Peri-Implant Therapy for the Dental Hygienist

Susan S. Wingrove

• Publisher: Wiley-Blackwell
• Year: 2022
• Print ISBN:
  9781119766186
• eBook ISBN:
  9781119766223
• Edition: 2
• Topic: Medicine
• Subtopic: Dentistry

Practical guidance for dental hygienists on how to maintain dental implants in daily practice

The newly revised Second Edition of Peri-Implant Therapy for the Dental Hygienist provides a comprehensive guide to biofilm-focused assessment, maintenance, and home care for the prevention of long-term implant complications. The book offers clinical protocols ranging from single titanium and ceramic implant-borne restorations to the fixed full arch final prosthesis. The text also discusses pre-surgical regenerative procedures, implant placement, and patient communication to support hygienists and other dental professionals in talking to patients about implant dentistry.

The book is a valuable clinically oriented resource guide for dental professionals seeing patients with titanium and ceramic dental implants. This new edition introduces readers to new information on ceramic implant instrumentation and 'Mastering the Arch', as well as detailed information on how to remove, assess, and provide maintenance for full arch prostheses patients. A new companion website provides dental instructor materials, review questions and answers, lesson plans, videos, PowerPoint slides, skills evaluations, and learning objectives. The book includes:

• Useful clinical photographs, illustrations, and patient cases to demonstrate the concepts discussed throughout the book
• Researched protocols for assessment, professional in-office maintenance, and biofilm-focused patient home care to meet all the peri-implant therapy challenges
• Updated classification, guidelines, and treatments for peri-implant disease
• Technology and resources for prevention of peri-implantitis and complications that can be prevented with early detection and patient awareness

Ideal for dental hygienists and dental hygiene and dental students, Peri-Implant Therapy for the Dental Hygienist is also an essential reference for any dental professional seeking a one-stop resource for maintaining dental implants and managing their complications.

1
Implants 101: History, Implant Design, Parts, and Pieces

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• History
• Dental implant history timeline
• Implants
  • Implant design
• Orthodontic implants/temporary anchoring devices (TADs)
  • Parts and pieces for implants
• Implant dentistry terminology
• Summary
• References

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Understand as hygienists a tidal wave of ailing or failing implants may be imminent. It is imperative that hygienists are trained in identifying and treating peri‐implant mucosal inflammation that could affect overall body health (1).

—G. Nogueira‐Filho, DDS, MDent, PhD

Dental hygienists must be ready and be prepared to take on this next, very important challenge in our profession! The 21st century is an important and critical time to be a hygienist. During this exciting time in dentistry, we as hygienists have a critical role in implant therapy. As a hygienist, your role will be to access patients for healthy periodontium prior to placement of implants, to monitor the tissue surrounding the implants, and to maintain the implants through safe, effective implant maintenance. Current studies reveal that infections in the periodontium occur in more than 50% of implants placed (2). Therefore, we as dental professionals will be faced with different dynamics, challenges, and complications.

As a hygienist, the history of implant dentistry makes you aware that implants are not new, but have been evolving for decades. Patients may have concerns that implants are so new that not enough research or development has been done for them to feel comfortable with the procedure. With your knowledge of the history, design, and research done on implants you will be better able to talk with your patients and address these concerns. A fundamental understanding of key terms and statistics associated with implant dentistry will also be a valuable tool to add to your verbal skills when talking with patients about tooth replacement.

History

Believe it or not, the history of dental implants dates back to 600 AD with the ancient Mayans. Dr. and Mrs. Wilson Popenoe found the lower mandible of a young Mayan woman in Honduras in 1931 (Figure 1.1). She was missing some of her lower teeth and they had been replaced with the earliest example of the first dental implants, made from pieces of shell, shaped to resemble teeth. Scientists believe that these shells may have actually worked. Slots were made into the bone and the shells were pounded in like little wedges, without anesthesia!

Similar discoveries were made in Egypt, artifacts that date back to the 1700s. Ivory and the bones of animals were also sometimes used to replace missing teeth. It would be decades after these archeological discoveries before the modern world caught up with the Mayans' and Egyptians' dental technology.

In the late 18th and 19th centuries, the level of dental care went through many changes. Through the letters, journals, and accounts left by our first president, George Washington, we have a well‐documented case history of his lifelong dental problems and the level of dental care available at that time. George Washington started losing his teeth at the age of 24 and by 1789, the year that Washington took his oath of office, he had only one of his original teeth left (Figure 1.2).

Figure 1.1 Discovery by Dr. and Mrs. Wilson Popenoe, Honduras, 1931.

Reprinted with permission from Ring (20).

Dr. John Greenwood made a set of dentures for Washington made of hippopotamus ivory and eight real human teeth attached by brass screws. The denture, which was anchored on the one remaining tooth in Washington's mouth, has a hole that fits snugly around the one tooth. Dr. Greenwood was noted to be quite ahead of his time in his dental practice, extracting teeth, and utilizing them in the manufacture of dentures, but he also experimented with implantation.

Unfortunately for Dr. Greenwood, the 18th century's lack of antibiotics and any understanding of germ theory or antisepsis doomed any such experiments to failure. He did make President George Washington several sets of dentures, none made out of wood as often referred to. They were made from gold, ivory, lead, and human and animal teeth (horse and donkey teeth were common components), with springs to help them open and bolts to hold them together.

Figure 1.2 George Washington's lower denture.

Courtesy of Rick Blanchette.

In the 18th century, researchers experimented with gold and other metal alloys including lead as implants. Dr. Maggiolo fabricated gold implants that were placed in sockets where teeth had recently been extracted and after a healing period attached a donor tooth. Dr. Harris, a physician, attempted the same procedure with a platinum post, both had poor results.

Dr. Edmunds in 1886 was the first in the United States to implant a porcelain crown mounted on a platinum disc and presented at the First District Dental Society of New York. Other metal alloys with porcelain crowns were experimented with, but these implants did not have a long‐term success rate.

Dr. E.J. Greenfield, pioneer of the endosseous implant, provided many of the basic concepts of nascent field of implantology. He was known for his patented hollow‐cylinder implants made of wire soldered with 24 karat gold. This hollow‐basket design was a similar design that Straumann Implant Company from Switzerland adopted many...

Table of contents

• Cover
• Table of Contents
• Title Page
• Copyright Page
• Dedication
• Foreword
• Acknowledgments
• About the Author
• List of Contributors
• About the Companion Website
• 1 Implants 101: History, Implant Design, Parts, and Pieces
• 2 Implant Therapy: Oral‐Systemic Health, Medical History, and Risk Assessment
• 3 What Lies Beneath the Surface? Natural Teeth, Bone, and Implant Surgery
• 4 Setting the Stage: Adjunctive Surgical Procedures, Restorative Options, and Treatment Planning
• 5 How to Talk to Patients About Implant Dentistry: Risks, Benefits, and Alternatives
• 6 AIM for Implant Success: Assess, Identify, and Monitor
• 7 Implant Complications: Peri‐Implant Disease, Biofilm, and Corrosion
• 8 Biofilm‐Focused Implant Home Care
• 9 Professional In‐Office Implant Maintenance and Disease Treatment
• Appendix: Terminology and Resources
• Index
• End User License Agreement