To report on a possible relationship between the use of dental floss or superfloss and the development of peri-implantitis.
Materials and methods
patients with progressive peri-implantitis with an intensive oral
hygiene protocol, which consisted of extensive professional supra- and
submucosal cleaning, and not responding to this therapy were scheduled
for examination. Plaque and bleeding indices and probing depth
measurements were assessed, and radiographic examination was performed
every two years.
all ten cases, remnants of dental floss were found around the neck and
coronal part of a dental implant. After careful removal of these floss
remnants and implant cleansing, a significant improvement in the
peri-implant conditions in nine of ten cases was noted. In one case,
peri-implant probing depth decreased substantially. However, bleeding on
probing was still present. In vitro testing yielded that the
application of various types of dental floss on the exposed rough
implant surfaces may easily lead to tearing of floss fibers. This may
result in the deposition of floss remnants on rough implant surfaces,
which, in turn, may lead to the development of plaque-related
peri-implant inflammation and, subsequently, bone loss.
case of exposed rough surfaces of the dental implant, the peri-implant
conditions may be jeopardized by the application of dental floss, and
hence, the utilization of interproximal brushes or toothpicks may be
preferred for daily home care practices.