One of the key factors in the long-term success of oral implants is the maintenance of healthy tissues around them. Besides the maintenance of the prosthesis, patients who have experienced the benefits of implant dentistry must be enrolled in a systematic individualized supportive care program, alternating visitations between the surgeon and the restorative dentist, to maintain the health of the peri-implant tissues. They must be informed of this before implant placement (see Appendix E).

Rationale for Plaque Elimination Around Dental Implants

Experimental and human studies have shown that long-standing plaque accumulation around dental implants induces inflammatory changes in the soft tissues that increase the risk of peri-implant diseases (Schou et al., 1993; Pontoriero et al., 1994). Consequently, one of the key factors for the long-term success of dental implants is the maintenance of healthy tissues around them (Esposito et al., 2010). However, there is no reliable evidence as to which regimens are most effective for long-term maintenance.

The development of peri-implant diseases is associated with an increase of bacterial species, such as P. gingivalis, T. forsythia, and A. actinomycetemcomitans, which are involved in the pathogenesis of periodontal diseases (Heitz-Mayfield & Lang, 2010). Therefore, it is not surprising that the prevention of peri-implant diseases is similar to the prevention of periodontal diseases and may include daily implant cleaning techniques by patients and regular cleaning by dental/>