Protocolli di igiene per il mantenimento di protesi rimovibili, overdenture e Toronto su impianti

OBJECTIVES The gradual increase in the age of the general population, world-wide, will favor the presence of partially or completely edentulous elderly. Edentulous condition lim-its the subject’s ability to perform some essential tasks in life, such as speaking and eating, as associated to the progressive alveolar bone resorption and the reduction of masticatory performance. It can compromise the aesthetics of the face with a negative impact on not only oral, but also general health and psychosocial well-being. In these patients, prosthetic rehabilitation plays a fundamental role, in the perspective of ensuring a high-level quality of life. The aim of this manuscript is to describe oral hygiene procedures, performed both at home and at the dental clinic, keystones for oral health prevention and for the long-term maintenance of pros-theses. MATERIALS AND METHODS This narrative review emphasizes the risk of biofilm colonization of the prosthetic surfaces, and it fo-cuses on the main methods for the hygienic maintenance of re-movable prosthesis, overdenture and Toronto prosthesis. An updated search of recent scientific literature has been, thus, carried out to provide, based on the clinical data available so far, useful advic-es for the patient to be followed at home, and for the dental team to be performed at the dental chair. CONCLUSIONS The compliance of the patient is mandatory for the successful treatment plan at long-term; this can be achieved by motivating the patient in a stimulating and repeated manner over time, providing him precise and personalized oral hygiene instructions, and in-cluding him in a personalized re-call program with periodic dental visits and regular professional oral hygiene sessions. During the re-call visits, it is essential to check the status of the prostheses and of the dental and mucous tissues, as well as renewing the patient’s oral hygiene instructions. The recommended interval of these visits varies according to the plaque control of the patient. It should be at least annual for the patient with a traditional removable prosthesis or overdenture, while more frequent in the case of Toronto rehabilitations based on implants. In the latter case, the follow-up varies between three and six months and involves the removal of the prosthesis from patient’s oral cavity and the cleaning of the underlying implants. CLINICAL SIGNIFICANCE The dental team is responsible for instructing the patient about the successful home maintenance of traditional removable prosthetic rehabilitation, overdenture or To-ronto prosthesis. It is essential that all the oral health professionals in-volved in the management of the rehabilitated patient, in particular the dentist and the dental hygien-ist, are prepared on the methods to be recommended to the patient for the correct home cleansing of prostheses, teeth and implants, as well as on the methods to be performed in the outpatient setting. Home and professional oral hygiene procedures for the maintenance of prostheses are crucial for the long-term success of rehabilitation. The frequency of control visits and professional hygiene sessions will be modulated according to the needs of the patient and established based on the type of prosthesis, patient’s manual ability and his compliance.