Source: Implantologie Journal 3 / 2015
Authors: Jenny Hoffmann, Oemus Media
A number of studies published in recent years show that one third to one half of all implants are subject to the danger of periimplant diseases.1 Without adequate treatment these will generally result in loss of the implant. The risk of inflammation of the periimplant hard tissue (periimplantitis) and/or soft tissue (periimplant muscositis) is particularly high for patients with periodontitis and it significantly increases the risk of implant loss.2 Therefore a suitable prophylaxis concept for the period after implantation is very important.
Consultation and compliance
While a consistent recall programme with regular check-ups is important, the active cooperation of the patient in the maintenance of oral hygiene at home is equally important for reducing the risk of periimplant disease. Because the attachment of the gum with the implant is looser than the natural attachment to the tooth, biofilm can more easily accumulate in the intermediate spaces. The patient should therefore be made aware of recommended hygiene practices for daily cleaning. Prophylaxis should also include advice in risk reduction, such as avoiding tobacco and alcohol.
Professional implant cleaning
In contrast with conventional treatment, differences in the tissue must be taken into account during professional implant cleaning and periimplantitis treatment. The use of metallic hand scalers and curettes should be avoided as much as possible to prevent scratching or roughening the surface of the implant. Even when plastic hand instruments are used, great care is required due to the increased sensitivity of the periimplant tissue.
Currently abutments and implant crowns are mostly cleaned mechanically by air-polishing with low-abrasion powder or special ultrasonic scalers. A chemical disinfectant solution and, more and more frequently, photodynamic therapy (PDT) are used as adjuvant measures for decontamination.
The W&H Tigon+ piezo scaler is equally suitable for periodontic and periimplant treatments.
Atraumatic removal of concretions
The Tigon+ (W&H) has become one of the most commonly used ultrasonic scalers, offering flexibility and atraumatic functioning. This piezo scaler can save time and offer versatility with four preset programs and one customisable program.
With its prophylaxis and periodontal settings using special implantology tips the Tigon+ is ideal for periimplantitis treatment. The adjustable power ensures atraumatic removal of deposits. In basic mode the scaler power remains constant regardless of the pressure on the tooth or implant, and in smooth mode the greater the pressure of the tip of the instrument the lower the power. In power mode the power is increased as the resistance increases. This offers the correct setting for every situation, to avoid injuries and an unpleasant feeling in the mouth of the patient.
The piezo scaler comes with a set of periodontal and prophylaxis tips. The plastic 1i Implant-Clean tip can be also be used for atraumatic and thorough cleaning of implants and the associated superstructures.
The ergonomic design of the Tigon+ and the illumination with the 5x ring LED make removal of concretions simple and efficient. The facility for heating the coolant fluid also enables treatment of sensitive areas without irritation.
Four preset programs and one customisable program ensure efficiency.
The good illumination with the 5x ring LED makes removal of concretions simple and efficient.
Conclusion
The high sensitivity of periimplant tissue requires careful use of suitable instruments for treatment of the tissue and professional implant cleaning. Treatment with the piezo scaler used here is particularly atraumatic for the tissue and reduces stress for the patient, and at the same time the dentist can work quickly and efficiently with programs designed for specific situations. This means that the patient is more prepared to cooperate with regular check-ups and cleaning and greatly increases the chance that periimplantitis will be prevented successfully.
References
1 Academy Report: Peri-Implant Mucositis and Peri-Implantitis: A Current Understanding of Their Diagnoses and Clinical Implications. Journal of Periodontology. April 2013, 84:4, 436–443.
2 Sgolastra F, Petrucci A, Severino M, R Gatto, Monaco A: Parodontitis, Implantatverlust und Periimplantitis. Eine Meta-Analyse. Clin Oral Implants Res 31. Dezember 2013 doi: 10.1111/clr.12319.
