Peri-implantitis. Part 2: Prevention and maintenance of peri-implant health.

The prevention of any disease process should be the cornerstone of any healthcare provision. This ethos is well established in dentistry with plaque associated disease such as periodontitis and caries but is at the current time less developed for peri-implantitis. The current review identities potential modifiable and non-modifiable risk factors for per-implantitis development and details strategies for the prevention of the disease. These include poor oral hygiene, previous history of periodontitis, smoking, genetic factors, occlusal overload and foreign body reactions. Local factors include soft tissue and bone quality, implant positioning, restoration design and the implant-abutment interface. An implant maintenance protocol is proposed and a schematic for maintenance visits is also detailed.