implants - international magazine of oral implantology

I overview Figs. 1–4_The hygiensation phase: The hygienisation phase is an essential treatment step at the beginning of periimplantitis treatment. Hard and soft plaque must be removed from the superconstruction and at the transition from gingiva to superconstruction. To avoid scratches on the implant surface, many authors recommend the use of plastic curettes or curettes with titanium covered ends. Additional disinfectant measures, i.e. rinsing with chlorhexidine digluconate, may be necessary. Polishing is the final step in this initial treatment regimen. Now the patient has to be guided back to the straight and narrow: He or she has to be willing and, with enhanced instructions, also able to clean the superconstruction sufficiently. A continuous recall system guarantees the respective success monitoring. If the periimplant lesion is limited to mucositis, the hygienisation phase may even be the final step in the treatment of periimplantitis. _Introduction While in the early stages of implantology, issues concerning the “healing” of artificial abutment teeth wereinthefocusofinterest,thoseearlycomplications have become rare due to improved implant forms, op- timised minimally invasive diagnostic and surgical techniques, and especially because of improved im- plantsurfaces. Instead, “long-term complications” with implants thathavebeenosseointegratedformanyyears,which arefunctioningandhavedevelopedperiimplantinfec- tions, have become the focus of interest for dentists/ implantologists. Thistypeofinfectionon/aroundtheimplant,which can lead to serious bone loss and, if untreated, will re- sult in the loss of the artificial abutment tooth (and generally also in the loss of the superconstruction), is referredtoasperiimplantitis. Therearetwopossiblecauses: a)Infectious/bacterial(asdefinedbyMOMBELLI,1987). b)Functional/aseptic, e.g. due to stress phenomena caused by not observing a balanced proportion of implant length/crown length and disregarding seri- ousdeficitsoftheosseousimplantsite(asdefinedby JASTY, 1991). Functional/aseptic periimplantitis is usuallytheexception. Themajorityofperiimplantinfectionsareofbacte- rial/infectious origin. According to information pro- vided by the only chair holder of dental implantology, ProfessorDrHerbertDeppe,aprevalenceofupto15per centofimplantscanbeexpectedafter10years. Thus, the prevention and treatment of periimplan- titis have now become two of the major tasks in im- plantology. This article will provide information about tried and tested laser treatments, but also about new therapeutic approaches with laser light for the treat- mentofbacterialperiimplantitis. Periimplant lesions— causes and treatment options Author_Dr Georg Bach, Germany 20 I implants3_2013 Fig. 1 Fig. 2 Fig. 3 Fig. 4