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Dental Tribune Middle East & Africa No. 3, 2017

Dental Tribune Middle East & Africa Edition | 3/2017 ◊Page 20 GENERAL DENTISTRY 21 on the clinical outcome following combined surgical therapy of peri- implantitis: a randomized controlled clinical study. J Clin Periodontol 2011;38:276-284. 6. Heitz-Mayfi eld LJ, Salvi GE, Mom- belli A, et al. Supportive peri-implant therapy following antiinfective sur- gical peri-implantitis treatment: 5-year survival and success. Clin Oral Implants Res 2016. 7. Serino G, Turri A. Outcome of sur- gical treatment of peri-implantitis: results from a 2-year prospective clinical study in humans. Clin Oral Implants Res 2011;22:1214-1220. 8. Schwarz F, Sahm N, Bieling K, Beck- er J. Surgical regenerative treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combina- tion with a collagen membrane: a four-year clinical follow-up report. J Clin Periodontol 2009;36:807-814. 9. Leonhardt Å, Renvert S, Dahlén G. Microbial fi ndings at failing implants. Clin Oral Implants Res 1999;10:339-345. 10. Taschieri S, Weinstein R, Del Fab- bro M, Corbella S. Erythritol-enriched air-polishing powder for the surgical treatment of peri-implantitis. The Figure 3a-c. Sequence of surgical therapy: Flap elevation revealing chronic infl ammatory tissue; Debridement and decontamination of implant surface; and Defects fi lled with Bio-Oss and covered with Bio-Gide and mucoperiosteal fl aps are repositioned and sutured. ney. He has been awarded membership of the Royal Australasian College of Den- tal Surgeons as well as separate research grants in the fi elds of periodontology and craniofacial biology. Working in private practice in Sydney since 2009, Dr Vo has also been a visit- ing clinical demonstrator for the DMD program at the University of Sydney. He is a member of the Australian and New Zealand Academy of Periodontists and the International Team for Implantology, speaks at conferences nationally and lec- tures on topics including the advanced and latest concepts in the management of periodontal diseases. Figure 4. Post-op intra-oral photo at 6 months after therapy Figure 5. Post-op radiographs at 3 months after therapy. Scientifi c World Journal 2015;2015. 11. Drago L, Del Fabbro M, Bortolin M, Vassena C, De Vecchi E, Taschieri S. Biofi lm removal and antimicrobial activity of two different airpolishing powders: an in vitro study. J Peri- odontol 2014;85:e363-e369 (Perio) (Syd), (Adel), DClinDent Specialist Periodontist, Australia BDS MRACDS (Perio) Dr Vo is a Specialist Periodontist. He ob- tained his BDS dental degree from the University of Adelaide and then went on to receive a Doctor of Clinical Dentistry in Periodontics from the University of Syd- Celtra® Duo Zirconia-Reinforced Lithium Silicate (ZLS) Block Developed to make a difference Celtra Duo (ZLS) is the one and only material block that provides you with an unsurpassed level of freedom, control, and workflow flexibility, resulting in a final restoration in which to have complete confidence with respect to the clinical, functional, and esthetic outcomes. Restorations made with Celtra Duo (ZLS) possess a chameleon effect, enabling them to blend in with surrounding teeth for a natural vitality and lifelike appearance. For more information, visit celtra-dentsplysirona.com The following case study illustrates a protocol that was used to treat ad- vanced peri-implantits. The case was treated successfully with a 6-month follow-up. Success was defi ned by a reduction in probing pocket depths (≤4mm), along with a reduction of soft tissue redness and bleeding on probing. Case Study: Regenerative ap- proach for treatment of peri- implantitis A 70-year-old female was referred for advanced peri-implantitis in the mandible. She presented complain- ing of pain and she also noticed discharge from one of the anterior implants. Her medical history was non-contributory and she was a non- smoker. Clinical examination revealed 5 im- plants in the mandible supporting a fi xed full arch reconstruction. Prob- ing pocket depths were of the order of 8-9mm around 3 of the anterior implants. The distal implants had normal probing depths. CBCT imag- ing revealed an intrabony compo- nent of 6.1mm for the implant in the 43 position, 4.2mm at the 41 implant and 3.1 at the 33 implant. A prepatory phase was carried out, including assessment of oral hy- giene and non-surgical implant decontamination in 1 session. After 6 weeks, the patient underwent sur- gical treatment. This comprised of full thickness mucoperiosteal fl aps being raised and the chronic infl am- matory tissue removed from the de- fects around the 3 implants with the use of tefl on curettes. The implant surface was then decontaminated using EMS AIR-FLOW® technol- ogy with very fi ne erythritol powder (EMS AIR-FLOW® PLUS Powder). The implants were also irrigated and cleansed with saline-soaked cotton foam. A crater shaped defect was present around all the implants at the proxi- mal and lingual surfaces, however the implants had a dehiscence on the buccal aspect. The craters were fi lled with BioOss granules (Geistlich) and Bio-Gide was placed to cover the defects. Lastly, the fl aps were repo- sitioned and secured with mattress and sling sutures. Systemic antibi- otics were administered postopera- tively. The full arch prosthesis was re- issued at the completion of surgery. Clinical parameters and radiograph- ic examinations were performed at 3 and 6 months. At both intervals, there was resolution of the clinical parameters for all 3 implants, in- cluding plaque index, bleeding on probing and probing pocket depth. At these visits, non-surgical mainte- nance was carried out, including oral hygiene reinforcement and removal of biofi lm via EMS AIR-FLOW® tech- nology and EMS AIR-FLOW® PLUS Powder. References 1. Lindhe J, Meyle J. Peri-implant dis- eases: Consensus Report of the Sixth European Workshop on Periodontol- ogy. J Clin Periodontol 2008;35:282- 285. 2. Figuero E, Graziani F, Sanz I, Herrera D, Sanz M. Management of peri-im- plant mucositis and periimplantitis. Periodontol 2000 2014;66:255-273. 3. Renvert S, Polyzois IN. Clinical approaches to treat peri-implant mucositis and peri-implantitis. Peri- odontol 2000 2015;68:369-404. 4. Claffey N, Clarke E, Polyzois I, Renvert S. Surgical treatment of peri-implantitis. J Clin Periodontol 2008;35:316-332. 5. Schwarz F, Sahm N, Iglhaut G, Beck- er J. Impact of the method of surface debridement and decontamination

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