The following consensus report is based on four background reviews. The frequency of maintenance visits is based on patient risk indicators, homecare compliance and prosthetic design. Generally, a 6‐month visit interval or shorter is preferred. At these visits, peri‐implant probing, assessment of bleeding on probing and, if warranted, a radiographic examination is performed. Diagnosis of peri‐implant mucositis requires: (i) bleeding or suppuration on gentle probing with or without increased probing depth compared with previous examinations; and (ii) no bone loss beyond crestal bone level changes resulting from initial bone remodelling. Diagnosis of peri‐implantitis requires: (i) bleeding and/or suppuration on gentle probing; (ii) an increased probing depth compared with previous examinations; and (iii) bone loss beyond crestal bone level changes resulting from initial bone remodelling. If diagnosis of disease is established, the inflammation should be resolved. Non‐surgical therapy is always the first choice. Access and motivation for optimal oral hygiene are key. The patient should have a course of mechanical therapy and, if a smoker, be encouraged not to smoke. Non‐surgical mechanical therapy and oral hygiene reinforcement are useful in treating peri‐implant mucositis. Power‐driven subgingival air‐polishing devices, Er: YAG lasers, metal curettes or ultrasonic curettes with or without plastic sleeves can be used to treat peri‐implantitis. Such treatment usually provides clinical improvements such as reduced bleeding tendency, and in some cases a pocket‐depth reduction of ≤ 1 mm. In advanced cases, however, complete resolution of the disease is unlikely.

No abstract

The aim of the present study was to use a decision making model in order to assess the periodontal treatment needs of a random sample of employees in a large Swedish industrial corporation. The model used provided data on critical bone loss limits for different tooth types and ages, beyond which treatment must be initiated, in order to fulfill the goal of maintaining all teeth in a functional state throughout life. A sample comprising 192 subjects belonging to four age strata (31-35 yr, 41-45 yr, 51-55 yr, and 61-65 yr) was involved. From each subject, a full mouth series of intra-oral radiographs were available. The radiographic bone height was assessed at the mesial and distal aspect of all teeth by measuring the distance between the cementoenamel junction and the bone crest. The clinical examination included assessments of plaque, gingivitis, probing pocket depth, and probing attachment level. The results revealed that (i) only 3.1% of all approximal tooth sites exhibited radiographic bone loss exceeding the critical limit, (ii) all individuals and 70% of the approximal tooth sites were in need periodontal treatment when presence of gingival inflammation (bleeding on probing) was employed as the single criterion for therapeutic intervention, (iii) the proportion of individuals and tooth sites requiring treatment amounted to 98% and 27%. respectively, when a probing pocket depth of at least 4 mm was included as an additional criterion, and 54% and 4.1%, respectively, if a probing depth threshold of 6mm was used, while (iv) the use of bleeding on probing in combination with radiographic bone loss beyond the critical limits disclosed a need of treatment in 40% of the subjects and 2.5% of the approximal tooth sites.

Since the number of reports on RPD is very few, it was difficult to evaluate the RPD treatment for periodontally compromised patients. From the results of some long-term follow-up retrospective studies, however, it was suggested that FPD of high-risk design showed excellent results. Regarding management in periodontits- susceptible subjects, it should be discussed whether positive prosthodontic treatment is necessary. Strict plaque control by both doctors and patients before/after treatment is indispensable for prosthodontic management in periodontally compromised patients.

Although there were only a few long-term follow up studies, it was indicated that individuals who had susceptibility to periodontal disease can be treated successfully with the implants. In all reports, treatment for infection was done before implants installation, and the importance of regular maintenance after the installation has been emphasized. From this literature review, it was advocated that periodontally compromised patients could be treated successfully with the implants. However, implant therapy should be reconsidered if oral infection cannot be satisfactorily controlled.