DTUK2010

17Implant TribuneAugust 2-8, 2010United Kingdom Edition limited reduction in bleeding on probing was achieved and that the mean peri-implant probing depth (PD) remained unchanged (3.9mm) in the chlorhexidine group. On the other hand, in the minocycline group, the reduc- tion of bleeding on probing was statistically significantly greater than that in the chlorhexidine group, coupled with an improve- ment in mean peri-implant PD (from 3.9mm to 3.6 mm). These results suggested that the topi- cal application of chlorhexidine provides limited or no adjunc- tive clinical improvements when treating shallow peri-implant lesions as compared with using mechanical debridement alone. (33) Moreover, in another study was compared the efficacy of sub-mucosal debridement alone for the therapy of peri-implanti- tis utilising an ultrasonic device versus hand instrumentation with carbon fibre curettes. He concluded that there was no sta- tistically significant difference reported for the implants treated either by the ultrasonic device or manually scalers between baseline and three to six months regarding reduction in bleeding on probing and radiographical bone loss. (34) An interesting treatment mo- dality can be the laser decontam- ination of the implant surface. The use of Er:YAG laser was used alone and compared to the combination of mechanical deb- ridement (using plastic curettes) and antiseptic (0.2 per cent chlo- rhexidine digluconate) adminis- tration for the treatment of peri- implantitis. In both studies the results obtained at six months after therapy suggested that the treatment modalities were equal- ly efficacious in significantly im- proving peri-implant probing pocket depth (PPD) and clinical attachment level (CAL). However, at 12 months in both groups, the mean values of peri-implant PPD and CAL was not statistically significantly different from the correspond- ing values at baseline. There- fore, the efficacy of the Er:YAG laser seems to be limited to a six-month period, particularly for advanced peri-implantitis lesions and the main reason for this result can be found in the difficulty accessing the apical portion of the defect in those lesions. (30) Treating advanced peri-im- plant lesions may include an at- tempt to regenerate as much as possible of the lost bone struc- ture. The efficacy of two bone regenerative procedures for the treatment of moderate intra- bony peri-implantitis lesions were also compaired. The defects were randomly treated either with a combination of access flap surgery and the application of nanocrystalline hydroxyapa- tite or with a combination of flap surgery and the application of a bovine-derived xenograft (Bio- Oss, Geistlich, Wolhusen, Swit- zerland) and the placement of a bioresorbable porcine-de- rived collagen membrane (Bio- Gides, Geistlich, Wolhusen, Switzerland) (31) . After two years the evaluation of the study showed that application of the combination of natural bone mineral and collagen mem- brane seemed to correlate with greater improvements in clinical parameters (32) . Several treatment modalities have been suggested for treat- ment of peri-implantitis, how- ever, it was demonstrated in the case series that it was possible, but not predictable, to maintain implants using a treatment mod- el consisting of surgical clean- ing and a systemic antimicro- bial treatment for five years (9) . Long-term treatment modalities need to be assessed and there is a need for randomised-control- led studies evaluating treatment of non-surgical therapy of peri- implantitis. Conclusion The management of implant page 18DTà ‘The management of implant infec- tions should be focused both on infection control of the lesion, detoxi- fication of the im- plant surface, and on regeneration procedures’. Habits, good or bad, started at a young age can last a lifetime. As you know, many adults do not brush their teeth for as long as they should – twice a day for 2 minutes. At Aquafresh we understand good toothbrushing habits can offer patients a lifetime of protection. That’s why we have developed a range of products to suit children of all ages, from when milk teeth first appear and to support your recommendations. With the help of the “nurdle” characters we hope to make brushing a fun activity and help children develop good oral hygiene habits. 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To find out more about Aquafresh and the Nurdles, visit: www.aquafresh.co.uk Aquafresh big teethAquafresh big teeth toothpaste Aquafresh big teeth toothbrush mouthwash • All round protection for new big teeth • 1400 ppm • Sugar free • Fresh mint taste • Different length bristles • Designed to clean between gaps and gums • Alcohol and sugar free • 225 ppm fluoride • Antibacterial • Mild mint flavour 6+ years toothpastetoothpaste • All round• All round protection for new big teeth • 1400 ppm • Sugar free • Fresh mint taste 6+ years Habits started at a young age can last a lifetime • Protection boost for maturing milk teeth • 1400 ppm fluoride • Sugar free • Mild mint taste • Soft & gentle bristles • Comfortable grip for ease of use • Fun character designs Aquafresh little teeth 4-6years • Protection boost for toothpaste toothbrush • Comfortable grip Aquafresh big teeth 4-6yearsyears • Gentle protection for baby teeth and gums • 1000 ppm fluoride • Sugar free • Mild mint flavour • Soft & gentle bristles • Rubber cushioning on brush head to protect gums Aquafresh milk teeth 0-3years 0-3years 0-3years • Gentle protection for toothpaste toothbrush Milky SM1813_8 Aquafresh Kids Dental Tribune.indd 1 21/6/10 12:17:09

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