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ePaper created 2018-04-10, 12:30:21 | version 1.38.0
| interview Peri-implantitis prevention Source: Dental Tribune International In addition to maintaining a specialist periodontics practice in West Perth, Australia, and serving as the Edi- tor-in-Chief of the Clinical Oral Implants Research journal, Periodontist and implant specialist Dr Lisa Heitz-Mayfield holds several academic positions, including that of ad- junct professor at the University of Western Australia and the University of Notre Dame Australia. Dr Heitz-Mayfield has emphasised the importance of preventive strategies and early diagnosis regarding peri-implant disease, and found time for an interview on the topic which she also addressed at the 26th Annual Scientific Meeting of the European Association for Os- seointegration (EAO), held in October in Madrid in Spain. What were some of the key messages of your pre- sentation during the EAO meeting? In brief, my presentation focused on diagnosis and treatment planning for implant procedures in relation to the high prevalence of peri-implantitis. I emphasised the importance of achieving infection control prior to implant placement—this involves conducting a comprehensive examination of the patient to determine whether there are any problems, such as periodontal disease or any other intraoral infections. programme with good compliance and maintenance before receiving an implant. What is involved in this infection control? Firstly, one needs to eliminate any deep periodontal pockets. We have good evidence today that supports the idea that the presence of residual periodontal disease is a risk factor for patients developing peri-implantitis at a later date. Infection control also means that patients must have really good oral hygiene. They must have low full-mouth plaque scores, which again is strongly sup- ported by evidence that suggests patients with poor plaque control are at a much greater risk of developing peri-implantitis. Of course, once one has achieved good infection con- trol, one then needs to ensure that there will be good access for cleaning the implant site once the prosthesis has been placed. This will allow the patient to continue infection minimisation practices at home. If one designs a prosthesis that is inaccessible through the patient’s cleaning habits, it is simply more likely that he or she will contract an infection later on. As a practising periodontist, how have you imple- mented a preventive approach to infection control? I highlighted the need, particularly for a periodontal patient, to have been fully treated beforehand so that he or she doesn’t have active periodontal disease when any implants are placed. The patient should have already gone through the entire process of infection control and should ideally be in a supportive periodontal therapy Having good infection control before placing implants is crucial, as it is the best way to prevent these infections occurring later on. When I am planning for implant pro- cedures, I make sure that I start with a good foundation where any infection has been dealt with and that the pa- tient has displayed good compliance and is likely to con- 40 1 2018