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Dental Implant Maintenance in Milton Keynes

Implants are not the same as teeth. They do not have the same connection to the jaw and they require extra special attention.

The Key Points are

Good oral Hygiene
A healthy diet
Regular and frequent visits for Dental Hygienist maintenance Treatment and Dentist Examinations
No Smoking


It is important to remember that the support structures in the gum are different between an implants and a normal tooth.

For most patients with dental Implants a normal visit t the hygienist is quite sufficient to maintain a health gum.

It is also important to realise that Implants can be lost because of such conditions as Peri-Implantitis.

Click for more information about Peri-Implantitis

Home Dental Care for Patients with Implants

While hygienists typically are not involved in the placement procedure, they are a very important part of the care team after mini implant placement.

Patients with No Teeth
Proper care begins with brushing, which can be a challenge for edentulous patients out of the habit of brushing, who were likely not good brushers when they had natural teeth. Proper brushing can also be an issue simply due to someone’s age. For these reasons, use of an electric toothbrush is strongly encouraged. This can be a great help for patients with dexterity issues, and toothbrushes with built-in timers can help ensure that patients achieve an adequate duration of brushing.

Patients with Natural Teeth and Implants
Patients should be instructed to brush throughout the mouth and pay particular attention to the implants, as plaque can build up on them just as it does on natural teeth, potentially compromising the long-term success of the implants.

Patients should return to the dental Practice for checkups every six months following implant placement. This helps the dental team ensure that the implants remain stable and that patients care for them properly.

Most implant patients regain motivation to take good care of their dental health once they experience the stability and confidence of mini implants. Being able to eat foods such as steak, corn on the cob, and apples gives patients a tangible motivator to maintain their implants.

Why the difference between cleaning implants and Teeth

In a nutshell, cleaning around implants differs from maintenance of natural teeth for two reasons: The first is that each attaches to surrounding bone and gums in a very different way; secondly, the materials from which implants are made are very different from natural teeth.

Dental implants replace the root parts of the teeth. Artificial crowns, bridgework or removable dentures — tooth replacements that make up the visible (crown) part/s of teeth — are attached to the implants. In between the implant and the crown of a tooth there is often a connector known as an abutment. The success of the whole system is based on the implant's attachment to bone. Titanium, the metal of which implants are made, is uniquely osteophilic — literally “bone-loving.” It fuses to bone in a process called osseointegration (“osseo” – bone; “integration” – fusion or joining).



Above the bone where the integration process ends, the abutment comes in contact with the gum tissue where it is supported by a connective (i.e. “connecting”) tissue composed of fibers made of a tough material called collagen. The fibers run beneath the surface parallel to the implant ending at the top of the bone. They hold the gum tissues against the implant surface.

At the very top of the implant assembly, the abutment and lower part of the crown attach to the gum (the surface “skin” layer) via a specialized structure known as an epithelial attachment (“epi” – on top; “thele” – nipple). The cells actually attach to the highly polished metal or ceramic, of which the implants are made, by means of microscopic suction pads.

By contrast, a tooth root is attached to the bony socket that surrounds it — by a periodontal ligament (“peri” – around; “odont” – tooth). The ligament is composed of tiny fibers that insert into the bone on one side and into the tooth root on the other. Above the bone, the fibers attach from the tooth into the gum tissue. An implant has no such attachment.

Since the whole periodontal ligament has a greater blood vessel supply through which it can bring cells and nutrients, it is more readily able to resist and fight against infection.

Why Do You Need To Clean Dental Implants?

Cleaning implant-supported tooth replacements is just as important as cleaning natural teeth, as both depend on healthy surrounding tissues for support. Bacterial biofilm (plaque) collects on implant crowns just as it does on natural teeth, and must be removed on a daily basis at home. Without daily biofilm removal, infection can develop known as peri-implantitis (“peri” – around; implant “itis” – inflammation), which can result in loss of the attachment described above.

Unlike inflammation around teeth, this reaction can be quite catastrophic both in rate and amount, quickly leading to a well- or dish-shaped loss of bone around an affected implant. Bone loss can rapidly progress to loss of the implant.

The dental hygienist has an important role to play in keeping dental implants infection-free, and there are many factors to be considered in selecting the right instruments for a professional cleaning. They include: the nature of the debris, meaning whether soft (biofilm, foods) or hard (calculus or tartar, calcified material); the location of the deposits; the type of surface on which they accumulate; and the stubbornness with which they adhere.

The Right Tools For The Job
Our Well Equipped Hygienist

Our hygienist uses instruments for cleaning that will not damage the crown, abutment, or the implant itself. Maintaining the highly polished, smooth surface of the abutment and crown are critical. If they are scratched they can attract and harbor bacteria. That's why the instruments used, called scalers and curettes, are most often made of plastics and resins.

Natural teeth don't scratch in the same way, and therefore metal instruments can be used to clean them.





A number of power (ultrasonic) instruments have nylon or plastic sheaths or tips to minimize implant damage. They clean by using high-frequency vibration, which may be necessary if large quantities of debris have accumulated. They are used on a low power setting with a lot of water irrigation, and sometimes antibacterial solutions, to clean and flush material.

If any part of the implant body (root replacement portion) itself is visible, this may mean there is infection that has resulted in gum and/or bone loss. The implant surface becomes exposed following loss of its fusion to the bone. Implant surfaces are generally microscopically “roughened” to increase surface area for bone attachment.

But this surface roughness makes implants difficult if not impossible to clean and disinfect. Additionally, some implants are screw-shaped and their threads just add to the cleaning dilemma.

Brushes are used to clean biofilm from exposed areas of an implant wherever possible. If calculus or dental cement (used to secure the crowns) is present on an implant surface, the hygienist needs to use instruments that are effective in removing these contaminants. In such cases the clinician must ensure no scratching or damage is caused by completing the task.

Despite these special cleaning challenges, implants are highly successful. In fact, studies indicate long-term success rates well over 95%. However, the prevention of peri-implant disease is fundamental to implant health, maintenance and function. And cleaning implants and their related components is an important part of success. Your question indicates that your hygienist is on top of it.

Peri-Implantitis

Peri-Implantitis is an infectious disease that causes an inflammatory process in the soft and hard tissues surrounding an osseointegrated implant, leading to the loss of supporting bone.



Bone, for a variety of reasons, is lost around the dental implant. This condition generally occurs without the patient being aware of it. There are many factors on why this can happen.



Some dental implants on some patients will develop bone loss which can happen very early after having the crown put on the implant or it can happen many years down the road.



Dental implants are fantastic, but nothing is without risks. If your dentist tells you they are 100% successful and have no problems ever, I would suggest seeking another opinion.

Risk Factors

•Tobacco use
•Poorly controlled systemic conditions (e.g., diabetes mellitus, osteoporosis, post-irradiated jaws)
•History of periodontitis and noncompliance to treatment
•Poor oral hygiene
•Parafunctional habits (e.g., bruxism)
•Iatrogenic factors (e.g., lack of primary stability and premature loading during the healing period)

Signs

•Progressive increase in probing depth
•Suppurations (Pus) and exudation from peri-implant space
•Bleeding on probing
•Clinical appearance of inflamed tissue (bleeding, swelling, colour change, suppuration, and
plaque/calculus accumulation)
•Progressive loss of supporting bone on follow-up radiographs (Figs. 1 and 2): loss of supporting bone beyond 0.2 mm annually, after the expected physiologic remodelling.
•Metal thread exposure
Long tooth

Symptoms

Most patients are unaware that they have bone loss around the dental implant. Peri-implantitis generally progresses in a painless fashion. Once it is established, you may begin to develop symptoms.

•Not always symptomatic
•Pain severity: typically none
•May have dull aches, tenderness on brushing or palpation
•Bad taste: potentially noticeable if there are purulent exudates
•Increasing mobility (in cases of a failed implant)
•Lymphadenopathy

Treatment

The long-term goals are to stop the progression of the disease and maintain the implant site. Depending on the etiology of the problem, a specific treatment is selected. Appropriate management of peri-implantitis often requires referral to a periodontist.



Treatment Options include:

Control the acute bacterial infection and reduce the inflammation in the tissues through:
Mechanical debridement
Localized and/or systemic antimicrobial therapy
Improved patient compliance with oral hygiene until a healthy peri-implant site is established
Detoxify the implant surface by using mechanical devices (e.g., high pressure air powder abrasive, laser decontamination) and/or by applying chemotherapeutic agents
Perform flap management with either (or both) resective and regenerative approaches, depending on the morphology and size of the bone destruction.

Pain Free Laser Gum Treatment

Our Laser



The EPIC Laser is the only diode laser with three unique therapy modes –

Soft Tissue Surgery,
Whitening, and
Pain Therapy.

How Do Lasers Improve Dental Care

Lasers are a great asset in modern dentistry. However because they are expensive to purchase and maintain, most dentists fail to utilise their benefits.

Using a laser for certain treatment can have a number of benefits for patients by

Providing faster healing times,
Reducing the risks of infection,
Creating less bleeding.
Creating less postoperative pain.

The laser generates a beam of concentrated light bringing energy into your mouth to help remove areas of infection as it destroys many bacteria and viruses found in the mouth. In almost every case the patient feels nothing except a warm sensation in the gum.

The Ultimate in Patient Comfort

One of the most promising aspects of laser dentistry is the opportunity to do more with less anesthetic, and less damage to the tissue. Our EPIC laser delivers on that promise with ComfortPulse, a proprietary innovation that delivers precisely controlled micropulses of diode energy to the tissue, followed by “down” time to allow tissue to relax and respond positively to laser treatment.

Our EPIC laser also introduces a new ComfortPulse setting that delivers pulses to the tissue as short as one ten-millionth of a second, resulting in improved patient comfort, less damage to surrounding tissues, and better healing. With Our EPIC laser, patient comfort is a reality

Treatment of Gum Disease Around Dental Implants

We use our laser to remove debris and bacteria between your teeth and gums that can cause bleeding gums, gum recession and even loss of teeth. The laser is highly effective at killing bacteria and may even stimulate gum tissue growth.

Take advantage of our Laser's capabilities including performing "pocket therapy" using single-use disposable Perio tips.



The laser is not hot and there is virtually no awareness of what is happening.

Our EPIC Laser is a painless and effective alternative to the traditional method of surgically treating periodontal disease.

When treatment with Our EPIC Laser is combined with Good Effective maintenance then the results are excellent.

Benefits of Laser Gum Treatment:

It eliminates the disease
Completely painless
You can save teeth, which usually would have to be extracted*
It’s a long term result which is easy to maintain
You will have beautiful healthy teeth and a fresh breath again

Click To Watch Clinical Videos

For more information on laser dentistry, call our practice in Milton Keynes, on 01908 690326.