implants - international magazine of oral implantology

overview I _Treatment of the infectious form of periimplantitis Thefour-phasetreatmentscheme Manyauthorsagreeonafour-phaseregimenforthe treatmentofperiimplantitis: 1)Initialtreatment:ThisinitialphaseofPItreatmentcon- sists of diagnosing periimplant lesions (as early on as possible), cleaning and hygiene procedures as well as motivating/instructing the patient suffering from periimplantitis. 2)Surgical resective phase: After local anaesthesia and thecreationofasoft-tissueflap,animageoftheperi- implant defect (generally with its unique crater-like form) is taken, the granulation tissue is removed and theboneiscleaned. 3)Augmentative/reconstructive phase: The primary goal—althoughnotalwaysachievable—isanaugmen- tation which will ultimately lead to a restito ad inte- grum:Inthiscase,asopposedtoanaugmentation,the patient’sownboneisnotthegoldstandard;bonesub- stituteshavebecomeestablished. 4)Recall-Phase:Allauthorsagreeintheirdefinitionthat recallisjustasimportantastheactualtreatmentofa periimplant infection. If there is no adequate and short-term recall after the successful treatment of periimplantitis,recurrencewillbejustamatteroftime. _Explantation as a treatment option for periimplantitis Explantation would indeed be a “treatment op- tion” if the defect situation proves very difficult for executing the above-mentioned regimen or if the osseouslesionsaresoseverethatthereisonlyapoor overall prognosis for the implant. At times, explan- tation may even be the only choice if it can be as- sumed that, by leaving the implant in place, the in- fection would result in further bone loss that could prevent implantation at a later time or complicated augmentative measures. _Use of laser light There is more and more mention of the use of laser light in both the resective/surgical and the re- call phases primarily. In principle, two types of laser light applications can be defined: a) Laser light application without morphological changes on the implant surface and without ab- lative effect: decontamination. b) Laser light application with abrasive effect: abla- tive treatment (possibly in combination with de- contamination). 4,0 x 5,0mm 4,5 x 6,0mm 5,0 x 5,0mm 6,0 x 5,7mm 6,0 x 5,0mm 5,0 x 6,0mm www.bicon.de.com Since 1985 5,0 x 6,0mm 6,0 x 8,0mm 5,0 x 6,0mm 5,0 x 5,0mm 6,0 x 5,7mm 4,5 x 6,0mm 5,0 x 5,0mm 4,5 x 6,0mm 5,0 x 5,0mm 5,0 x 6,0mm 6,0 x 5,7mm 14 Years 6,0 x 5,7mm 14 Years 0 x 5,4 mm0,5 e 1985Sinc Simple»e 1985 .dte Lporun EociB 1.rtstpuaH reubnehcueB19455 ner nyamreG 56)0(94+enohP 34 002818 mo.cnoic@byanmreg m om.cde.oncib.www AD