 2021 (Microsoft Corp., Redmond, WA, USA) was performed. The differences were considered statistically significant for probability values P<0.05.

RESULTS

It can be seen that the brushing carried out with a sonic technology is more effective than the roto-oscillating technology. However, the FMPS, MOPI and OPI indexes do not show differences between the use of the two toothbrushes. The OHI-S index shows a statistically significant difference using the sonic toothbrush with a significance level of 0.05%.

CONCLUSIONS

It can be said that both electric toothbrushes are effective for maintaining a good home oral hygiene in patients with fixed orthodontics.

Management of Oral Hygiene in Head-Neck Cancer Patients Undergoing Oncological Surgery and Radiotherapy: A Systematic Review

Background: In the literature, among oral health prevention programs dedicated to cancer patients, a wide heterogeneity is evident. The purpose of this work is to analyze the available scientific evidence for the treatment of head and neck cancer (HNC) patients undergoing resective surgery and radiotherapy and to draw up a diversified oral hygiene protocol during oncological therapy. Methods: PubMed was used as database. Studies published from 2017 to September 2022 were analyzed. Studies investigating the effectiveness of the preventive procedures carried out by the dental professionals in HNC patients undergoing postoperative adjuvant therapy have been taken into account. Results: The application of the search string on PubMed allowed the selection of 7184 articles. The systematic selection of articles led to the inclusion of 26 articles in this review, including 22 RCTs, 3 observational studies, and 1 controlled clinical study. Articles were divided according to the debated topic: the management of radiation-induced mucositis, xerostomia, the efficacy of an oral infection prevention protocol, and the prevention of radiation-induced caries. Conclusions: Dental hygienists are fundamental figures in the management of patients undergoing oncological surgery of the maxillofacial district. They help the patient prevent and manage the sequelae of oncological therapy, obtaining a clear improvement in the quality of life.

Consensus Report of the Technical-Scientific Associations of Italian Dental Hygienists and the Academy of Advanced Technologies in Oral Hygiene Sciences on the Non-Surgical Treatment of Peri-Implant Disease

BACKGROUND

The recent publication of the new classification of periodontal and peri-implant disease has given clear indications on the parameters to be taken into consideration to correctly diagnose the different phases of these diseases. To date, however, there are no equally clear indications on the treatments to be implemented to solve these diseases. The objective of this Consensus Report is to provide guidance for the non-surgical management of peri-implant mucositis and peri-implantitis. For the drafting of the consensus, the most recent scientific literature was analysed.

MATERIALS AND METHODS

A group of 15 expert Italian dental hygienists were selected by the Italian technical-scientific societies (AIDI, UNID and ATASIO) and, starting from the literature review, they formulated indications according to the GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation, a tool for rating the quality of evidence, used to draw up systematic reviews and clinical guidelines) on the treatment of peri-implant mucositis, peri-implantitis and on management of the various implanting surfaces.

CONCLUSIONS

in accordance with the international literature, non-surgical therapy alone can resolve peri-implant mucositis, but not peri-implantitis. Several adjunctive therapies have been considered and some appear to be helpful in managing inflammation.