Dental Tribune United Kingdom Edition

29Event reviewApril 25-May 1, 2011United Kingdom Edition T he eighth Emerging Trends Symposium ini- tiated by Philips took place in Cologne, Germany the day before the start of the IDS on 20-21 March 2011. It was at- tended by 50 key opinion lead- ing dental professionals from across Europe, attracted by a roster of international speakers, each adding to the knowledge- base which is redefining oral hygiene intervention. By the close of the symposium the as- sembled delegates were left in no doubt about closing the gap between the science and art of dentistry. As a precursor to the in- troduction of two new Philips products at the close of the symposium, the event kicked off with a lecture about peri- implantitis and what is known and can be done to tackle this condition which can lead to the body’s rejection of an implant. According to the first speak- er, Professor Hugo de Bruyn, peri-implantitis is an inflam- matory process within the tis- sues surrounding the implant components, which in most cases is related to a bacterial infection. It affects both soft and hard tissues around dental implants in a dramatic way because it leads to bone loss and is relat- ed to pocket formation and pus evacuation. This often irrevers- ibly affects the appearance as well as position of the gums and the interior zone of the maxilla, and has aesthetic consequences leading to patient dissatisfac- tion. Central to the treatment of peri-implantitis is biofilm re- moval, however there are im- portant differences between the gums around teeth and im- plants which should affect the approach to oral hygiene for those with implants. Surgi- cal treatment is predominately based on implant surface de- contamination and this is typi- cally combined with pocket reduction and regenerative pro- cedure’s to close the defect. The first option is a radical way to reduce the defect and improve accessibility for oral hygiene measures whilst the second op- tion aims to avoid recurrence of disease and enhance the aes- thetic outcome by defect clo- sure. Currently there are a very limited number of powerful clinical studies available which focus on etiology, pathogenesis and efficacy of peri-implan- titis treatment. Yet Professor de Bruyn questioned whether the ‘alarming rise in the dis- ease’ discussed in some papers is the reality of everyday clini- cal practice. He also questioned whether it is related to changing treat- ment protocols or changed implant surfaces or designs which have been introduced. His lecture concluded with an overview of the literature and treatment rationales and showed, by means of case reports, ome clinical conse- quences, protocols and clinical guidelines related to disease prevention and treatment. He was followed on the lec- ture podium by Dr Klaus Höcker who discoursed about whether oral hygiene is a success pa- rameter during systematic ther- apy. Dr Höcker explained that chronic periodontitis is prima- rily caused by the accumulation and mobilisation of bacteria on the surfaces of the teeth. As we improve our detailed knowledge about these bacte- rial deposits and the pathways of periodontal breakdown, the improvement of the patient’s in- dividual oral hygiene becomes pivotal to the goal of improved periodontal therapy. Information, instruction and the motivation of periodontally diseased patients plays a large part in a systematic treatment approach which is based on the control of plaque, infection and inflammation. Once systematic therapy is successfully accomplished the long term success will be challenged by the practitioners’ ability to keep to a high level of oral hygiene and a lifelong compliance. This was backed up in an energetic talk about contem- porary oral hygiene by Maria Perno Goldie who took as her theme the need to translate science into practice. She start- ed by providing an overview of the International Federation of Dental Hygienists (IFDH) which she heads up and provided a global perspective of the practice of dental hy- giene. She then presented the ADHA Standards for Clini- cal Dental Hygiene Practice before evaluating the clinical treatment and maintenance challenges faced today by practitioners, with a focus on contemporary treatment con- cepts and patient recommenda- tions. She concluded that pa- tient communication is a vital part of these challenges and ad- dressed a number of interven- tion techniques for practition- ers to use with patients. Dr Paul Stoodley took as his theme ‘Biofilm Management beyond Plaque Removal’ and started by explaining that den- tal plaque biofilm is a living community of many different types of bacteria and microor- ganisms which attach and grow to tooth and gum surfaces. The resilience of dental plaque biofilms is underlined by the ongoing management ef- fort required to maintain good oral health. Direct scrubbing using brush bristles is an es- tablished method of removing dental plaque biofilm, how- ever there are many locations within the mouth, such as the interproximal spaces, gingival sulcus and pits and fissures in the occlusal grooves, which are difficult to access. Biofilms can also be re- moved by fluid flow, if high enough shear forces are gen- erated. Dr Stoodley demon- strated that powered brushing using Philips Sonicare sonic toothbrushes, can remove biofilm formed from Strepococ- cus muntans, a common bio- film dental plaque cariogenic pathogen, from interproximal spaces and frontal tooth sur- faces by the generated fluid flow alone. In more inaccessible areas, where some biofilm remained, he demonstrated that fluid flow could act as a reservoir for fluoride, potentially having the beneficial effect of increasing contact time with the enamel surface. Fluoride also reduces the degree of acidity at the tooth surface by reducing biofilm ac- tivity. Building on the application of fluid flow for biofilm man- agement, Dr Stoodly introduced the concept of the new Philips Sonicare AirFloss which utilis- es a small volume of high veloc- ity liquid to create high shears and jet impingement pressures to remove biofilm from inter- proximal spaces. By using a typodont model and artificial biofilms com- prised from biopolymers pro- duced by biofilms, he showed how he had captured the re- moval from interproximal spaces using high speed imag- ing. On impact the artificial bio- film in the interproximal space was immediately pushed back by the flow, the biofilm then stretched until the breaking point was reached and the bio- film detached Finally Thomas Clos ad- dressed the need to draw to- gether more closely new tooth- brush production methods with marketing requirements and beneficial performance for us- ers. During his presentation he gave an overview of the evolu- tion of industrial toothbrush production and demonstrated the state of the art methods used today. The pros and cons of each method were highlighted and the presentation concluded with an insight into develop- ment and production methods used for the creation of a new Philips Sonicare DiamondClean brush head. At the climax of the sympo- sium the assembled delegates were given a preview and in- sight into the research and clinical effectiveness of two new Philips Sonicare products which were launched the fol- lowing day at the IDS. The new Philips Sonicare AirFloss is the first interden- tal cleaning device which uses microburst technology to clean interproximally whilst Philips Sonicare DiamondClean power toothbrush is considered the most sophisticated, high per- formance Sonicare toothbrush to date DT Emerging trendsA look at the recent Philips Symposium in Cologne, Germany ‘As we improve our detailed knowledge about these bacterial deposits and the path- ways of periodontal breakdown, the im- provement of the patient’s individual oral hygiene becomes pivotal to the goal of im- proved periodontal therapy’ Attendees at the symposium