title: Mechanical self-performed oral hygiene of implant supported restorations: a systematic review.
abstract: A systematic review of self-performed oral hygiene practices for optimal maintenance of dental implant-supported restorations reveals a lack of evidence to support best practices.
  
  
  BACKGROUND
  The standard of the patients' home care is a key factor for long term stability of dental implants and the prevention of biological complications. The objective of this systematic review is to evaluate and summarize the literature with respect to various mechanical oral hygiene modalities around implant-supported restorations.
  
  
  METHODS
  MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to October 2013 to identify eligible studies. Five studies that met the inclusion criteria were included. Two cohort studies about powered toothbrushes and three (randomized) controlled trials comparing powered to manual toothbrushes were reviewed. All studies showed an improvement in the clinical parameters over time. Powered toothbrushes were found to perform better than manual toothbrushes but no firm conclusions can be made between treatment modalities.
  
  
  CONCLUSIONS
  There is a lack of evidence with respect to effective and optimal self-performed oral hygiene around dental implants. At present, home care recommendations are based on the knowledge that is available with respect to cleaning of natural teeth. It becomes evident that there is an urgent need for academic institutions and industry to initiate and support high quality randomized controlled clinical trials on this topic in the near future.
authors.affiliation: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. Electronic address: A.Louropoulou@acta.nl.
authors.forename: Anna
authors.initials: A
authors.lastname: Louropoulou
authors.affiliation: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
authors.forename: Dagmar E
authors.initials: DE
authors.lastname: Slot
authors.affiliation: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
authors.forename: Fridus
authors.initials: F
authors.lastname: Van der Weijden
mesh_terms: D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D006801:Humans; D009910:Oral Hygiene / Q000295:instrumentation / Q000379:methods*; D014099:Toothbrushing / Q000295:instrumentation
chemical_list: D015921:Dental Implants
keywords: Dental implants; oral hygiene; systematic review