Supportive care and maintenance of dental implants

Dental Implant Support Care and Maintenance

Jenny Walker and Kathryn Mayo explain the role of dental hygienists and dental therapists in maintaining dental implants.

As dental technology and materials science continue to advance, dental implants have become the gold standard for restorations that look, feel, and function like natural teeth. However, while the demand for implants continues to grow, there is growing evidence of the susceptibility of implant patients to peri-implant disease. These include perimucosal and peri-implantitis, which may lead to implant failure.

Dental hygienists and therapists play an integral role in the early detection of implant disease. Additionally, provides personalized patient care within maintenance programs. Therefore, knowledge of risk factors for peri-implant disease and early disease detection are crucial for appropriate management.

A team approach to implant treatment and patient education on the importance of supportive care are essential. This should include, but is not limited to, periodontal assessment, risk assessment and obtaining patient consent. Before embarking on the implant journey, patients should be fully informed of the proposed post-treatment support care commitments.

maintenance agreement

Studies show that patients who receive supportive dental implant treatment have lower rates of peri-implant disease. Patients without regular maintenance may have a 4.25-fold increased risk of peri-implantitis. Therefore, supportive care should be considered necessary (Frisch et al., 2020).

During maintenance therapy, collecting necessary baseline data for reference is key to identifying early signs of peri-implant disease. Peri-implant mucositis caused by biofilm is a reversible condition and a precursor to peri-implantitis. Therefore, it is crucial to detect perimucositis early enough to reverse the condition.

Removes plaque and biofilm

Implant maintenance includes professional mechanical plaque removal (PMPR) to remove plaque biofilm and plaque-retaining factors on natural teeth and dental implants on and subgingivally/marginally. PMPR is an important component of plaque control, especially for patients with full-arch fixed implant-supported prostheses (Yang et al., 2021).

Air polishing (using a low-abrasive soft powder) is a highly effective method of destroying the biofilm around dental implants. It induces minimal surface modification of any instrumentation mode, providing a minimally invasive method of accessing around and beneath implant prostheses and structures. This is an extremely simple, quick and comfortable treatment. It is well accepted by patients and may also aid in recall of compliance.

Ultrasonic equipment has some use around implants, particularly in peri-implantitis, where the equipment can work well on implant threads. It should be noted that any ultrasound using a stainless steel tip will significantly alter the implant surface. Therefore, a “pros and cons” approach should be adopted. Plaque-retaining factors on implants are generally not as strong as those on natural teeth. When considering potential surface modification, low power is recommended.

The NSK Varios Combi Pro is a device that combines ultrasonic scaling and powder treatment for efficient implant maintenance. The Varios Combi Pro features a removable chamber and handpiece that allows for easy switching between supragingival (enamel only) application to remove staining and subgingival application to disrupt biofilm below the gum line. In the case of implants, only the subgingival chamber is combined with an appropriate powder.

team approach

Ultimately, the role of the entire dental team is to support the patient throughout the dental implant process, encouraging them to maintain optimal biofilm control at home and engage in a supportive care plan over the long term.

Teams should also be prepared to address changes in risk factors that may occur with age and adjust their approach accordingly to ensure the longevity of their implant work. While preserving natural teeth should be prioritized whenever possible, dental implants provide a solution for missing teeth and can significantly improve a patient’s quality of life.

Comprehensive planting support management

For hygienists and therapists looking to expand their knowledge of dental implant maintenance, Kathryn Mayo and Jenny Walker will host an exclusive NSK Ikigai Live event 'Comprehensive Implant Support Management' on Saturday 2nd November 2024 in North London. This course consists of a full day of lectures and practical sessions exploring the principles of managing and supporting patients throughout the implant process from a dental hygiene perspective.

For full details and to book, visit

For more information about Varios Combi Pro, please visit

refer to

  • Frisch E, Vach K, Ratka-Krueger P. Journal of Clinical Periodontology. 2020 Jan;47(1):101-109. doi:10.1111/jcpe.13206. Epub November 6, 2019.
  • Yang Jie et al. BMJ Open 2021;11:e053286. doi:10.1136/bmjopen-2021-053286.

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