Cutting down on complications – Kate Scheer W&H UK

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  Posted by: The Probe      2nd April 2019


Dental implants already have a very favourable success rate, but certain patients are still at risk of failure in the long-term.[1]By better understanding the reasons for this and the ways in which complications can be reduced, we can help ensure that patients benefit from their implants for many years to come. 


Smoking & Diabetes

Smoking can delay soft tissue healing, increase the likelihood of inflammation of the tissues around the implant, and decrease resistance to post-operative infection.[2]

Provided diabetes is controlled, it should not adversely affect the patient’s prognosis. Where diabetes is poorly controlled, it can significantly slow osseointegration. Within the first 6 years of receiving an implant, the success rate for diabetic patients is the same as for those without the condition, though in the long term there is an increased incidence of peri-implant inflammation.[3]

Maintenance

One of the main threats to implant health is peri-implantitis, which is inflammation of the gums due to bacterial build up. This can result in progressive damage to the hard and soft tissues.

Preventing this largely depends on patients being able to adequately manage their oral hygiene, meaning regular check ups and visits to the hygienist are, of course, highly recommended. Research indicates that around a third of British men only brush their teeth once a day, which enables bacteria to multiply unmolested, giving rise to harmful plaque and tartar.[4]With so many people following suboptimal oral hygiene practises, it is crucial that patients understand how much of a difference improving this can make to their long-term prognosis.

Stability

Osseointegration is the process by which the patient’s bone tissue bonds with the implant, providing it with a sound mooring. Without successful osseointegration, the implant is considered to have failed. Primary implant stability refers to the mechanically induced stability from the procedure (dependent on the properties of the bone, implant and technique utilised). Secondary stability is a measure of how successful osseointegration has been, which is contingent on the primary stability achieved.[5]

Traditional methods of gauging implant stability by using blunt instruments and the percussion test are unreliable and potentially misleading. While microscopic and histologic analysis were historically considered the most accurate means of evaluating osseointegration, they were highly invasive and destructive. New non-invasive diagnostic tools have become popular and can provide very useful diagnostic information.[6]

Maintaining its ethos of “no implantology without periodontology”, W&H offers a full range of surgical equipment, including the Piezomed ultrasonic unit and the Implantmed with the optional integrated Osstell ISQ diagnostic system. These devices are designed to ensure effective and efficient, patient-friendly treatment when placing implants. Furthermore, W&H’s Osstell Beacon is an innovative tool that provides an easy, accurate and reliable means of measuring primary implant stability, and monitoring osseointegration through secondary stability readings. 

Improving primary stability in turn aids secondary implant stability. Accurate diagnostic information can greatly assist this, by helping pin point the optimal time for loading and catching problems early in their development. 


To find out more visit www.wh.com/en_uk, call 01727 874990 or email office.uk@wh.com


References


[1]Gómez-de Diego R., del Rocío Mang-de la Rosa M., Romero-Pérez M., Cutando-Soriano A., López-Valverde-Centeno A. Indications and contraindications of dental implants in medically compromised patients: update.Med Oral Patol Oral Cir Bucal. 2014; 19(5): 483-489. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4192572December 13, 2018.

[2]Gheorghiu I., Stoian I. Implant surgery in healthy compromised patients – review of literature. Journal of Medicine and Life. 2014; 7(Special Issue 2): 7-10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391351/December 13, 2018.

[3]Naujokat H., Kunzendorf B., Wiltfang J. Dental implants and diabetes mellitus – a systematic review. International Journal of Implant Dentistry. 2016; 2(1): 5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005734/December 14, 2018.

[4]Smith M. Three in ten Brits only brush their teeth once a day. YouGov.2017. https://yougov.co.uk/topics/health/articles-reports/2017/10/23/three-ten-brits-only-brush-their-teeth-once-dayDecember 14, 2018.

[5]Swami V., Vijayaraghavan V., Swami V. Current trends to measure implant stability. The Journal of the Indian Prosthodontic Society. 2016; 16(2): 124-130. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837777/

[6]Mistry G., Shetty O., Shetty S., Singh R. Measuring implant stability: a review of different methods. Journal of Dental Implants. 2014; 4(2): 165-169. http://www.jdionline.org/text.asp?2014/4/2/165/140891December 14, 2018.


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