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implants - international magazine of oral implantology

I overview Fig. 1_Treatment of advanced periodontal disease with implants replacing the natural dentition is recommended “time-tested” 3 to 6 months following periodontal therapy (SRP). _Introduction Thepreservationofthenaturaldentitionisthepre- requisite in daily patient care. In advanced periodontal disease, the successful realization of implant therapy requires knowledge in patient expectations, clinical di- agnostics,propersurgicalskillsanddelegationofbasic services to dental hygienists. Implant treatment in se- vereperiodontitisdemandsatwo-step,time-testedap- proach, evaluating the outcomes of basic periodontal therapybeforeimplantplacement. _Integrated dentistry: Success for today and tomorrow Thesuccessfulpositioningofdentalpartnershipsin the fast-growing health market implicates predictable treatmentstrategiestosavepermanentteeth.Accord- ing to orthopedic, cardiac or vascular medicine, an on- time decision-making for implant therapy is recom- mendedtocounterbalancefunctionalandestheticdis- comfort in advanced endodontic and periodontal breakdownsettings.Patient’scurrentandfutureexpec- tationsdriveourpracticesintothenecessitytoprovide synergistic periodontal and implant treatment solu- tions.Theadvantagesare: –Optimizing implant success by preceding with peri- odontaltherapy. –Enhancedeconomicprofitduetoby-effectsfromdel- egatedscalingandrootplaning. –Promotionoforalandbodyhealthofbothdentalpa- tientsandstaffmembers. The need to preserve healthy teeth and gums, the ever-expanding influences of web, TV and magazines and an increase in low-cost implant treatment render implantdentistryinternationallyattractive.Thetransi- tion of dental practices into the implant market is rea- sonable,especiallyforgrowingdentalpatnerships.The capitalinvestmentandrunningcostsforasurgicalim- plantsettingareredeemedbymorethan30implantsa year. Because of the economic commitment, a careful financial strategy is needed not to neglect challenges and developing concepts preserving and salvaging compromisedteethfromconservativeandperiodontal dentistry. _Decision-making in periodontal diseases Classicalimplanttherapyprotocolscomprisemust- indications resulting in an immediate treatment plan. According to patient preferences, clinical settings and insuranceplans,thesemust-indicationswithanadhoc implant placement recommendation are, in order of precedence: –Long-term missing bridgeworks or prosthesis, eden- tulousmandible –Advancedendodonticdamage –Trauma(toothfracture) –Oralcancersurgery. Periodontal diseases represent can-indications. Treatmentplanningisrunningmorecomplex.Thedeci- sion-making comprises a time-tested therapeutic ap- proach. In advanced periodontal settings of more than 50%bonelosswithfurcationinvolvementlevelIII,pa- tientssufferfromoraldiscomfort.Thetoothprognosis Perio meets implant dentistry A time-tested relationship Author_Prof Dr Rainer Buchmann, Germany 18 I implants4_2012 Fig. 1