Month: May 2019

Harness innovation to improve oral health

Ultaire AKP offers a biocompatible, lightweight, natural feeling and more aesthetically pleasing alternative…

No matter what age you are, a great smile has considerable appeal. The teeth affect physical attractiveness and can also influence the way in which a person is perceived. This could possibly be the reason why we have seen growth in the demand for cosmetic dentistry and facial aesthetics, as well as an increase in solutions to care and treat an ageing population.

Ageing baby boomers form one of the largest segments of modern society. According to the World Health Organisation the proportion of people over 60 years of age worldwide is set to double by 2025 and by 2029, the last of the baby boomers will reach the age of 65. Born between 1946 and 1964, this generation has witnessed unprecedented social and cultural change and have enjoyed the security of economic growth, a ‘cradle to grave’ welfare system and the life long benefits of the NHS. In addition, baby boomers tend to be more active, healthier, happier, better educated and better nourished than previous generations and this, along with advanced medical care, means that their life expectancy is increased significantly. As far as oral health is concerned, a lifetime of good sanitation and fluoridation means that those aged over 55 can reasonably expect to keep at least some of their natural teeth for life.

Since the establishment of the NHS in 1948, baby boomers have had access to the dental care that previous generations were unable to afford. It is not all great news though, as during the early years, general NHS dentists were remunerated with a ‘fee per item’ treatment system. This was to meet the demands of the nation’s previously untreated mouths. However, it has been heavily criticised since because this method of payment placed an emphasis on quantity of care rather than quality. It has been reported that a significant amount of unnecessary treatment was carried out and it was not until the mid 1970s that the flaws of the system were recognised and the remuneration system and structure of NHS dentistry was reformed. Similarly, it was not until this time that dental professionals were actively encouraged to provide preventive care and educate patients on oral health matters.

Although most baby boomers now understand the concept of preventive dentistry, it is likely that they will have experienced numerous dental procedures. Certainly, many have some of their natural dentition but these individuals are often referred to as the ‘heavy-metal generation’, as they present with a high number of fillings and other restorations. This poses further challenges for the dental profession, as many of these restorations are not expected to last a lifetime and dentists may need to deliver complex treatment plans to repair or replace them. Additionally, the effects of ageing can also impact oral health and place individuals at an increased risk of periodontal disease or decay to teeth that are already heavily restored or in a weakened state. For example, disability can prevent access to regular dental care, loss of dexterity can seriously compromise the oral hygiene routine and sensory impairments such as decreased sense of smell or taste can negatively impact nutritional status. Furthermore, as people age their medication requirements increase and so too do the possibilities for side effects. For instance, common drugs such as those used to treat high blood pressure, cholesterol, pain medications and muscle relaxants may cause xerostomia, which can place individuals at a higher risk of developing caries.

In the next 30 years, baby boomers are likely to be those in greatest need of dental care and treatments to restore, maintain and replace the dentition. Yet dental professionals should remember that this group of patients do not consider themselves to be old. In fact, it has been suggested that baby boomers are highly focused on self-improvement and maintaining a youthful appearance and lifestyle. What is more, this generation is likely to seek out and make use of the latest technology and advancements to achieve it. Consequently, dental professionals need to be able to offer highly innovative solutions to meet the oral health needs of this cohort, as well as their expectations.

To replace missing teeth with a modern, premium solution, patients can now opt for a removable partial denture created with Ultaire AKP. This is an advanced, metal-free denture base material that has been developed by Solvay Dental 360 specifically for removable partial dentures (RPDs). Frames created with Ultaire AKP can be designed in the digital workflow to offer a long lasting, customised fit. Plus, bridging the gap between metal and flexible RPDs, Ultaire AKP offers a biocompatible, lightweight, natural feeling and more aesthetically pleasing alternative.

To keep patients smiling, whatever their age, clinicians can harness innovation and offer solutions that accelerate dentistry, improve oral health and enhance the overall patient experience.

To book a Solvay Dental 360 Professional Lunch and Learn, or to find more information on Ultaire AKP and Dentivera milling discs, please visit the website at www.solvaydental360.com

About the author

Phillip Silver is the UK Country Manager and Consultant at Solvay Dental 360.He is a specialist in medical technologies and materials with over two decades of experience in both implantable and non-implantable devices. Phillip has worked in a range of clinical fields incorporating digital techniques and introducing new and novel technology into restorative dentistry, replacement and reconstructive surgery and facial plastics.

Dental Directory signals further evolution with bold new brand identity

Dental Directory has rebranded to ‘DD’ as it unites its full-service offering and further demonstrates its ambition to be a sector disruptor.

The evolution from Dental Directory to DD, now one of the leading partners to dental professionals and aesthetics practitioners, comes a year after the appointment of new managing director, Paul Adams.

Adams said: “Over the years we’ve grown through acquisition as we strived to deliver a full solution for our customers, but as we grew so did our customers’ confusion about what we offer.

“We didn’t get it right and not everyone understood that as well as consumables, we also have expertise in equipment and its installation, testing and compliance, decontamination, orthodontics and facial aesthetics, as well as some of the most experienced trainers in the business in the team.

“Our rebrand announcement is more than a new look and name – it’s backed by millions of pounds worth of investment to consolidate our whole service offering as we continue to become the provider of choice with an Amazon standard online service.

“We’re enhancing every part of DD, investing in innovative technologies and our people.”

DD’s offering will now be broken down into core ranges making it’s easier for customers to navigate. These include; Supplies, Equipment including Digital technology, Servicing and Repairs, Specialist, Services and Aesthetics.

Over the last year DD has transformed. The company, which has more than 45 years of industry heritage, has entered new sectors and territories and overhauled key areas such as customer service.

DD also recently announced a multi-million-pound investment in its back-end infrastructure to deliver market-leading levels of customer service and made several key appointments, including Brent Sercombe who has joined as sales director. 

Adams adds: “Our vision is to become the first choice for clinical treatment solutions.

“Over the last 45 years we’ve been credited for a number of market leading firsts – and  that’s only going to continue – everything must evolve. The future of DD is one of disruption through services and innovation.”

BDA announces succession plans for GDPC leadership following EU election

The British Dental Association (BDA) has outlined succession plans following the election of General Dental Practice Committee (GDPC) Chair Henrik Overgaard-Nielsen to the European Parliament.

At its meeting in early May, the GDPC agreed that there would be a conflict if an individual was performing both the roles of MEP and GDPC Chair at the same time.

The General Dental Practice Committee will be electing a new chair on 19th June. Co-Vice Chairs Shaun Charlwood and Dave Cottam will be covering the Chair’s responsibilities in the intervening period.

The British Dental Association’s Acting Chief Executive Martin Woodrow said:

“The British Dental Association is free of any party-political allegiance, and sets its policies in the best interests of the profession it serves.

“We have clear guidelines for staff and officers engaging in political activity, including elected members seeking political office. These processes ensure our senior team and representative bodies are able to evaluate and manage any role conflicts when and if they emerge.

“The BDA’s General Dental Practice Committee concluded it would not be appropriate for their Chair to remain in post in the event of his election to the European Parliament.

“We would like to thank Henrik for his leadership of the GDPC and tireless commitment to the profession.”

BUPA DENTAL CARE ACQUIRES TOTAL DENTAL CARE

Bupa Dental Care has announced the acquisition of Total Dental Care, adding a further four sites to its network of UK dental practices.

The purchase follows a period of steady growth for Bupa, which now owns and operates over 470 dental practices across the UK, including 11 acquired this year.

Based in Peterborough, Folkestone, Dover and on London’s Harley Street, the practices provide a mixture of NHS and private dentistry, and offer a range of general, cosmetic and specialist treatments.

Three of the practices – Harley Street, Folkestone and Peterborough – also include TDC Implant Centres, where dentists offer an award-winning, same-day implant service, TDC Smile in a Day. Unlike traditional procedures, their innovative approach allows for implants to be placed on the same day, eliminating the need for multiple surgical procedures and months of healing time.

Speaking of the news Gabriela Pueyo, General Manager for Bupa Dental Care, said: “We’re really excited to welcome Total Dental Care to the Bupa family. It was clear from the outset that they share our commitment to clinical excellence and patient care. Their innovative work in dental implants is market-leading and will be a valuable addition to our network. We look forward to supporting their continued success.”

Drs Michael and Anthony Zybutz from Total Dentalcare and TDC Implant Centres added: “We are very proud of our team and the reputation we’ve built up over many years amongst our patients and peers. In Bupa we have a partner who understands the pioneering, highly skilled and genuinely life-changing nature of our TDC Smile in a Day same-day implant solutions. The whole team are looking forward to working with Bupa and meeting our clinical colleagues across the network, to build upon the success of our TDC Implant Centres and Total Dentalcare practices.”

Bupa Dental Care operates approximately 470 practices within the UK, with over 2,000 dentists and over 5,000 practice staff. It offers both NHS and private dentistry and is looking to further expand its network of quality practices providing a high standard of patient care. It currently operates through its Bupa Dental Care, Total Orthodontics, Platinum Dentistry, Dental Care Plus and Smiles Dental brands.

Peri-implantitis – risk factors and implications – Matthieu Dupui TBR

Peri-implantitis is a serious inflammatory condition that affects the tissues surrounding an osseointegrated dental implant, resulting in the loss of bone. It is believed to affect around 30% of dental implant recipients (though published estimates of the scale of the problem vary considerably from 1% to nearly half).[1],[2]Peri-implantitis is highly destructive, potentially difficult to treat, and can reduce further treatment options for the patient.

Peri-implantitis is commonly compared to periodontitis, and this comparison is appropriate. Both conditions are essentially caused by bacterial colonisation, which ultimately leads to a sustained inflammatory response in the gum tissue. Left untreated, both can result in the loss of bone and connective tissue.[3]It should be noted that a history of periodontitis is considered a significant risk factor towards developing peri-implantitis.[4]While there is a resemblance between peri-implantitis and periodontitis, the two conditions are distinct from one another. Peri-implantitis tends to progress faster and with greater ferocity, in part due to the structural difference caused by the lack of a tooth and its supporting connective tissue. Lesions caused by peri-implantitis are often larger than their periodontitis equivalent, and it is suggested that it is more difficult for the immune system to fight peri-implantitis causing bacteria due to an increase in distance to the target.[5]

Peri-implantitis, thankfully, does not appear spontaneously. It is preceded by peri-implant mucositis (which has a prevalence of around 43%) – an inflammatory lesion of the soft tissues surrounding an endosseous implant (but without the bone loss characteristics of peri-implantitis).[6]The level of inflammation can vary from patient to patient, but bleeding upon probing is typical. Like gingivitis, this condition is triggered by bacterial colonisation and a subsequent failure to remove this bacteria. Peri-implant mucositis is a largely reversible state, although it can take three weeks or more for oral conditions to return to normal. The progression from peri-implant mucositis to a case of peri-implantitis can take considerable time (sometimes years), although in some cases the disease progresses much more quickly.[7]Once peri-implantitis has manifested, non-surgical therapy alone is seldom effective.[8]

Risk factors for peri-implantitis – besides a history of periodontitis – include smoking, overloading of the implant site, and xerostomia. Partially edentulous patients may be at greater risk of developing peri-implantitis, due to differences in the typical bacterial flora between the two groups.[9]Diabetes mellitus has a more controversial status as a risk factor within the literature. The survival rate of implants in those with diabetes is in line with healthy patients over the first six years and in the first year, the risk of developing peri-implantitis is equal to that of patients without diabetes. In the long-term, the odds of developing peri-implantitis are most likely higher for those with diabetes, particularly if the condition is uncontrolled.[10]

Polycystic ovary syndrome (PCOS) is the most commonly occurring endocrine disorder among pre-menopausal women by a significant margin (though it can often go undiagnosed). Among those with PCOS, evidence suggests that between 50-70% have insulin resistance regardless of body mass index values.[11]Due to this and other factors (the effect of oestrogen and progesterone on the gingiva, Vitamin D deficiency, and other comorbidities that PCOS can contribute to), there is reason to believe that patients with PCOS may be at increased risk of developing peri-implantitis (and periodontitis). However, while there are hypothetical means by which PCOS could adversely affect oral health and encourage the development of peri-implantitis, there is currently a decided lack of research and evidence into this.[12]

It has been suggested that tissue engineering may help improve long term implant success, based on the observation that increased keratinised mucosa around implants results in healthier peri-implant tissues and less crestal bone loss. It is proposed that soft-tissue grafting could be used to provide sufficient keratinised mucosa. While promising, research into this area is still at its very early stages.[13]

Ultimately, maintaining oral hygiene is critical to avoiding peri-implantitis. However, good case selection and choice of implant can also help reduce the chances of failure. The design and composition of the implant chosen could potentially play a role in modifying the risk of peri-implantitis.[14]

The intelligently designed Z1 implant from TBR is well suited to all types of prosthetic restorations. The innovative zirconia collar of the Z1 encourages the soft tissues to heal around the implant in a manner that closely resembles natural gingival growth. This helps to protect the crestal bone and the gingiva from iatrogenic inflammation and infection, minimising the risk of patients developing peri-implant complications.

Peri-implantitis is a threat to patients with dental implants. However, with good treatment planning and implant selection, in conjunction with good oral hygiene, peri-implantitis is preventable in the overwhelming majority of cases. Where peri-implantitis is detected, due to its capacity for tissue destruction, it should be treated with all possible haste.

 

For more information on the Z1 implant, visit tbr.dental, email support@denkauk.comor call 0800 707 6212

 

 

References

[1]Schminke B., vom Orde F., Gruber R., Schliephake H., R.Bürgers, Miosge N. The pathology of bone tissue during peri-implantitis. Journal of Dental Research.2015; 94(2): 354-361. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438728/#!po=71.7391Accessed March 21, 2019.

[2]Salvi G., Cosgarea R., Sculean A. Prevalence and mechanisms of peri-implant diseases. Journal of Dental Research. 2016; 96(1): 31-37. https://journals.sagepub.com/doi/full/10.1177/0022034516667484March 21, 2019.

[3]Delima A., Karatzas S., Amar S., Graves D. Inflammation and tissue loss caused by periodontal pathogens is reduced by interleukin-1 antagonists. The Journal of Infectious Diseases.2002; 186(4): 511-516. https://academic.oup.com/jid/article/186/4/511/806088Accessed March 21, 2019.

[4]Sgolastra F., Petrucci A., Severino M., Gatto R., Monaco A. Periodontitis, implant loss and peri-implantitis. A meta-analysis. Clinical Oral Implants Research. 2013; 26(4): 8-16. https://doi.org/10.1111/clr.12319Accessed March 21, 2019.

[5]Salvi G., Cosgarea R., Sculean A. Prevalence and mechanisms of peri-implant diseases. Journal of Dental Research. 2016; 96(1): 31-37. https://journals.sagepub.com/doi/full/10.1177/0022034516667484March 21, 2019.

[6]Salvi G., Cosgarea R., Sculean A. Prevalence and mechanisms of peri-implant diseases. Journal of Dental Research. 2016; 96(1): 31-37. https://journals.sagepub.com/doi/full/10.1177/0022034516667484March 21, 2019.

[7]Heitz-Mayfield L., Salvi G. Peri-implant mucositis. Journal of Clinical Periodontology.  2018; 45(Suppl. 20). https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12953March 21, 2019.

[8]Charalampakis G., Rabe P., Leonhardt A., Dahlen G. A follow-up study of peri-implantitis cases after treatement. Journal of Clinical Periodontology. 2011; 38(9): 864-871. https://www.ncbi.nlm.nih.gov/pubmed/21770994March 21, 2019.

[9]Cortes A., Ferraz P., Tosta M. Influence of etiologic factors in peri-implantitis: literature review and case report. Journal of Oral Implantology. 2012; 38(5): 633-637. https://doi.org/10.1563/AAID-JOI-D-10-00139March 21, 2019.

[10]Naujokat H., Kunzendorf B., Wiltfang J. Dental implants and diabetes mellitus – a systematic review. International Journal of Implant Dentistry. 2016; 2(5). https://journalimplantdent.springeropen.com/articles/10.1186/s40729-016-0038-2March 21, 2019.

[11]Ding T., Baio G., Hardiman P., Petersen I., Sammon C. Diagnosis and management of polycystic ovary syndrome in the UK (2004-2014): a retrospective cohort study. BMJ Open. 2016; 6: e012461. http://discovery.ucl.ac.uk/1504811/1/BMJ%20Open-2016-Ding-.pdfMarch 21, 2019.

[12]Tanguturi S., Nagarakanti S. Polycystic ovary syndrome and periodontal disease: underlying links – a review.Indian Journal of Endocrinology and Metabolism. 2018; 22(2): 267-273. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972486/March 21, 2019.

[13]Shah R., Shah H., Shetty O., Mistry G. A novel approach to treat peri implantitis with the help of PRF. The Pan Africa Medical Journal. 2017; 27: 256. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5660301/March 21, 2019.

[14]Salvi G., Cosgarea R., Sculean A. Prevalence and mechanisms of peri-implant diseases. Journal of Dental Research. 2016; 96(1): 31-37. https://journals.sagepub.com/doi/full/10.1177/0022034516667484March 21, 2019.

 

Unique social networking site for dental professionals launches at the Dentistry Show

Launched at the Dentistry Show on 18th May, a unique online platform created to facilitate networking between dental professionals and patients has arrived in the form of OralHealthNet.

Registration is free, enabling OralHealthNet members (both individuals and clinics) to post a photo, contact details of their practice and their educational background. Further facilities are available for a small fee and right now the site is running a special deal, offering incredible value.

For anyone who signs up before the end of June 2019, a one-off payment of £50 will cover them until 1st January 2020, essentially offering four months free during the roll-out of the website as it is introduced to consumers.

Ordinarily, the cost will be £25 per month to add treatments, services, prices, more photos, a social media news feed and a website link, as well as a way to make direct contact without exposing personal details, or £50 for the added extra of a live booking facility and to add videos.

Speaking about the launch, Vaida Buksnaityte, Founder and CEO of the OralHealthNet project and a practising hygienist, commented: ‘I am delighted to be able to invite fellow dental professionals to join me in this incredibly important project, strengthening ties within the dental team and with patients. This has been a personal project of mine for about 5 years now, and my blogs have an active following with around 14,000 readers, so the site is already a hive of activity.’

Vaida continued: ‘I have ambitious plans, including member benefits and events etc., which will be announced in the coming months. Some of the UK’s top dentists and hygienists are already signed up, and I would love every dental professional to join us.’

This is your chance to showcase your talents and educate consumers about your services within this dedicated community, growing your patient base and building stronger relationships.

For further information, visit oralhealthnet.co.uk or email info@oralhealthnet.co.uk.

Men, it’s time to look after your health – Julie Deverick BSDHT

You would think that gender would not make a significant difference, but did you know that men are far less likely to seek medical attention than women? Data collected has revealed that males are far less likely to book hospital appointments, meaning that they are putting themselves at increased risk of general health conditions.[i]

Men were 32% less likely to arrange seeing their doctor, and it was even noted that they were less likely to consult when in need of recurring care, such as for prescription of anti-depressants or heart medicine, indicating a problem that needs to be addressed.

Data collected for dental care tells a similar story. According to some sources, a third of men only visit the dentist once every five years, and 62% of males also only attend if they have dental pain or some other problem that needs to be sorted right away.[ii]

So why are men so bad at seeking medical attention? There are a variety of factors that may be the cause, but one pervading argument is that they have the attitude of “if it isn’t broke don’t fix it”. The common assumption seems to be that if you have no symptoms it’s unlikely that something is wrong, but there are plenty of medical conditions affecting men that can be completely symptomless.

Furthermore, as we all know, the signs of dental diseases and decay may not necessarily be noticeable, and by not visiting the dentist regularly, it is highly possible for male patients to develop much more serious conditions such as periodontitis if something simple like gingivitis isn’t nipped in the bud.

Another reason may be that admitting they are unwell or need treatment is, in someway, considered a sign of weakness. Society has long painted a picture of men being strong and unlikely to be burdened by illness, and it is this image that has led to many men believing that they can “soldier through” illnesses and complaints without seeking treatment.

So how can we encourage male patients to attend the dental practice? It may be as simple as hosting a male only open day, or even coming up with some special offers to inspire them to visit.

Education is also an important step, and it is a good idea to speak to male patients and remind them that they need to attend regularly, especially as so many oral health problems can worsen quickly if left untreated.

Men’s Health Week takes place on the 15th– 21stJune this year, so why not base some events around this awareness week to help encourage more men to look after their health? Perhaps you can organise a talk about oral health at the local gym or any other establishment that has a high percentage of male clientele? Whatever you decide to do, it’s important to make sure that men are hearing, and understanding, that their health should come first.

The image painted that illness is weakness, is an attitude that needs to change. By opening doors to more male patients and warning them about the importance of regular health check ups, you can do your part in ensuring that men can improve and maintain their health.

 

For more information about the BSDHT, please visit www.bsdht.org.uk

call 01788 575050 or email enquiries@bsdht.org.uk

 

 

[i]Wang, Y., Hunt, K., Nazareth, I., Freemantle, N., Peteresen, I. Do Men Consult Less Than Women? An analysis of Routinely Collected UK General Practice Data. BMJ Open 2013;3:e003320. doi: 10.1136/bmjopen-2013-003320

 

[ii]Express. Hell’s Teeth! A Third of Men only Visit Dentist Once Every Five Years. Link: https://www.express.co.uk/life-style/health/625472/Teeth-third-men-visit-dentist-5-years-health[Last accessed March 19].

Endodontics and Sinus Issues – Mark Allen Coltene

Endodontic treatment is frequently used to save teeth that have become damaged due to decay or infection. As a means of combatting and eliminating infections of the root canal system, endodontic treatment is highly reliable with a success rate of around 90%.[i]However, sinus problems remain an unpleasant potential complication for patients.

To date, a truly comprehensive study of sinonasal complications arising from dental treatment has yet to be completed,[ii]but when a simple web search of a term like “root canal sinus problems” returns over 1.5 million pages we can see that this is at the very least a concern, if not a pressing issue for many patients.

Sinusitis is a swelling of the sinuses resulting from bacterial or fungal infections causing the sinus to no longer drain properly (there are other causes but these are not thought to be due to dental work). Symptoms can include excessive mucus, pain, tenderness, toothache and headaches. Without treatment sinusitis can become a chronic condition in some cases, and acute infections can be damaging (in rare instances resulting in severe consequences like blindness or a thrombosis forming in the sinus which can potentially break free).[iii]That this area can cause issues is unsurprising, as the roots of teeth are in very close proximity to sinuses, with only a thin layer separating the two. In some cases the roots even protrude into them.

There are several indicators of sinusitis that can quickly be discerned: the presence of nasal blockage and or discharge, tooth pain that is not localised to a single tooth, and using a light to gauge whether the mucosa is congested or swollen (allowing less light through making the area appear darker). Pain caused by sinus problems is also said to be more consistent and dull than that of other dental causes, which can vary from sudden sharp pain to protracted severe pain, or manifest as sensitivity to temperature. Once suspected, ultrasound, CT or MRI scans are very useful for diagnosis and evaluation.[iv]Treatment depends on the specific cause, in many cases antibiotic therapy is sufficient, but surgery can be required.

Some timeworn advice for patients in the days following the operation can also help to avoid sinus complications, namely to refrain from blowing their nose and if sneezing to not close their mouths. Of course, after a lifetime of sneezing as politely as possible, patients may find the latter in particular difficult not to lapse into.

The main risks for sinus issues arising from endodontic treatment itself are from misjudging the amount of obturation material required (over or underfilling), damage to the maxillary sinus or sinus mucosa through chemical or physical trauma during treatment, and the introduction of fungus, bacteria or foreign material into the sinus.

Filling materials can extrude during treatment into the sinus resulting in inflammation and potentially providing a vector for infection. In particular, root-filling materials containing zinc have been linked to promoting the growth of Aspergiollosis fumigates, resulting in fungal ball formation.[v]Even filling materials that are regarded as relatively bioinert may cause chronic sinusitis when overfilled.[vi]

A dental abscess describes the accumulation of pus in the alveolar bone at the root apex of the tooth. Dental abscesses can allow microorganisms to infest the root canals, resulting in the formation of biofilms. Left untreated these can lead to sinus issues and in serious cases septicaemia, shock and brain abscesses. Early diagnosis can unfortunately be frustrated due to the vagueness of early symptoms. Dental abscesses can be caused by, among other things, a failed root canal.[vii]While antibiotics are still the frontline treatment for bacterial infections of all sorts, antibiotic resistance is a growing threat and is expected to become an ever more serious threat in the foreseeable future.

While sinus problems arising from dental work can be successfully treated in the vast majority of cases once the irritant has been isolated,[viii]obviously it is in the interest of patients and practitioners to avoid this complication as much as possible. The biggest addressable factor here is accurate measurement; over and underfilling, and to some extent damage during treatment can be minimised or avoided entirely through precise measurement.

To assist with defining and confirming the working length, the CanalPro Apex Locator from COLTENE is highly recommended. Utilising electrical resistance to provide an excellent level of precision, the CanalPro Apex Locator is both highly accurate and easy to use. Providing audio feedback, you are free to verify canal length quickly and easily as often as required.

While no procedure is totally risk-free, with careful technique and guided by reliable tools you can help ensure your patients do not suffer from complications like sinusitis.

 

To find out more visitwww.coltene.com, email info.uk@coltene.comor call  01444 235486

 

[i]Friedman S., Mor C. The success of endodontic therapy – healing and functionality. Journal of the California Dental Association. 2004; 32(6): 493-503. Available at http://www.endoexperience.com/documents/SuccessHealingFriedman.pdfAccessed August 9, 2018.

[ii]Felisati G., Chiapasco M., Lozza P., Saibene A., Pipolo C., Zaniboni M., Biglioli F., Borloni R. Sinonasal complications resulting from dental treatment: Outcome-oriented proposal of classification and surgical protocol. American Journal of Rhinology & Allergy. 2013; 27(4): 101-106. Available at https://www.researchgate.net/publication/251877687_Sinonasal_complications_resulting_from_dental_treatment_Outcome-oriented_proposal_of_classification_and_surgical_protocolAccessed August 9, 2018.

[iii]Siqueira Jr. J. Microbiology and treatment of acute apical abscesses. Clinical Microbiology Reviews. 2013; 26(2): 255-273. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623375/Accessed August 9, 2018.

[iv]Hauman C., Chandler N., Tong D. Endodontic implications of the maxillary sinus: a review. International Endodontic Journal. 2002; 35: 127-141. Available at https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.0143-2885.2001.00524.xAccessed August 9, 2018.

[v]Park G., Kim H., Min J., Dhong H., Chung S. Endodontic treatment: a significant risk factor for the development of maxillary fungal ball. Clinical and Experimental Otorhinolaryngology. 2010; 3(3): 136-140. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950265/Accessed August 9, 2018.

[vi]Kim J., Cho K., Park S.H., Park S.R., Lee S.S., Lee S.K. Chronic maxillary sinusitis caused by root canal overfilling of Calcipex II. Restorative Dentistry & Endodontics. 2014; 39(1): 63-67. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916508/Accessed August 9, 2018.

[vii]Prakash S., Prakash S.K. Dental abscess: a microbiological review. Dental Research Journal. 2013; 10(5): 585-591. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858730/Accessed August 9, 2018.

[viii]Felisati G., Chiapasco M., Lozza P., Saibene A., Pipolo C., Zaniboni M., Biglioli F., Borloni R. Sinonasal complications resulting from dental treatment: Outcome-oriented proposal of classification and surgical protocol. American Journal of Rhinology & Allergy. 2013; 27(4): 101-106. Available at https://www.researchgate.net/publication/251877687_Sinonasal_complications_resulting_from_dental_treatment_Outcome-oriented_proposal_of_classification_and_surgical_protocolAccessed August 9, 2018.

 

Cutting down on complications

Dental implants already have a very favourable success rate, but certain patients are still at risk of failure in the long-term. By better understanding the reasons for this and the ways in which complications can be reduced, we can help ensure that patients benefit from their implants for many years to come.

Smoking & Diabetes

Smoking can delay soft tissue healing, increase the likelihood of inflammation of the tissues around the implant, and decrease resistance to post-operative infection. Provided diabetes is controlled, it should not adversely affect the patient’s prognosis. Where diabetes is poorly controlled, it can significantly slow osseointegration. Within the first six years of receiving an implant, the success rate for diabetic patients is the same as for those without the condition, though in the long term there is an increased incidence of peri-implant inflammation.

Maintenance

One of the main threats to implant health isperi-implantitis,whichisinflammationof the gums due to bacterial build up. This can result in progressive damage to the hard and soft tissues.

Preventing this largely depends on patients being able to adequately manage their oral hygiene, meaning regular check ups and visits to the hygienist are, of course, highly recommended. Research indicates that around a third of British men only brush their teeth once a day, which enables bacteria to multiply unmolested, giving rise to harmful plaque and tartar. With so many people following suboptimal oral hygiene practises, it is crucial that patients understand how much of a difference improving this can make to their long-term prognosis.

Osseointegration is the process by which the patient’s bone tissue bonds with the implant, providing it with a sound mooring.

Without successful osseointegration, the implant is considered to have failed. Primary implant stability refers to the mechanically induced stability from the procedure (dependent on the properties of the bone, implant and technique utilised). Secondary stability is a measure of how successful osseointegration has been, which is contingent on the primary stability achieved.

Traditional methods of gauging implant stability by using blunt instruments and the percussion test are unreliable and potentially misleading. While microscopic and histologic analysis were historically considered the most accurate means of evaluating osseointegration, they were highly invasive and destructive. New non- invasive diagnostic tools have become popular and can provide very useful diagnostic information.

Maintaining its ethos of “no implantology without periodontology”, W&H offers a full range of surgical equipment, including the Piezomed ultrasonic unit and the

Elements for an efficient practice

Mark Allen, General Manager for Coltene, looks at how to achieve maximum productivity within your practice…

Making efficiency part of your practice’s culture and key to your brand is a strong selling point. Being known for delivering high quality treatment at an efficient rate is important in light of the fact that dentistry is a patient-orientated industry. After all, everything you do, every skill and technique you learn, and all the new materials, products and equipment you use, are all designed to make the patient’s experience as good as it can be.

Front-desk staff who are able to answer patient queries as satisfactorily as possible could avoid the need for an emergency appointment being booked, keeping the time slot free. Good scheduling is also key to efficiency and you may find that practice management software helps here; more practices are going paperless. Generally, digital solutions are all about presenting accurate details quicker in order that decisions can be made faster.

If your practice has not yet moved over to digital, you may find it hard to resist some of the stunning options available on the market for much longer. You are not looking to swap one way of working for another, this is about combining approaches in order to give patients the very best of both worlds.

The way that you communicate with patients, for example, can be aided, but not replaced by technology. Digital scans can help you show a patient clearly and quickly what the problem is, but trust and the confidence to say ‘yes’ to treatment is something that will be born from a good patient/practitioner relationship. Communication is the bedrock of efficiency; an efficient well-run practice is one that has an open, communicative atmosphere.

Combining treatments in one time slot can also help you to make the most of every appointment, because the patient will need to make fewer visits. Modern dentistry is becoming defined by more treatments that can be completed in a single visit. A streamlined approach, which has led to the development of hard-working materials, means that many procedures simply do not take as long as they did. Direct restorative materials can be placed in a single appointment. Resin-based composites and bulk fills – which offer great handling and a range of other attractive properties – have speeded up the process for many common procedures. For efficient restorative materials, that are high-quality that will save time and aid efficiency, COLTENE comes highly recommended by dentists. Fill-Up! is perfect for all Class I and II fillings for when a fast restoration is needed; BRILLIANT Crios composite bloc means reliable, aesthetic and efficient restorations without the need for a separate firing process

True efficiency will never compromise quality. Your patients never want to spend more time in the chair than they need to, but their expectations of receiving stable, functional and aesthetically sound treatment are also higher than ever. An efficient practice is one that is committed to achieving maximum productivity and working in an organised way, using all resources as mindfully as possible to deliver the highest quality service, every time.

To find out more visit www.coltene.com, email info.uk@coltene.com or call 01444 235486