Maintenance-driven Implant Treatment

Abstract

Implant treatment must transition to a maintenance-driven approach over time. The authors have been involved in implant treatment for 35 years, and initially, the focus was on implant surgery. As implants became more widespread, it was found that although implants were placed, they caused inconveniences in prosthetics. Consequently, the concept of top-down treatment and prosthesis-driven implant treatment was proposed. With advancements in diagnostic technologies such as CT scans, it has become possible to visualize the superstructures, that is, prosthetics, in detail before starting treatment, leading to clinical success.

Both practitioners and patients must recognize that the placement of the superstructure is not the goal of implant treatment, but rather the second start. While the period until the placement of the superstructure is at most about two years, the time required to maintain the superstructure can exceed 30 years in our clinical cases, overwhelmingly longer than the former. Considering everyday clinical practice, the concept of maintenance-driven treatment, which goes a step further than prosthesis-driven treatment, aligns more closely with the actual circumstances.

The most important aspect of maintenance is to prevent peri-implant diseases and to stop their progression if they occur. We discuss actual maintenance practices, precautions, and areas for improvement in dealing with peri-implant diseases to protect implants, based on their day-to-day clinical efforts.