Dental Tribune Italian Edition

17SpecialeHygiene Tribune Italian Edition - Dicembre 2013 Attenzione continua per i pazienti, a casa come nel suo studio Un’igiene orale eccezionale richiede un tocco delicato. Grazie a Oral-B uno spazzolamento senza eccessiva pressione. IL DEI PAZIENTI CHE FA USO DI ORAL B TRIUMPH HA RIDOTTO L’ECCESSIVA FORZA DI SPAZZOLAMENTO IN MESE TRIPLO CONTROLLO DELLA PRESSIONE Per ulteriori informazioni sugli spazzolini elettrici Oral-B visiti il sito www.dentalcare.com Il sensore interno si attiva quando il paziente supera una forza di spazzolamento sicura (>3 N) L’indicatore luminoso lampeggia per ricordare al paziente di ridurre la pressione Lo spazzolino riduce la velocità del 35% e ferma le pulsazioni Reference: 1. Janusz K et al. J Contemp Dent Pract. 2008;9(7):1-13. © 2012 P&G PGW-5036 ORAL-13137 P13056.02 Parthenon 2 JournalAd ITA 210x297+5.indd 1 13/03/2013 09:59 < pagina 16 It is very important that oral hygie- ne for the patient is not made too complicated thereby prolonging the time required by using too many oral hygiene aids. In the aesthetic zone, a cross over flossing technique can be used (Figs. 2a-f). A poor flossing technique or no flos- sing at all can lead to subgingival in- flammation of the peri-implant tis- sues. It is essential that if a cement retained crown is placed that all the cement is removed as subgingival irritants such as excess cement can provoke an acute peri-implantitis which can cause soreness, swelling, bleeding on probing and eventual bone loss (Figs. 3 & 4). In premolar and molar areas the use of floss or interdental brushes can be easier for the patient in the case of single unit implant, and in fixed bridgework. Calculus formation on dental im- plants is very similar to that found on teeth the only difference is that the abutment and the porcelain are very highly polished therefore the calculus is not as tenacious as on a natural tooth. When removing su- pragingival calculus from the im- plant crowns it is very important not to use stainless steel scalers as this will damage the titanium sur- faces. Therefore it is recommen- ded that one uses a material that is softer than titanium either gold plated or reinforced plastic instru- ments (Fig. 5). It is very important that an ultrasonic is never used on an implant as this will heat up the implant and could kill the bone that helps integrate the implant. When pocketing has been noted then using the CIST protocol will help treat the majority of peri-im- plantitis cases. Below is an example of an UR2 with 8 mm pocketing, the site was treated non-surgically with local delivery antimicrobials and with the patient using chlorhexidi- ne gel with the largest interdental brush (Figs. 6a-c). At the 2 week re- view the pocketing associated with the UR2 has reduced to 5 mm with simple non-surgical therapy any further intervention will need to re- viewed by the implant dentist. Conclusion Good oral hygiene performed by the patient has a significant affect on the stability of the marginal bone around dental implants. Therefore regular hygienist appointments are necessary to ensure that your patients are main- taining a high standard of oral hygie- ne around their dental implants. La bibliografia è disponibile presso l’Editore. Fig. 6a - 8 mm pocketing UR2. Fig. 6b - After subgingival currettage of the pocket the patient was shown how to use a large interden- tal brush with chlorhexidine gel twice a day. Fig. 6c - Patient reviewed at 2 weeks. The inflamed tissue have reduced exposing the crown margin. Fig. 6d - U2 pocketing has reduced 5 mm.