In a review article published in February 2019 in Periodontology 2000, Dr. Andrea Mombelli highlights maintenance therapy guidelines.
There are three components to maintenance therapy post periodontal therapy and implant therapy. These components include preventative measures taken by the patient, preventative procedures carried out by a dental professional, and “supportive periodontal therapy”. That last component is where the difference between prophylactic treatment and maintenance therapy is distinguished.
Recent studies have illustrated that tissue damage related to periodontal disease and peri-implantitis is attributed to biofilm, dysregulation of inflammatory pathways, and inadequate immune response. The pathogenesis varies between patients and even from site to site in the same patient. Therefore, individual assessments for each patient is necessary at each maintenance appointment. This type of assessment would not be necessary for a preventative prophylactic appointment.
Determining the frequency of maintenance therapy should be determined on an individual basis. Unfortunately, present knowledge and research are insufficient in guiding precise clinical decision making. It is necessary to use critical thinking and assess each patient as an individual focusing on recent changes and new pathology. The one thing that seems to be the most important factor that plays the biggest role in the success of preventative or maintenance therapy is patient compliance.
How do you determine frequencies of maintenance appointments? What adjunctive antimicrobial therapies do you use and have found most successful? What home care products do you recommend that have shown the most improvement for your maintenance patients? What is your secret to achieving optimal patient compliance? We welcome you to read the entire article and give us your feedback on maintenance therapy.
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