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15Perio TribuneMarch 2014United Kingdom Edition page 16DTà Laser Dentistry - LaserWhitening - LaserTherapy Made in Britain QLDL130214RG No battery No power loss No expensive tips All-in-one Laser £3,300£3,300 Inc. VAT, Delivery, all Accessories plus Online & Hands on BILD training course inc. Proud Sponsors of T. +44 1227 780009 E. info@quicklase.com W. www.quicklase.com QuickLase QuickWhite @QLQW T he preservation of the nat- ural dentition is the pre- requisite in daily patient care. In advanced periodontal disease, the successful realisa- tion of implant therapy requires knowledge in patient expecta- tions, clinical diagnostics, proper surgical skills and delegation of basic services to dental hygien- ists. Implant treatment in severe periodontitis demands a two-step, time-tested approach, evaluating the outcomes of basic periodon- tal therapy before implant place- ment. Integrated dentistry: Success The successful positioning of dental partnerships in the fast- growing health market implicates predictable treatment strategies to save permanent teeth. Accord- ing to orthopaedic, cardiac or vascular medicine, an on-time decision-making protocol for im- plant therapy is recommended to counterbalance functional and aesthetic discomfort in advanced endodontic and periodontal breakdown settings. Patient’s cur- rent and future expectations drive our practices into the necessity to provide synergistic periodontal and implant treatment solutions. The advantages are: • Optimising implant success by proceeding with periodontal therapy • Enhanced economic profit due to by-effects from delegated scal- ing and root planing • Promotion of oral and body health of both dental patients and staff members The need to preserve healthy teeth and gums, the ever-expand- ing influences of web, TV and magazines and an increase in low-cost implant treatment ren- der implant dentistry internation- ally attractive. The transition of dental practices into the implant market is reasonable, especially for growing dental partnerships. The capital investment and run- ning costs for a surgical implant setting are redeemed by more than 30 implants a year. Because of the economic commitment, a careful financial strategy is need- ed not to neglect challenges and developing concepts preserving and salvaging compromised teeth from conservative and periodon- tal dentistry. Decision-making Classical implant therapy proto- cols comprise must-indications resulting in an immediate treat- ment plan. According to patient preferences, clinical settings and insurance plans, these must-in- dications with an ad-hoc implant placement recommendation are, in order of precedence: • Long-term missing bridgeworks orprosthesis,edentulousmandible • Advanced endodontic damage • Trauma (tooth fracture) • Oral cancer surgery Periodontal diseases represent can-indications. Treatment plan- ning is running more complex. The decision- making comprises a time-tested therapeutic ap- proach. In advanced periodontal settings of more than 50 per cent bone loss with furcation involve- ment level III, patients suffer from oral discomfort. The tooth prognosis becomes less positive, the frequencies of follow-up vis- its increase (Fig 1). Periodontal therapy ‘before’ implant planning is aimed at saving doubtful (not hopeless) teeth with a grace peri- od of at least three to six months to evaluate for periodontal treatment outcomes. Thorough scaling and root planing frequently results in a mid-term improvement (two years) up to a long-term stabilisa- tion (five years) of preliminary af- fected teeth. The decision to maintain the periodontally compromised denti- tion undergoes the following cri- teria (Fig 2): • Patients with no preferences to comfort, aesthetics and costs • Patients willing to accept en- hanced tooth mobility, occasional Perio meets implant dentistry Author_Rainer Buchmann T. +441227780009