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Susan S. Wingrove. Peri-Implant Therapy for the Dental Hygienist
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Peri‐Implant Therapy for the Dental Hygienist
Foreword
Acknowledgments
About the Author
List of Contributors
About the Companion Website
1 Implants 101: History, Implant Design, Parts, and Pieces
History
Dental implant history timeline
Implants
Implant design
Orthodontic implants/temporary anchoring devices (TADs)
Parts and pieces for implants
Implant dentistry terminology
Summary
References
2 Implant Therapy: Oral‐Systemic Health, Medical History, and Risk Assessment
Oral‐systemic health link to overall health
Box 2.1 Four major diseases linked with periodontal disease/risk factors for peri‐implant disease
Cardiovascular/cerebrovascular (CV/CV) disease
Preterm birth/low birth weight
Diabetes
Respiratory disease
Box 2.2 Chair‐side tests for risk factors
Medical history/risk assessment
Bisphosphonates, BRONJ/BON, ARONJ, MRONJ
Xerostomia
Medical history/risk assessment forms
Summary
References
3 What Lies Beneath the Surface? Natural Teeth, Bone, and Implant Surgery
Natural teeth versus implants
Bone: it is all about the bone!
Four classifications of bone
Hygienist Tip:
Frequently asked questions. Why is bone density or type so important?
What is the tooth relationship to type of bone?
What happens if teeth are lost and not replaced?
Bone loss overview
Hygienist Tip:
Box 3.1 Wolff’s Law
Bone regeneration
Regenerative procedures
Procedures to prevent bone resorption
Post‐regenerative procedures home care
Implant surgery
Endosteal dental implant surgery
Post‐surgery implant home care
Specialized implant placement. Subperiosteal dental implant placement
Transosteal dental implants placement
Zygomatic dental implants
Implant supported fixed final prosthesis dental implant procedure
Summary
References
4 Setting the Stage: Adjunctive Surgical Procedures, Restorative Options, and Treatment Planning
Adjunctive surgical procedures. Contributed by Robert Horowitz, DDS
Surgical therapy
Socket preservation
Graft and/or barrier protection of the socket
Alveolar ridge and maxillary sinus augmentation
Sinus augmentation
Summary
Restorative options. Contributed by Robert Schneider DDS, MS
Fixed cement or screw‐retained restorations (crowns or bridges) implant options
Options for the edentulous arch
Removable tissue‐supported attachment‐retained overdenture option
Removable bar‐supported attachment‐retained overdenture
Hygienist Tip:
Implant‐supported fixed full‐arch final prosthesis
All‐on‐4
Specialty options pontic designs, cases by Robert Schneider, DDS, MS
Types of pontics most frequently utilized
Pontic materials
Box 4.1 Criteria for pontics
Maintenance criteria for pontics
Summary
Treatment planning for long‐term implant success
Treatment planning introduction
Dental implant complications: risk factors and prevention. Biologic complications
Prosthetic complications
Adjunctive surgical procedures overview. Implant site preparation procedures
Initial clinical and radiographic evaluation
Tooth extraction: natural healing and ridge preservation
Bone replacement grafts
Alveolar ridge augmentation
Sinus augmentation
Other treatment options at severely deficient sites
Adjunctive soft‐tissue grafting at dental implants
Treatment planning overview
Box 4.2 Comprehensive treatment plan
What can I expect to happen during the preliminary examination process?
Summary
References
5 How to Talk to Patients About Implant Dentistry: Risks, Benefits, and Alternatives
What are the risks, benefits, and alternatives to replacing missing teeth?
Risks
Benefits
Hygiene Tip:
Box 5.1 Benefits of dental implants
Alternatives
Bridges
Box 5.2 Key points for hygienist to remember and quote to patients when having a conversation on tooth replacement with implants:
Fixed full and partial denture
Summary of risks, benefits, and alternatives
Communication and motivation
Hygienist Tip:
How do you introduce value?
Presenting treatment to patients
Hygienist Tip:
Box 5.3 Example of information to consider about patients to YES to Treatment
Generation overview: How to speak the way patient wants to hear. Traditionalists: born 1922–1945
Baby boomers: born 1946–1964
Generation Xers (Gen Xers): born 1965–1980
Millennial generation (Y Generation): born 1981–1996
Z Generation: born 1997–2012
Summary
References
6 AIM for Implant Success: Assess, Identify, and Monitor
Assess
Mechanical, biological, and aesthetic component complications
Assessment: visual soft tissue
Assessment: probe and palpate for signs of infection
Box 6.1 Protocol for probing dental implants
Box 6.2 Steps to palpate for signs of infection
Assessment: calculus and/or residue
Assessment; mobility, pain, and occlusion
Hygiene Tip:
Assessment; bone level
Box 6.3 Radiographic guidelines to monitor bone level (14)
Monitoring. Failing implant
Box 6.4 Signs of a failing implant
Summary
References
7 Implant Complications: Peri‐Implant Disease, Biofilm, and Corrosion
What is the hygienist's role in restoratively driven implant complications?
Implant complications: prevention, identification, and treatmentContribution by Dr. Maria L. Geisinger DDS, MS
Peri‐implant disease; mucositis and peri‐implantitis
Biologic and prosthetic complications. Factors associated with biologic complications. Systemic Disease
Systemic medications
Smoking status and /or tobacco cessation
Periodontal health
Plaque/Oral biofilm control
Peri‐implant soft tissue quality/quantity
Prosthetic complications
Prosthetic design and occlusal load
Retained cement
Parafunctional habits/occlusal dysfunction
Examination, diagnosis, and treatment of peri‐implant disease
The role of biofilm in peri‐implant disease
Understanding biofilms
Biofilm composition and host response in health and disease
Management of biofilms around implants
What is our best approach to achieving long‐term stability?
The role of corrosion in peri‐implant diseaseContribution by Dr. Luciana Safioti DDS, MSD
Summary
References
8 Biofilm‐Focused Implant Home Care
Postsurgical home care
Post‐regenerative surgical home care
Box 8.1 Post‐regenerative surgical procedures home care protocol
Box 8.2 Postsurgical implant placement home‐care protocol
Postsurgical implant placement home care
Box 8.3 Pre‐restorative implant home‐care protocol
Single implant home care
Box 8.4 Single implant home‐care protocol; single, mini, ball or Locator, and bar‐supported
Brushing implants
Electric toothbrush
Interdental brushes
Flossing an implant
Box 8.5 Protocol for flossing implants
Water flossers/water irrigation units
Box 8.6 How to use a water flosser/water irrigation unit
Stimulators
Antimicrobial mouthrinses/chemotherapeutic agents
Specialized home care
Implant‐supported full‐arch fixed final prosthesis
Box 8.6 Implant‐supported full‐arch fixed final prosthesis home care protocol
Box 8.7 Implant‐supported full‐arch removable final prosthesis (overdenture) home care protocol
Box 8.8 Peri‐implant mucositis/early peri‐implantitis home care protocol
Implant‐supported full‐arch removable prosthesis (overdenture)
Peri‐implant mucositis/early peri‐implantitis
Educate and motivate
Box 8.9 Motivational teaching points
Summary
References
9 Professional In‐Office Implant Maintenance and Disease Treatment
Professional in‐office regimen
Highlights for ACP clinical practice guidelines implant‐borne restorations
Box 9.1 Highlights ACP Clinical Practice Guidelines, Implant‐Borne Restorations (2)
Medical history
Box 9.2 Professional in‐office implant maintenance protocol
Assess and monitor implants and implant‐borne restorations/prostheses
Maintenance; biofilm removal, debridement, polishing, and recare
Biofilm identification and professional removal
Professional oral biofilm removal; powder streaming device
Debridement instrumentation and ultrasonic research
Debridement; implant type (narrow‐ or wide‐diameter, specialty) instrumentation
Implants; narrow‐diameter, wide‐diameter, or specialty
Narrow‐diameter implants
Wide‐diameter implants
Specialty: Exposed implant threads, bar‐supported, and residue implants
Lavage and debridement with safe ultrasonic tips
Polishing the implant‐borne restoration/prosthesis
Antimicrobial varnish
Professional in‐office implant maintenance recare
Single implant maintenance
Box 9.3 Single implant maintenance protocol for titanium and ceramic implants
Mastering the Arch© Implant‐supported full‐arch removable/fixed final prosthesis maintenance
Full arch removable final prosthesis (Overdenture)
Box 9.4 Full‐arch supporting implants and removable overdenture maintenance protocol
Hygiene Tip:
Box 9.5 O‐ring replacement protocol
Box 9.6 Locator cap replacement protocol
Full arch fixed final prosthesis in‐place, not removed
Box 9.7 Bar‐clip system replacement protocol
Box 9.8 Full‐arch final prosthesis in‐place, not removed, maintenance protocol
Full‐arch fixed final prosthesis removed and reseated
Box 9.9 Tools and materials for removal/reseating of fixed final prosthesis
Fixed final prosthesis removal
Box 9.10 Fixed final prosthesis removal protocol
Assessment after the fixed final prosthesis is removed
Box 9.11 Assessment after fixed final prosthesis is removed protocol
Implant maintenance and reseat fixed final prosthesis
Box 9.12 Full‐arch fixed final prosthesis removed and reseated maintenance protocol
Hygiene Tip:
Peri‐implant disease assessment and treatments
Box 9.13 Peri‐mucositis/early peri‐implantitis treatment protocol
Box 9.14 Labrida BioClean peri‐mucositis/early peri‐implantitis treatment protocol
Cement residue assessment and treatment
Summary
References
Appendix: Terminology and Resources
Implant dentistry terminology
Resources. Companies
Organizations associated with implant dentistry
Index
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