Prevention is the best treatment!
PD Dr. Kristina Bertl, PhD MSc MBA
The 18th European Workshop on Periodontology was held in autumn 2022 and focused on the treatment of peri-implant diseases. The results once again highlighted what a huge challenge the treatment of peri-implant diseases represents. This is why prevention should be a top priority.
Prevention can be broken down into various levels:
- Primordial prevention – This involves the reduction of risk factors for patients who are due to receive an implant in the future.
- Primary prevention – Primary prevention deals with patients who already have an implant and involves reducing risk factors that can encourage peri-implant diseases to develop.
- Secondary prevention – Secondary prevention aims to prevent peri-implant diseases from recurring in patients who have already been diagnosed and treated for such diseases.
- Tertiary prevention – Tertiary prevention deals with chronic diseases and attempts to slow down their progress and prevent complications in the course of the disease.
A French research group (Carra 2023) looked at precisely this topic during the 18th European Workshop on Periodontology. After conducting a systematic review of 48 studies, the group came to the following conclusions as regards primordial and primary prevention of peri-implant diseases:
- Primordial prevention of peri-implant diseases has not yet been examined in a scientific study.
- Primary prevention has been successful in the following areas:
- Diabetes control (11 studies): Diabetics who are managing their condition poorly have a higher risk of peri-implant diseases.
- Supportive implant therapy (14 studies): Regular and individually tailored supportive implant therapy reduces the risk for peri-implant diseases. The main goal here is to stress the importance of these accompanying measures to patients.
- Peri-implant soft tissue (17 studies): A widening of the peri-implant, keratinised mucosa reduces the risk of peri-implant diseases.
- Giving up smoking (4 studies) & oral hygiene habits (3 studies): Further scientific studies are required here in order to draw clear conclusions.
- Bruxism (0 studies): There is no scientific evidence on this.
In short, our goal with regard to peri-implant diseases should be primordial and primary prevention. We need to invest sufficient time in order to prevent subsequent complications that may be difficult to treat.
- Carra, M. C., Blanc-Sylvestre, N., Courtet, A., & Bouchard, P. (2023). Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis. Journal of Clinical Periodontology, 1–36.