Noticias
23.09.2024
The (orally) healthy patient with implants
In the medical history, the 55 year-old patient states that he has no systemic disease and is not taking any medication. The patient’s lifestyle is similarly unremarkable. The patient has a few tooth restorations and two implants (2nd and 4th quadrants). On the basis of current findings, gingivitis is identified in an otherwise stable periodontal condition on the reduced periodontium (stage III, grade A).
02.09.2024
The healthy patient with pre-existing periodontal disease & peri-implantitis
A 52-year-old patient presents at a prevention session. The patient has no systemic disease and is not taking any medication. He has had various dental treatments and also has two active carious lesions. In addition, the patient has four implants (2nd, 3rd and 4th quadrants). He is revealed to have early periodontal disease (stage IV, grade B). His periodontal condition is stable; a probe depth of 5 mm is only evident at the implant in region 36. Gingivitis is also identified.
30.08.2024
ISQ as a guide for implant rehabilitations
Long-term success in implant therapy is an aim that all clinicians strive for. Fundamental to this is proper implant placement, surgical site preparation, and good osseointegration after insertion. Although a torque value is a basic prerequisite for primary stability, it alone does not provide complete information for the clinician. Therefore, knowledge of ISQ values is fundamental to assess both primary implant stability (mechanical stability) and secondary implant stability (biological stability or osseointegration).
19.07.2024
Snus causes mucosal lesions & gingival recession
Snus is usually brought into contact with the oral mucosa via its placement beneath the upper lip, and in some cases under the lower lip, whereby the nicotine it contains can enter the bloodstream via the oral mucosa
19.07.2024
Stress + poor sleep = even more periodontitis …?
Stress, defined as a state in which the affected individual perceives a sense of threat or lack of control, as well as sleep disorders and poor sleep quality, are both undeniably issues that cause a significant degree of difficulty in today’s society.
04.06.2024
Innovation and problem-solving with W&H's Synea Power Edition
The concept of using rotary tools to cut hard materials, such as granite, is at least 6,000 years old. As early as 25,000 BCE, our ancestors were using hand-held lithic borers to cut through shells without breaking them. These tools were generally made of flint, and pressed against the object to be perforated and then rotated back and forth at low speed and relatively high torque. Powerful modern handpieces have elevated the principle of variable speed and high torque to enable precise cuts into much harder materials like zirconia.
23.05.2024
Is one visit to the dentist per year enough if you have implants?
This study once more underlines that patients who do not regularly attend check-ups after receiving their implant-supported restoration have a very high risk of peri-implant diseases in general and specifically peri-implantitis; based on this data, at least two check-up visits per year are recommended.
12.04.2024
Tooth or implant?
The fight for periodontally compromised teeth and therefore retaining these teeth usually also pays off for patients from a financial perspective and is usually cheaper than extraction and subsequent implantation.
12.04.2024
More arthritis, more periodontitis?
Patients with rheumatoid arthritis are at significantly higher risk of periodontitis and this risk increases further for patients with particularly active rheumatoid arthritis.
26.03.2024
What does interdental cleaning achieve in the long term?
Interdental cleaning with dental floss or interdental brushes significantly reduces interdental plaque build-up and even tends to lead to a reduced rate of tooth loss in the long term.
15.03.2024
A pragmatic approach to manage
peri-implant biological complications
Explore the complexities of dental implant care: This scientifically backed article summarises the critical aspects of diagnosis, oral hygiene, and expert strategies for the effective management of both, mucositis and peri-implantitis.
08.03.2024
Periodontal treatment improves more than just the periodontium in diabetics
A non-surgical periodontal treatment can reduce the long-term blood glucose level (HbA1c) in type 2 diabetics by 0.3% and this effect persisted even after six months following treatment.
08.03.2024
Caution parents – risk of infection!
Untreated periodontal disease in parents can negatively influence the development of their children’s oral microbiome and promote the development of a dysbiotic oral microbiome.
20.11.2023
Implant crowns must be kept clean… but how?
The shape of an implant crown has a significant influence on how well it can be kept clean using home oral hygiene, and concave crown shapes appear to be easier to clean; it also seems that the underside of an implant crown in the molar area is easiest to access with dental floss.
20.11.2023
Unhealthy lifestyle = worse treatment outcomes?
Factors that can be categorised as a poor lifestyle, and primarily also a combination thereof, significantly increased the number of residual pocket probing depths with ≥ 6 mm and significantly reduced the likelihood of attaining the desired treatment outcome in periodontitis patients following non-surgical periodontal treatment (treatment step 1 and 2).
23.10.2023
Successful treatment – does it make a difference? Part 2
Commonly used definitions for successful periodontal treatment are extremely difficult to achieve, but are nevertheless associated with a lower rate of tooth loss; however, the tooth loss rate in patients who regularly attend supportive periodontal treatment sessions is generally very low.
23.10.2023
Prevention is the best treatment – Part 2
Biofilm accumulation is the main aetiological factor in the development of peri-implant diseases; plaque control and supportive implant therapy are therefore crucial in preventing peri-implant diseases.
25.09.2023
Social participation in society even without teeth?
In old age, tooth loss leads to significantly reduced social participation in society, while maintaining a minimum of 20 teeth has the opposite effect and leads to a significant improvement and therefore more frequent social participation.
25.09.2023
Patient- and implant-related factors – what affects the outcome of treatment?
In this study, non-surgical treatment of peri-implantitis was only successful in 25% of cases and was adversely affected by a medical history involving periodontitis and smoking, inadequate oral hygiene and a wide implant diameter.
29.08.2023
Keratinised soft tissue crucial for implants
The prevention of peri-implant diseases is the best treatment and the peri-implant soft tissue can play a decisive role here; for this reason, the team should discuss if there is a need for treatment in patients with a lack of keratinised mucosa (i.e. < 2 mm width of keratinised mucosa).
29.08.2023
Implants – Also a success story from a patient perspective?
A very high percentage of patients had a positive experience of implant treatment and most patients were very happy with the result; however, frequent points of criticism were the treatment costs and the cleansing ability.
26.07.2023
Exercise is great for our health … and our teeth too?
Women who exercise regularly showed a significantly reduced risk of periodontitis and a significantly reduced severity of periodontitis.
26.07.2023
No teeth, no quality of life?
Rehabilitation and replacement of missing teeth lead to a significant improvement in quality of life relating to oral health and also tend to improve general health.
26.06.2023
Periodontitis also impairs our sense of
taste and smell!
A questionnaire-based survey showed that periodontitis significantly increases the risk of an impaired sense of taste and smell.
26.06.2023
Smoking and increased probing depths are early warning signs
Smoking and increased probing depths at a young age (i.e. at an age of < 20 years) are significant risk factors for the early onset of periodontitis (i.e. at an age of < 30 years).
24.05.2023
Tooth brushing in just 10 seconds?
Automatic toothbrushing could have future potential, but still requires further technical developments to improve existing shortcomings with regard to customizsation for different jaw sizes and tooth positions, interdental spaces and choice of optimal brushing time.
24.05.2023
When as well as possible is not good enough
Even when told to brush their teeth as well as possible, the quality of tooth brushing among young adults is poor; the main weaknesses are cleaning palatal/lingual surfaces and overall brushing technique.
27.04.2023
Peri-implant mucositis – are chemical adjunctive therapies effective? Part 2!
Additional measures locally applied or taken systemically by the patient (e.g. antiseptics in the form of mouth-rinse solutions or probiotics) could have an additional positive effect in the treatment of peri-implant mucositis.
27.04.2023
Prevention is the best treatment!
Optimal diabetes control, regular supportive implant therapy and augmentation of peri-implant soft tissue deficits have proven to be crucial features in primary prevention of peri-implant diseases.
31.03.2023
Non-surgical peri-implantitis treatment – chemical cleaning ...?
Chemical additives for cleaning the implant surface as part of non-surgical peri-implantitis therapy may make sense, but there is a shortage of well-conducted studies with a sufficient number of patients and a long-enough follow-up period to really be able to recommend a specific method and/or a specific product.
31.03.2023
Non-surgical peri-implantitis treatment – gold standard ...?
Due to a continuing lack of well-conducted clinical studies, it is still not possible, based on the evidence, to give a clear treatment guideline for mechanical cleaning as part of non-surgical peri-implantitis treatment.
09.03.2023
El acierto de combinar innovación clínica y cultura
El reciente desarrollo de un concepto verdaderamente original, que incluye cursos educativos, talleres "hands-on" y que integra también un importante aspecto cultural de América Latina, está cambiando la manera de aprender y de relacionarse entre los profesionales de la odontología.
20.02.2023
Peri-implant mucositis – are chemical adjunctive therapies effective?
Based on the evidence, it is not possible to recommend professionally administered chemical adjunctive therapies in the treatment of peri-implant mucositis; the products tested to date did not demonstrate any significant benefits in comparison with debridement alone.
20.02.2023
Electric interdental cleaning – a good alternative …?
Electrically-powered interdental cleaning devices seem to have a comparable effectiveness to dental floss for gingivitis patients, but at the same time have the advantage that patients prefer them.
30.01.2023
Chewing gum as treatment …?
Chewing sugar-free xylitol chewing gum could have significantly positive effects in reducing gingival inflammation when used as an adjunct to traditional therapies for treating gingivitis (mechanical cleaning and optimisation of home oral hygiene), but further clinical studies are required in order to confirm this assumption.
30.01.2023
Periodontal diagnosis made easy
Implementing the new classification for periodontal and peri-implant diseases takes time and is a question of experience and practice, but simple reference tools such as a flowchart can help with this process.
27.01.2023
El prolongado y merecido éxito de los "Innovation Days"
Entrevista con Oliver Goetzendorff, Area Manager de W&H para América Latina, que ha recorrido país a país todo el continente, demostrando las innovaciones clínicas que ofrece su empresa, reconocida por desarrollar soluciones en campos de la Odontología como la Implantología, la Cirugía Oral, la Profilaxis o la Esterilización y el Mantenimiento de instrumental.
16.12.2022
Oral hygiene helps even in difficult situations!
Oral health (gingivitis, periodontitis) influences the occurrence and the healing process of oral mucositis in patients with haematological disorders who are given high-dose chemotherapy.
16.12.2022
Air polishing as an adjunct in non-surgical periodontal treatment …?
As part of non-surgical periodontal treatment, the additional use of air-polishing treatment could be beneficial for deep baseline probing pocket depths (≥ 5.5 mm) in particular.
11.11.2022
Gingivitis treatment = happier and healthier patients!
Treating gingivitis is not only the most effective option for preventing the occurrence of periodontitis, but also leads to a reduction in systemic inflammatory markers, whilst also improving the patient’s quality of life in terms of oral health.
28.10.2022
What is the situation with e-cigarettes and periodontal health?
Based on the available literature, the smoking of e-cigarettes seems to have a slightly less negative effect on periodontal health compared to traditional cigarettes.
28.10.2022
Periodontitis & bowel disease – Is there a link?
Patients with inflammatory bowel disease have a higher risk of oral diseases (periodontitis and tooth loss) and these diseases appear in turn to increase the degree of activity of inflammatory bowel disease.
13.10.2022
Lifelong supportive periodontitis treatment? Absolutely!
Periodontitis patients should always be integrated into supportive periodontitis treatment, as otherwise the rate of recurrence, and therefore a further episode of periodontal inflammation, is likely to be very high.
13.10.2022
The long-lasting effects of smoking on our implants …
Tobacco consumption has a lasting negative effect on the peri-implant tissue and leads to an increased risk of developing periimplantitis. This negative effect continues for years, even after an individual has successfully stopped smoking.
06.10.2022
Tooth loss rate in Europe – what is the trend?
We always endeavour to improve the health of our patients’ teeth, but are we actually successful in achieving this? Has oral health in Europe actually improved in recent years/decades and are our patients actually losing fewer teeth?
06.10.2022
Emdogain – can it help even without surgery …?
Emdogain is a product that consists of enamel matrix proteins and is obtained from porcine tooth germs. It has been successfully used in periodontal surgery for more than 20 years and, with the right indication and application, it can be used to achieve outstanding results including at least partial regeneration of periodontal defects.
27.07.2022
Periodontitis doesn’t normally come alone!
As early as 2016 (Monsarrat et al. 2016), a study outlined a link between periodontitis and 57(!) systemic diseases, the most well-known of these being diabetes mellitus and cardiovascular diseases. Time and again, these links prompt a discussion about the need for positive cooperation between dentists and doctors in order to improve early diagnosis of specific systemic diseases.
27.07.2022
Sensitive tooth cervix following periodontal therapy...
Experiencing cervical tooth sensitivity following periodontal therapy? Here’s what you can do about it! Non-surgical periodontal therapy can unfortunately entail a number of disadvantages, which are the sources of some complaints from our patients time and again. For example, they complain about the longer appearance of their teeth and/or about increased sensitivity of the exposed tooth cervix. Studies have shown that around 60 to 90% of our patients suffer from cervical tooth sensitivity in the period immediately following non-surgical periodontal therapy and that from a third up to a quarter of patients still suffer from cervical tooth sensitivity after 4 to 8 weeks (Lin et al. 2012).
28.06.2022
When does it make sense to splint teeth?
Periodontitis and the related attachment loss inevitably lead to increased tooth mobility after a certain period of time. This increased tooth mobility often makes patients aware that “something is not right,” but for many patients it is also a very unpleasant side effect of periodontal disease and one which can make them feel as if they are losing their teeth.
28.06.2022
Does periodontitis increase the risk of gestational diabetes
The links between diabetes mellitus and periodontitis are very well described and documented in the literature. A specific malfunction in the sugar metabolism can occur during pregnancy, which is referred to as gestational diabetes. In Austria, around 5–10% of all pregnant women are affected by gestational diabetes.
20.05.2022
Interdental cleaning – by itself or with an “extra” component?
Every day we try to persuade our patients to brush their teeth twice a day and to brush the interdental spaces at least once a day as well. However, we all know how particularly difficult it is to persuade our patients to brush the interdental spaces, as this calls for a certain amount of skill on their part.
20.05.2022
Can yoghurt reduce tooth loss ...?
Many beneficial effects on our health are attributed to the consumption of dairy products. Research indicates that there is a lower risk of diabetes mellitus, metabolic syndrome and cardiovascular disease. It also describes beneficial effects specifically for the oral cavity thanks to the consumption of dairy products. Certain studies, for example, showed that high and regular consumption of dairy products led to a lower risk of periodontitis.
21.04.2022
Can too much coffee lead to tooth loss …?
Coffee is clearly one of the world’s favourite drinks! For example, in 2019 around 160 million 60-kilo sacks of coffee were consumed worldwide, and Austria is also one of Europe’s biggest consumers of coffee. In Austria, annual consumption is around 162 litres or 7.2 kilos – this equates to an average of 2.6 cups of coffee per person per day!
21.04.2022
Knowledge is motivation!
The key to success in periodontal treatment is the cooperation of the patient. If the patient fails to comply every day of their life with good and efficient oral hygiene at home and fails to attend recalls consistently, we will unfortunately fail despite all our efforts.
15.03.2022
Medium bristles – are they really a problem?
The discussion on soft, medium or hard bristled toothbrushes is not a new one, and yet new literature on the subject is appearing all the time, so it is something we are keen to address.
15.03.2022
Successful treatment – does it make a difference?
The ‘new’, although also now almost five-year-old, classification for periodontal and peri-implant conditions included a definition for a successfully treated periodontitis patient for the first time.
01.03.2022
Lessons from the pandemic: continuity in treatment is important!
The Covid-19 pandemic has posed and continues to pose major challenges for all of us – this includes our patients and their compliance in terms of attending regular dental check-ups. For example, already during the first few months of the pandemic, patients proved to be far more reluctant to attend medical check-ups and appointments (Makiyama 2020). Now that the pandemic has continued for far longer than initially anticipated, however, it is important for us to encourage our patients to begin attending regular appointments for check-ups and treatment again.
01.03.2022
Prognosis for teeth with through-and-through furcations
The optimal treatment result for periodontitis patients is for them to keep their own teeth in good condition for as long as possible. However, there are both patients and teeth with certain characteristics that make it significantly harder to actually achieve this objective!
04.01.2022
AirFloss – a popular alternative …?
Interdental cleaning is not a favourite activity for most patients. Furthermore, based on a survey of 2000 representative Americans, it was found that almost a third of patients lie to their dentist when asked about their teeth-cleaning habits and, in particular, about the use of dental floss. Having said that, it is our responsibility to recommend the best tool for effective interdental cleaning for each of our patients – in terms of effective plaque removal, but also in terms of long-term compliance.
04.01.2022
Dementia and periodontitis …?
The principal symptom of dementia is a worsening of cognitive capabilities. This can impact short-term memory, ability to think and/or motor skills, for example, and those affected lose the skills they once had.
04.01.2022
How often should we actually be cleaning our teeth?
We are used to telling our patients, ‘Clean your teeth twice daily!’. But where does this idea come from, and is it really necessary to brush twice daily? What would happen if we only brushed our teeth once every two days?
04.01.2022
Which factors have affected dental status in the last two decades?
In Germany, cross-sectional studies of oral health are carried out at regular intervals (German Oral Health Study). Data from five cross-sectional studies are available thus far, and the sixth study is scheduled to take place between 2021 and 2023.
04.01.2022
Can using mouth-rinse reduce the pain of periodontal treatment?
To achieve a high level of compliance among periodontitis patients in the maintenance phase of treatment, it is important to make this maintenance therapy, including professional mechanical plaque removal, as pleasant as possible. Unfortunately, however, patients often experience pain during cleaning with (ultra)sonic devices, which could reduce their compliance later on and, in particular, in the long term.
04.01.2022
Air polishing as an adjunct to ultrasound?
According to the recently published S3 guidelines about treating patients with stage I–III periodontitis (Sanz 2020), the current evidence-based recommendation is to perform subgingival debridement as part of non-surgical periodontal treatment with hand instruments and/or (ultra)sound devices. But of course, the search continues to find options that will further improve the outcome of non-surgical periodontal treatment.
04.01.2022
Stress results in poorer treatment outcomes!
In a previous article (‘Does periodontitis cause anxiety and depression?’) we explored the links between periodontal disease and mental illnesses and, based on a systematic review, it was shown that periodontitis increases the risk of both depression and anxiety disorder. This connection is thought to be bi-directional.
04.01.2022
Does periodontitis cause anxiety and depression?
Are anxiety and depression caused by periodontitis? Or is periodontitis caused by anxiety and depression? According to the literature, the connection between periodontal disease and mental illness or mood disorders is probably bi-directional; this means that each illness can influence the other.
04.01.2022
Regular tooth brushing reduces the risk of stroke!
‘Tooth brushing and risk of stroke’ – are the two really connected? This hypothesis is based on the following theory: Poor and insufficient oral hygiene can lead to gingivitis and, in turn, to periodontitis. In periodontitis, oral bacteria can enter the bloodstream, resulting in a local and systemic inflammatory reaction. This inflammatory reaction is accompanied by an increase in inflammatory markers, and it is this mechanism that could in turn increase the risk of having a stroke.
04.01.2022
Covid-19 & periodontitis
In the previous article we summarized the results of a systematic review about manifestations of oral symptoms in patients with a Covid-19 infection (see: Covid-19 & oral symptoms). Another fascinating study was recently published in the Journal of Clinical Periodontology. In this study, Marouf et al. (2021) investigated the possible influence of periodontitis on the progression of Covid-19 infections.
04.01.2022
Covid-19 & oral symptoms
According to data from the World Health Organization (WHO), almost 110,000,000 people have tested positive for Covid-19 since the pandemic began in December 2019, and 2,435,000 of these cases have had a fatal outcome. On account of this huge outbreak, our professional and social lives have also changed over the past twelve months, in some cases massively.
04.01.2022
Peri-implant disease risk assessment
The ‘spider web diagram’ devised by Bern University is intended to help clinicians assess the individual risk profile of patients with periodontitis. You can find more information about this in a previous article (Periodontal maintenance therapy – how often do I need it?). But does such a thing also exist for implant patients? As of this year, the answer is: yes, it does – the Implant Disease Risk Assessment.
04.01.2022
Mechanical biofilm management at home
Mechanical biofilm management at home is indispensable for preventing gingivitis and subsequent periodontitis. The German Society for Periodontology (DG Paro) recently published new guidelines on this topic: ‘Mechanical biofilm management at home for the prevention and treatment of gingivitis’
04.01.2022
The long-lasting effects of smoking on our teeth …
How can we demonstrate to our patients exactly how bad smoking is for the teeth? We already tackled this topic in one of the first scientific articles and were able to provide a very vivid example (Smoking & periodontitis): ‘Smoking substantially reduces the ability of the periodontium to heal during periodontal treatment – it is thought that the healing capacity of a 50-year-old smoker’s periodontium roughly corresponds to that of an 86-year-old non-smoker’s periodontium – that is a difference of 36 years!’
04.01.2022
Treating periodontal disease during pregnancy
Periodontitis and pregnancy – it’s something we deal with regularly in our day-to-day work. But what can we do? And – most importantly – what are we allowed to do?
04.01.2022
Diabetes & periodontitis
Diabetes mellitus and periodontitis are two of the most common chronic diseases. Diabetes mellitus affects approximately 415 million people worldwide, and periodontitis affects as many as 750 million. Furthermore, these two diseases mutually affect each other, and periodontitis constitutes one of the main complications of diabetes. But what exactly is the current situation among patients with periodontitis and/or type 2 diabetes mellitus?
04.01.2022
Periodontal treatment in patients with diabetes – what do you need to know?
We recently discussed the links between periodontitis and diabetes mellitus. But what do you need to watch out for when giving periodontal treatment to patients who also have diabetes?
04.01.2022
The patient has their new implant-supported prosthesis – what now?
The patient has received their new implant-supported prosthesis, but our work is not done yet. Now we have to help the patient enjoy their new implant and crowns for as long as possible, a task that includes keeping the implant and surrounding tissue healthy and free from inflammation. To enable prompt recognition of any peri-implant disease that may subsequently occur, it is important to perform a ‘baseline examination’ after the patient has received their implant-supported prosthesis.
04.01.2022
Smoking & periodontitis
Smoking and periodontitis – how bad is it really?
03.01.2022
Taking good implant X-rays made easy!
To be able to diagnose peri-implant diseases correctly, it is helpful to have good-quality, informative X-rays. However, periapical bitewing X-rays of implants in particular can often turn out blurry. There is, however, one very simple rule you can follow to correct these images and to depict implant threads clearly and precisely, thus enabling exact determination of the patient’s bone level. Furthermore, this rule is easy to remember and, above all, can be implemented rapidly in daily clinical practice.
03.01.2022
New classification scheme for periodontal diseases
In June 2018, as part of the EuroPerio 9 conference in Amsterdam, the long-awaited new classification scheme for periodontal and peri-implant diseases was presented publicly to dentists.
03.01.2022
Classification of clinical periodontal health
For the first time, the new classification scheme for periodontal diseases, which was presented in June 2018, contains a definition of the concept of clinical periodontal health (Lang & Bartold, 2018).
03.01.2022
Classification of gingivitis
The new classification continues to differentiate between plaque-induced gingivitis and non-plaque-induced gingival diseases (Chapple et al., 2018).
03.01.2022
How to correctly diagnose peri-implant mucositis
Up to what point can an implant and its surrounding tissue be described as healthy? And at what point are caution and appropriate treatment required because the diagnosis of peri-implant mucositis already applies?
03.01.2022
How to correctly diagnose peri-implantitis
The article ‘How to correctly diagnose peri-implant mucositis’ discussed the criteria for peri-implant health and peri-implant mucositis. But how can you tell that the patient’s condition has already reached an advanced stage – in other words, how can I correctly diagnose peri-implantitis?
03.01.2022
Probing of implants – what to consider
Regardless of whether you are treating a new patient or seeing an existing patient for a check-up, there is no doubt that implants (see article ‘The patient has their new implant-supported prosthesis – what now?’) need to be monitored right from the start, just as natural dentition does – and that includes measurement of pocket probing depths!
03.01.2022
Classification of gingivitis
In June 2018, as part of the EuroPerio 9 conference in Amsterdam, the long-awaited new classification scheme for periodontal and peri-implant diseases was presented publicly to dentists.
03.01.2022
The importance of an up-to-date medical history
It is important to fully update our patients’ general medical history and medication at regular intervals (at least once per year) – even for patients we have known ‘for years’.
03.01.2022
Chemical biofilm management at home
Mechanical biofilm management should always be regarded as the basis for preventing periodontal diseases. It combines tooth brushing and interdental cleaning.
03.01.2022
Periodontitis – is it a risk for peri-implantitis....?
Affecting approximately 750 million people, periodontitis is the sixth most common disease worldwide. Apart from caries, it is the most common cause of tooth loss. Consequently, periodontitis patients often ask their dentist about implant-supported dentures.
22.12.2021
A residual pocket probing depth of 6 mm – is it a problem?
It is a situation we are all too familiar with: following the active phase of treatment, nearly all the patient’s teeth are now unaffected by increased pocket probing depths. However, there are still 1 or 2 places where the treatment goal has unfortunately not been achieved.
22.12.2021
Periodontal maintenance therapy – how often do I need it?
A very common question after the active phase of periodontal therapy is how high the patient’s risk is of re-developing periodontal problems.
22.12.2021
Interdental care – what is the best option?
Whether manual, sonic or electric, a toothbrush on its own is unfortunately insufficient to achieve perfect oral hygiene, because it is simply unable to penetrate the interdental spaces deeply enough. But what advice should we give to our patients?
22.12.2021
No-one wants bad breath ...
Bad breath (halitosis) can be extremely unpleasant for those affected, and it is estimated that approximately one person in four struggles with persistent bad breath. A Belgian study (Quirynen 2009) investigated 2000 patients whose main concern was unpleasant bad breath. The study showed that the oral cavity was the source of bad breath in 75% of patients and thus fell within the dentist’s remit. Only 10% of cases had an extraoral cause, and 15% of participants had what is known as pseudohalitosis, where a patient is convinced they have bad breath even though it can be neither detected nor perceived by other people.
22.12.2021
Air-polishing devices in periodontal treatment
Air polishing devices have become a firmly established part of periodontal treatment in recent years. But how efficient are they? What applications do they have? What should be considered when using them?
22.12.2021
Dentine hypersensitivity – what can be done?
Exposed dentine often leads to painful teeth and causes a short sharp pain. If this pain occurs regularly, it can substantially impair the patient’s quality of life. The prevalence of dentine hypersensitivity varies according to the population being investigated; as an example, however, one study found it affected 40% of individuals aged 18 to 35 (West et al. 2013). Any treatment should ideally be easy to use, effective, rapid and long-lasting.
22.12.2021
Using smart phones in prophylaxis
The use of smart phones for ‘mHealth’ (mobile health) in prophylaxis is becoming more and more fashionable – but what does it involve exactly?
22.12.2021
Will periodontal treatment really make me feel better?
From the patient’s point of view in particular, having treatment for periodontal disease can seem tedious and stressful. Patients find one fact hard to deal with in particular: periodontal disease is a chronic condition that requires a life-time follow-up (every 3 months in severe cases) to ensure the patient’s periodontal status remains stable after the active phase of treatment and during maintenance therapy. Inevitably we are asked the following question again and again: ‘will periodontal treatment really make me feel better?’
22.12.2021
Does periodontal treatment really pay off?
The previous report discussed a question that patients frequently ask: ‘will periodontal treatment really make me feel better?’ And, based on the literature, this question should be answered with a resounding ‘yes!’ However, personal well-being and oral-health-related quality of life are not the only issues – for many patients, financial considerations are also of primary concern, prompting the question: ‘does periodontal treatment really pay off?’
21.12.2021
Diabetes screening at dental surgeries?
The bidirectional links between periodontitis and diabetes are undisputed, and a big problem associated with diabetes is the relatively high number of unreported cases. To improve this number and to identify patients with pre-diabetes and diabetes sooner, the potential role of the dental surgery has been discussed more and more in recent years.
21.12.2021
Electric toothbrushes have a proven long-term effect
The effectiveness of electric toothbrushes is undisputed, and their safety when used correctly has also been proved over a period of at least 3 years (see also: ‘Can brushing your teeth be harmful...?’). This fact was also recently stressed in the new guidelines of the German Society for Periodontology (DG Paro; see also: ‘Mechanical biofilm management at home for the prevention and treatment of gingivitis’). And the last systematic Cochrane Review systematischen Cochrane Reviews (Yaacob et al. 2014) also concluded that electric toothbrushes reduce plaque and gingivitis by a statistically significantly greater amount than manual toothbrushes do. However, the following question remains: does this statistically significant benefit really lead to a better periodontal status and less tooth loss in the long term?
21.12.2021
Untreated peri-implant mucositis …
We know what we should do after the patient has been fitted with their implant-support prosthesis, but if our approach is less than strict, what actually happens? What happen to patients who have peri-implant mucositis but are nonetheless not included in a regular follow-up programme?
21.12.2021
Should dental floss be used before or after tooth brushing?
It is often very hard to persuade our patients to clean between their teeth. Patients are often still advised to use dental floss, despite the fact we know that in many cases floss is not their method of choice and, above all, is often rather unpopular.
21.12.2021
Smoking also affects the maintenance phase
A previous article (Smoking & periodontitis ) explained the severe effects of smoking on the periodontium. But how does a smoker’s periodontium behave compared with a non-smoker’s periodontium during the periodontal maintenance phase after active periodontal treatment?
21.12.2021
NIWOP – No Implantology Without Periodontology
Sowohl periimplantäre Mukositis als auch Periimplantitis sind leider häufig auftretende biologische Komplikationen rund um dentale Implantate. Bei fast jedem 2. beziehungsweise 4.Patienten/Patientin wird eine periimplantäre Mukositis beziehungsweise Periimplantitis diagnostiziert (Derks & Tomasi 2015)!
21.12.2021
NIWOP – pretreatment = the right start!
Patient request: ‘I would like to replace my missing tooth – can I have an implant?' In addition to implantological information, such as the patient’s available bone, medications, underlying diseases etc., several other very important factors need to be clarified before this question can be answered. Above all, these include the patient’s periodontal condition, their compliance and their smoking status. These issues are included and summarized in the first phase of the NIWOP workflow NIWOP Workflow (NIWOP – No Implantology Without Periodontology - )“ under ‘Pretreatment’. Everyone working in prophylaxis plays a very important role during this phase.
21.12.2021
Cleanability is a must!
Both when treating peri-implant diseases and after fitting a new implant-supported restoration, our top priority should always be to provide patients with instructions regarding home oral hygiene. However, there is one thing we must not forget: It must be possible for the patient to actually clean their implant-supported restoration!
21.12.2021
Personalized prevention – the implications of general health factors
Whether preventative or curative, dental measures need to be individually tailored according to the risk factors identified for each patient. In this context, general health is significantly influenced by three risk factors.
21.12.2021
Periodontitis & cardiovascular diseases
The ‘Perio–Cardio Workshop 2019’ took place in February 2019. This workshop was organized by the World Heart Federation in collaboration with the European Federation of Periodontology
21.12.2021
A long-term study confirms that implant follow-ups do help
In line with phase 3 of the NIWOP approach (NIWOP [No Implantology without Periodontology] – consistent & long-term follow-up care) regular implant follow-up sessions should be planned and adhered after completing implant treatment. But what happens if the practitioner and/or patient does not adhere to this, and regular implant follow-up sessions do not take place?
21.12.2021
Orthodontic treatment of periodontitis patients – is such a thing possible ...?
Patients with periodontitis often suffer from the problem that loss of attachment has caused the position of their teeth to change – i.e. they have drifted, rotated and/or elongated. Flared anterior teeth with a gap between the central incisors is a very common finding among periodontitis patients. As a result, these patients very often ask about the possibility of getting the (usually unaesthetic) position of their teeth straightened – either before they undergo periodontal treatment, or at the latest after.
21.12.2021
Is a manual or an electric toothbrush better during orthodontic treatment?
As mentioned in a previous article (article) one of the most important factors during orthodontic treatment is that the patient has a healthy, inflammation-free periodontium. This applies both to inherently periodontally healthy patients and to patients who have had successfully completed periodontal treatment.
21.12.2021
Can probiotics be used in maintenance therapy?
The article ‘Probiotics in periodontal treatment – an overview’ took a first look at the potential role of probiotics in periodontal therapy. The review presented in that article was from 2016. Since then, however, several new studies on this topic have been published, one of which had an interesting approach: Can probiotics be used in maintenance therapy?
14.12.2021
Mucositis & gingivitis – are they comparable?
Unfortunately, peri-implant diseases are an all too common part of our day-to-day work nowadays. Similar to gingivitis and periodontitis, the primary aetiological factor for developing peri-implant mucositis and peri-implantitis is the accumulation of oral biofilm. But how do the tissues respond to this bacterial load? Does the immune system also respond in a similar way?
14.12.2021
Probiotics in periodontal treatment – an overview
The term ‘probiotics’ refers to a preparation that contains viable micro-organisms, such as species of lactobacilli and bifidobacteria, and is intended to have a positive effect on health.
14.12.2021
Do air-polishing devices have any contraindications?
The use of air-polishing devices for the treatment of periodontal and peri-implant diseases is now part of daily routine at the dental surgery. When used for the right indications, they are regarded as safe and effective. In addition, patients often find them more pleasant than traditional methods.
14.12.2021
S3 guideline – Subgingival instrumentation
In collaboration with the German Society for Periodontology (DGParo), in October 2019 the German Society for Dental, Oral and Maxillary Medicine (DGZMK) published a new S3 guideline on the topic of ‘Subgingival instrumentation’, which is now valid for five years. This new guideline primarily focuses on the following two main topics:
14.12.2021
Some information about manual toothbrushes
Dagmar Else Slot is probably one of the most published dental hygienists, and her systematic reviews always make for interesting reading. This time she has published a review on the topic of the efficacy of manual toothbrushes, and this study also helps us to answer the question: Does it really make a difference whether I quickly brush my teeth for only one minute, or if I brush them for two?
14.12.2021
Are all interdental brushes equal ...?
Interdental brushes are viewed as the tool of choice for patients with periodontitis. This is because for interdental attachment loss in particular, they are regarded as more effective than dental floss, for example. Most interdental brushes on the market are cylindrical in shape. However, a research group from Austria (Innsbruck Medical University) asked the valid question of whether this cylindrical shape truly is the ‘best’ for optimum cleaning efficacy (Schnabl 2019).
14.12.2021
Interdental brush or oral irrigator?
In periodontal maintenance therapy, keeping our patients motivated is particularly important – in terms of both oral hygiene and attending appointments at the dental practice.
14.12.2021
Oral hygiene – just get stuck in ...?
Anyone who works in prophylaxis is aware of the importance of oral hygiene home care, particularly if we want to treat our periodontitis patients successfully in the long term.
14.12.2021
Do adjunctive therapies help in the treatment of gingivitis?
Another topic that was discussed as part of the Perio Workshop 2019 was the efficacy of chemical adjunctive therapies in the treatment of gingivitis. Of course, this is not a ‘new’ topic, and several reviews on this subject already exist; this time, however, two new issues were tackled:
14.12.2021
Adjunctive therapies in non-surgical periodontal treatment I
Another topic that was discussed as part of the Perio Workshops 2019 was the effectiveness of local and systemic adjunctive therapies or medications in non-surgical periodontal treatment.
14.12.2021
Adjunctive therapies in non-surgical periodontal treatment II
In the recently presented systematic review by Donos et al. (‘Adjunctive therapies in non-surgical periodontal treatment I’), local and systemic adjunctive therapies were discussed in the context of non-surgical periodontal treatment. However, as part of the Perio Workshop 2019, the possibilities offered by local antibiotics were also assessed.
14.12.2021
What are the desired endpoints after periodontal treatment?
In addition to evaluating treatment methods, the following topic was also discussed at the Perio Workshop 2019: ‘What are we actually trying to achieve with periodontal treatment – from a practitioner’s perspective, but above all from a patient’s perspective?’
14.12.2021
Determining patients’ caries risk – what makes sense?
The main diseases we are confronted with in dentistry are caries and periodontal conditions. Although the results of the fifth German Oral Health Study show a positive trend for the two diseases, effective prevention of both must nonetheless be our primary goal. We discussed the options for caries prophylaxis in a previous article (‘Update on caries prophylaxis’). The current article is intended to provide an overview of the tests for determining patients’ caries risk.
14.12.2021
Subgingival instrumentation – Part II
Effective instrumentation of the root surface is an indispensable part of treating patients with periodontitis. In Part I of the topic ‘subgingival instrumentation’ based on the results of the Perio Workshop 2019, the effectiveness of ‘standard techniques’ [(ultra)sonic instruments, hand instruments or a combination of the two] was described. Part II of this topic will now focus on newer approaches, such as laser Technology and photodynamic therapy, as supplements to mechanical cleaning.
14.12.2021
Adjunctive therapies in non-surgical periodontal treatment III
Following Part I (local and systemic non-antibiotic adjunctive therapies) and Part II (local antibiotics and antiseptics) about adjunctive therapies in non-surgical periodontal treatment, Part III now goes on to look at the results from the Perio Workshop 2019 regarding the effects of using systemic antibiotics as part of non-surgical periodontal treatment.
14.12.2021
Protection from aerosols – S1 guideline of the German Society for Dental, Oral and Maxillary Medicine
Since the outbreak of the pandemic and the resulting global spread of SARS-CoV-2, aerosol-generating activities have been a hot topic of discussion in dentistry. How should we handle them? How can we best protect our patients and ourselves? What measures should we take in daily clinical practice?
14.12.2021
Does using an intelligent toothbrush make for healthy gums?
In a previous article (Using smart phones in prophylaxis) we discussed the possible advantages of mHealth, the use of mobile electronic devices in healthcare, for dentistry. Tonetti et. al have just published a new study on this topic in the Journal of Clinical Periodontology, about the use of an intelligent electric toothbrush in combination with a mobile app.
14.12.2021
Personalized prevention – case-oriented needs adaptation
A patient-oriented tailoring of preventative measures seems to be next logical step to counter the complexity of oral diseases for the future. Although existing strategies – for example, caring for periodontitis patients by means of supportive periodontitis treatment (SPT) – can stabilize the treatment outcome of an individual disease, their integration in a case-specific and needs-oriented preventative approach is lacking.