Periodontal treatment and supportive care of patients with implant-prosthetic rehabilitation

OBJECTIVES The aim of this second Module is to emphasize the importance of periodontal preparation of the patient who has to undergo implant therapy and how to monitor effectively the implants during supportive therapy. The article de-scribes the conditions of implant health, mucositis and peri-implantitis according to the new classification of periodontal and peri-implant diseases published in 2018. The risk factors and indicators for peri-implant diseases will be investigated and the development of correct non-surgical therapy during primary and secondary prevention of biological complications around implants will be discussed. MATERIALS AND METHODS The most recent literature avail-able was analyzed and found through the main databases (PubMed, Scopus, Google Scholar and Cochrane Library). A clinical case was used to better explain how to treat a patient with periodontal disease before implant therapy. RESULTS The data in the literature highlight the importance of the prevention of biological complications around implant rehabilitation because surgical and non-surgical treatment of such complications is not as effective as periodontal treatments performed on natural teeth. The literature also points out that implant therapies on patients who are not periodontally stable lead to more complications in the medium term. Dental implant complications, mucositis and peri-implantitis, need to be prevented through a constant patient monitoring. CONCLUSIONS The dentist and dental hygienist must cooperate to control the periodontal disease of the patient candidate for implant rehabilitation. It is equally important to constantly monitor implant-prosthetic rehabilitation over time to prevent biological complications such as peri-implantitis, for which there is no validated therapy protocol to date. The last section of the paper underlined the importance of recall frequency customization, depending on patient susceptibility. CLINICAL SIGNIFICANCE The correct periodontal approach to the patient candidate for implant-prosthetic rehabilitation is a topic that the clinician needs to know and apply in his/her daily practice. In addition, being able to easily recognize the first signs of implant pathology is equally important for the long-term success of rehabilitation.