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page 19DTß May 201420 Implant Tribune United Kingdom Edition See demonstrations at www.pearldentalsoftware.com Call us on 0800 027 2406 and get a TRIAL COPY Prices Exclude VAT The best mince pies are not the most expensive ones! Compare your practice management software provider with this list: Which Report Free data transFer From existing soFtware. Pearl is charged per surgery not per PC, £44 per month for the first surgery, £22 per month for additional surgeries. there is no Charge for reception PCs, office PCs, xray rooms PCs or home PCs! Complete digital signature capture for a paperless practice at no extra charge Links to all digital x-ray systems with no extra charge online appointment diary at no extra charge Patient touch screen check-in at no extra charge software updates for new nhs contracts - NO EXTRA CHARGE! pilotscheme So SimplE, so pOwERful, so REliAblE, so iNEXpENSivE Time to change software supplier? Pearl dental software BHA-A4-ad-Mince pie (Dentistry).indd 1 14/02/2014 16:52 is still work in progress. This has meant that there is cur- rently no consensus or gold standard as to how to treat peri-implantitis, as there is limited scientific evidence available to back up either surgical or non-surgical treat- ment, or explantation of the dental implant. Peri-implant diseases If peri-implant mucositis is allowed to develop, it turns into peri-implantitis, which can lead to progressive loss of the supporting bone, and im- plant failure – and is therefore much more complex to treat. Peri-implant diseases are caused by bacterial infection and/or biomechanical over- load, which cause the inflam- mation. Patients with exist- ing periodontal disease and poor oral hygiene habits – and smokers in particular – are very susceptible to developing a peri-implant disease. Poor oral health and plaque control are a big cause of peri-implant diseases, and of- ten occur due to the patient’s reticence to clean the area due to fear of pain or bleeding. Additionally, the patient may be unable to brush and floss properly due to the implant’s positioning or design increas- ing bacterial prevalence. Diagnosis and treatment It’s important to ensure that the dental team works togeth- er to spot the warning signs of peri-implant diseases – as these are often not noticed until they become more se- vere – and that each mem- ber of staff is knowledge- able about the risk factors, signs and symptoms in order to achieve early diagnosis and intervention. It is also a good idea to partner with a periodontist as soon as pos- sible following diagnosis. Evidence suggests that peri- implant mucositis can be treated effectively if detected early, and is easily treated non-surgically. Prevention is possible with regular monitor- ing of dental implants, com- prehensive periodontal evalu- ation and proper periodontal maintenance. Peri-implantitis can be treated with mechanical de- bridement with antiseptics such as chlorhexidine, or surgery – or when all other therapies fail explanation. It is preferable to try a non- surgical treatment first, where possible. In terms of the merit of using antibiotics, Stefan Renvert et al in 2012 found that the use of antibi- otics makes no difference. Many bacteria are now also resistant to most antibiotics – we’re in the era of widespread antibiotic and multi-drug resistance. In cases where just an implant is affected by peri- implantitis, a non-surgical approach can have its mer- its. For example, scaling and root planing combined with an antiseptic such as chlorhex- idine digluconate. This has been clinically proven as an effective adjunctive treatment for peri-implantitis and an ef- fective first-line treatment for periodontal pocketing. In conclusion, as with all inflammatory diseases, early detection and intervention of peri-implant mucositis and peri-implantitis is the best solution – however in cases that do develop, judge the merits of a non-surgical ap- proach on a case by case basis and choose this option where possible to avoid invasive sur- gery. More study is needed on peri-implant diseases; we still do not know enough about them and require further re- search to substantiate emerg- ing claims. DT Prescribing information for PerioChip available on request. ‘It’s important to ensure that the dental team works together to spot the warning signs of peri-implant diseases’ About the author For more information or to contact the team behind PerioChip®, email team@periochip.co.uk or call 0800 013 2333 Call us on 08000272406 and get a TRIAL COPY BHA-A4-ad-Mince pie (Dentistry).indd 114/02/201416:52 0132333