[A PhD completed. Prevention and treatment of peri-implant diseases: cleaning of titanium dental implant surfaces].

The effect of various instruments on titanium dental implant surfaces was evaluated. Furthermore, a clinical guideline was developed regarding the diagnosis, prevention and treatment of peri-implant diseases. Air abrasive devices appear to be the most suitable meachnical instruments to remove biofilm from implant surfaces. From the available chemotherapeutica, (citric)acid and hydrogen peroxide seem to have the best potential. Regular controls and meticulous maintenance from both the patients and dental care professionals are mandatory to avoid problems. Baseline clinical and radiographic recordings are important to be able to follow implants over time and to differentiate between health and disease. The first time to assess probing pocket depths around implants should be preferably around 8 weeks after prosthetic installation. Changes in clinical and/or radiographic parameters can be an alarming sign. Patients should receive individually tailored instructions for optimal oral hygiene. Prevention and early diagnosis is the key for long-term success with dental implants.