The maintenance of gingival health around implants is of increasing concern to dentists and dental hygienists.
As you are well aware, the incidence of mucocitis, which is inflammation and bleeding around implants without bone loss, and peri-implantitis which actually has the same clinical appearance except there is clinical bone loss, are clinical entities that are becoming important as more and more implants have been placed.
How to maintain the health of the gingiva around the implants to preclude mucocitis is of concern to dental hygienists.
A new study comparing dental floss and water irrigation was recently completed with some interesting and important findings. Essentially, one group used dental floss and tooth brushing around the implants and the other group used tooth brushing and the use of a water irrigator.
At Day 14, 50% of the patients who used floss along with brushing had bleeding upon probing. At Day 30, 67% of the flosser/brushers had bleeding around implants. In the water irrigator group at Day 14, only 23% had bleeding upon probing; and at Day 30 only 18% had bleeding upon probing.
The study is important because it reveals the value of rigorous irrigation around the surface of an implant. It may well be that the soft debris that accumulates in the sulcus is more easily removed around the implant with a water irrigator as compared to removal around a natural tooth. In any event, my clinical experience using a water irrigator, personally and with my patient population, has shown there is an improvement in inflammation when a water irrigator is used on a daily basis and preferably twice a day.
It’s important to note that this is one of the first controlled studies that looks at two measures of plaque control which are attempting to maintain gingival health.
As always, your input is appreciated and valued.
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Victor Sternberg, D.M.D.