Prevention of periimplantitis - maintaining peri-implant tissues healthy

Prevention should take part at all levels of disease: Primary prevention immediately after insertion, secondary prevention at the first signs of periimplant mucositis and tertiary prevention after periimplantitis therapy. As prevention becomes more complicated and less predictable with progressing levels of disease, primary prevention plays an even more important role than in periodontitis or tooth-related diseases. However, the data base for the primary prevention of peri-implantitis is low and prevention is mainly based on mechanical plaque control, assisted by the use of disinfectants. Another risk factor oriented measure is the advice of smoking cessation. All these attitudes are well known from periodontitis and transferred to periimplant mucositis/perimplantitis. Additionally and specific for implants are efforts to develop implant surface coatings with antimicrobial characteristics. However, their efficacy remains unclear. Established and experimental strategies of prevention will be critically discussed and their scientific evidence highlighted in the presentation.