title: Clinical evaluation of an implant maintenance protocol for the prevention of peri-implant diseases in patients treated with immediately loaded full-arch rehabilitations.
abstract: OBJECTIVE
  The aim of this prospective study was to assess the outcomes of an implant maintenance protocol for implants supporting a full-arch rehabilitation.
  
  
  METHODS
  Sixty-one patients (28 women and 33 men) treated with immediately loaded full-arch rehabilitation, both mandibular and maxillary, supported by a combination of two tilted and two axial implants, were included in the study. Patients were scheduled for follow-up visits every 6 months for +2 years, then yearly up to 4 years. Each patient received professional oral hygiene treatment and detailed oral hygiene instructions. During each visit, modified plaque index, bleeding index and probing depth were assessed. The presence of peri-implant tissue inflammation was also evaluated.
  
  
  RESULTS
  Mean observation time, considering both mandible and maxilla, was 18.3 months ranging from 6 months to 5 years. Both plaque and bleeding indexes frequency decreased over time. Probing depth was stable (2.46 ± 0.5 mm at 4 years). Only three implants were lost due to peri-implantitis (1.4% at 12 months), whereas the incidence of peri-implant mucositis was less than 10% in each considered period.
  
  
  CONCLUSIONS
  The adoption of a systematic hygienic protocol is effective in keeping low the incidence of peri-implant mucositis as well as in controlling plaque accumulation and clinical attachment loss.
authors.affiliation: Department of Health Technologies, Milan University, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Corbella
authors.forename: M
authors.initials: M
authors.lastname: Del Fabbro
authors.forename: S
authors.initials: S
authors.lastname: Taschieri
authors.forename: F
authors.initials: F
authors.lastname: De Siena
authors.forename: L
authors.initials: L
authors.lastname: Francetti
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D003742:Dental Devices, Home Care; D015921:Dental Implants; D003773:Dental Plaque / Q000517:prevention & control; D003774:Dental Plaque Index; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003824:Denture, Complete; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000517:prevention & control; D006267:Health Education, Dental; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene / Q000295:instrumentation; D010353:Patient Education as Topic; D057873:Peri-Implantitis / Q000517:prevention & control*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000517:prevention & control; D011446:Prospective Studies; D013280:Stomatitis / Q000517:prevention & control; D014099:Toothbrushing / Q000295:instrumentation; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D015921:Dental Implants; D002710:Chlorhexidine