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Dental Tribune Middle East & Africa No.1, 2017

Dental Tribune Middle East & Africa Edition | 1/2017 HYGIENE TRIBUNE C4 Guided Biofilm Therapy A New Concept for Prophylaxis Professionals Guided Biofilm Therapy provides a two stages clinical protocol that is able to ensure complete cleaning of teeth while preserving tooth substance. ByDrMathieuDeudon,France Thepreviousprotocolfortheremov- al of hard and soft deposits, which begins with hand instruments, con- tinues with an ultrasonic device and ends with classical polishing (rubber cups, brushing, polishing pastes), is today still widely used in dentistry. However, recent clinical studies show that this method is obsolete. It leaves distinct marks on hard tooth structure and is aggressive on soft tissue. EMShasdevelopedanewsystematic approach for professional prophy- laxis under the name of Guided Biofilm Therapy. This prophylaxis procedure focuses not only on the removal of hard and soft deposits, but also on a different treatment sequence. The procedure guaran- tees complete cleaning, even in the most difficult-to-reach areas and at the same time preserves tooth sub- stanceandnaturaltissue. The final polishing with a polishing pastecannowbeavoided. TheProcedure For optimal results, it is first neces- sary to make a diagnosis of the soft tissue and mucous membranes, to raise patient awareness for the ben- efitsofgoodoralhygiene,andtomo- tivatethem. Because, professional prophylaxis always has to be supported by in- dividual prophylaxis. The primary common and widespread technique for the preparation of the tooth sur- facesisbrushingyourteeth.Itcauses thedisorganizationofthebiofilm. Professional tooth cleaning then en- sures the removal of biofilm in areas that are also difficult for patients to reach. The Advantages of The New Concept of Guided Biofilm Therapy This procedure guarantees efficient cleaning and a complete removal of biofilm, even in hard-to-reach areas, and preserves the tooth structure and natural tissue. The final polish- ing procedure using a polishing paste can thus be avoided. Further- more,patientsverymuchappreciate this gentle and totally painless form of treatment and are thus happy to cometoprophylaxissessions. TheProtocol STAGE1(Fig.3to9) 1 – Removal of Soft Deposits, Dis- colourationsAndBiofilm This stage is carried out using the AIR-FLOW® method by EMS in combination with the AIR-FLOW® Powder PLUS. It is based on erythri- tol, a natural component, together with 0.3% chlorhexidine. Thanks to its fine grain size (14 µm), the tooth surface and the soft tissues are not affected. This powder enables the removal of biofilm and soft deposits in both supragingival as well as sub- gingivalareasonnaturalteethorim- plants. It is recommended to not eat any chromogenic food for 3 hours afterthetreatment. 2–RehabilitationofDeepPockets In the 5-9 mm deep pockets, biofilm is removed with the PERIO-FLOW® handpiece with vertical movements back and forth for 5 seconds per pocket. This technique is four times as fast as with a curette. Thanks to its soft disposable plastic attachment, the handpiece does not damage the surface of the root or the implant andadaptsperfectlytotheanatomic shape. STAGE2(Fig.10to12) RemovalofHardDepositswiththe Piezon®NoPainTechnology The linear vibrations, which are aligned to the treatment area, stand in the center of the original PIEZON® method to ensure super smooth tooth surfaces. In combination with the intelligent No Pain technology, which automatically regulates the power and speed of the EMS attach- ments, this method provides maxi- mum protection of the gingiva. Soft deposits, discoloration and biofilm are eliminated with the AIR-FLOW® technologyandtheharddepositsare nowclearlyvisible. The combination of the PIEZON® No Pain technology and the PS attach- ment guarantees effective, quick, tissue-sparing and virtually painless treatment. Since calculus removal is Fig.1:Checking theattachment and thedepthof thepocket Fig. 4: Removal of supragingival biofilm and stains, also in con- tact with thegingiva Fig.3:AIR-FLOW®PowderPLUS Fig.8:Probing thepocket Fig.10and11:CalculusremovalfromnaturalteethwithPSattachment byEMS.Thisveryfineinstrument allowsthor- ough cleaning even in hard-to-reach areas, below and above the gingiva (up to 10 mm depth). Recommendation: Set thepower to30-60%,waterflow to70-100%. Fig. 12: Calculus removal on an implant with PI attach- ment by EMS. The tip enables cleaning of implant, im- plant post and crown surfaces without damaging tita- niumorzirconiumsurfaces. Fig. 6:The optimal positioning of the AIR-FLOW® handpiece Fig.7:Theoptimalpositioningof thesuction tube Fig. 5: Removal of biofilm under the gingiva (sulcus < 4 mm). Technically correct work is indispensable for successful air polish- ing:Setting thepower to30-50%,waterflow to100% Fig.9:Removalofbiofilmwith thePERIO-FLOW®handpiece Fig. 2: Professional diagnosis to raise patient awareness with a plaque test (GC) DrMathieuDeudon University diploma in dermatology and venereology of the oral mucous mem- brane (Paris, 2005), inter-university di- ploma in implantology and oral surgery (Corte,2013),dentalpracticeDrFernando Rojas-Vizcaya: Implant prosthodontic program (2013), resident in Combloux (since 2004), general practitioner with perio-implantologicalfocus. carried out only in the areas where it is really necessary, final polishing is not required. However, dental pro- fessionals can still quickly carry out air polishing with AIR-FLOW® Pow- der PLUS in the areas where calculus hasbeenremoved. After the prophylaxis treatment, it is recommendedtoapplyafluorideso- lutionforefficientprotectionagainst caries. Disclaimer Published in the magazine Dento- scopespecialeditionNo.ADF2016

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