Is implant flossing a possible risk for the development of peri-implnat disease?

Both in animal experiments and clinical studies, it was established that biofilm deposition on the implant surface was the important etiologic factor for the initiation and the maintenance of peri-implant inflammation and possibly subsequent loss of marginal bone. Prevention of peri-implant infections is therefore of utmost importance for long-term dental implant survival. Maintaining a high standard of oral hygiene is consequently very important for an optimal longevity of oral implants. In that context, cleansing of implants using interproximal cleansing devices is a necessity. A frequently recommended oral hygiene aid is dental floss or superfloss. However, the unrestricted use of these oral hygiene devices in regions with exposed roughened implant surfaces has to be questioned, as new evidences show that pieces of the floss may become trapped in the peri-implant sulcus. The purpose of this communication is to present the possible risks of dental floss encountered with either already existing peri-implantitis lesions or possible connection discrepancies between fixture and abutment. A prime example with diagnosis, treatment and 6 years follow up will be presented by mean of pictures, endoscopic clips, radiographs, recordings and electron microscope examinations.