Best oral self-care practices for peri-implant conditions and diseases: a systematic review

IntroductionThe increasing prevalence of dental implants has brought greater attention to the prevention and management of peri-implant diseases, which can compromise long-term implant success. This systematic review evaluated the current evidence on oral self-care practices for maintaining peri-implant health in healthy, non-smoking adults.MethodsThis systematic review was reported in accordance with the PRISMA 2020 statement and registered in the PROSPERO database (CRD420251028140). PICO methods and guidelines for the Center for Evidence-Based Medicine were used to develop the focus question, “What are the best practices for oral self-care for the prevention and management of peri-implant conditions and diseases?” Risk of bias was determined by applying the ROBIS Tool to assess risk of bias in systematic reviews and the revised Cochrane risk of bias tool for randomized trials (RoB2).ResultsAcross 12 studies, interventions were categorized into five domains: toothbrushes, interdental aids, toothpaste, mouth rinses/topicals, and multi-modal self-care strategies. Powered toothbrushes, particularly oscillating-rotating models, demonstrated superior plaque and inflammation reduction compared to manual options. Triclosan-containing toothpastes consistently outperformed fluoride-only formulations in decreasing plaque, bleeding on probing, and pathogenic bacteria. Interdental aids such as interproximal brushes and oral irrigators were more effective than floss in reducing inflammatory markers. Stannous fluoride-based rinses showed potential anti-inflammatory benefits, while prolonged chlorhexidine use may elevate inflammatory cytokines.DiscussionA multimodal approach combining mechanical and chemical adjuncts was most effective for peri-implant disease prevention. These findings emphasize the importance of individualized, evidence-based home care protocols in preserving implant longevity and reducing peri-implant disease burden.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251028140, PROSPERO CRD420251028140.