Dental Asia Jul/Aug 2017 - page 62

60
DENTAL ASIA
JULY / AUGUST 2017
USER REPORT
probing depth from 5-9mm (Figure 7, 8).
The crown was also mobile. Baseline
radiograph revealedbonelosstothefirstthread
(Figure 9). The patient had expressed his
desire for conservative management and
to avoid surgery if possible.
Upon examination, the implant was firm
and the mobile crown was attributed to
abutment screw loosening. The abutment
screw was removed together with the
crown to allow proper access and cleaning
of the implant (Figure 10). Sub-gingival
cleaning around the implant was done using
erythritol powder(EMS Plus powder) with a
sub-gingival nozzle (EMS Perio-Flow
®
nozzle)
(Figure 11).
The crown and abutment screw were
replaced and tightened. The patient came
back for follow-upmaintenance visits every
three months. During each visit, biofilm
removal was performed using air polishing
with erythritol powder. At the one-year
review, the peri-implant mucosa was
healthy and there
was no further
bone loss (Figure
12, 13, 14). Fulfilling
t h e p a t i e n t
i n i t i a l r eque s t
to avoid surgical
intervention, he
was satisfied with
t he t r ea tmen t
outcome.
Fig. 7: #21 with inflammation of the
peri-implant mucosa.
Fig. 8: Probing
depth around #21.
Fig. 13 : Probing
depth around #21 at
one-year review.
Fig. 9: Baseline
radiograph.
F i g . 1 0 : C r own a nd
abutmentscrewremoved.
Fig. 11: Sub-gingival biofilm removal
using EMS Perio-Flow
®
nozzle.
Fig. 12 : At the one-year review, the
peri-implant mucosa was deemed healthy.
Fig. 14 : Radiograph at
one-year review.
Conclusion
Based on the 8
th
Europerio congress
consensus statements13, air polishing is
as effective as mechanical debridement
with or without local antiseptic therapy,
or Er:YAG laser in treating peri-implant
mucositis. With regards
tonon-surgical treatment
o f pe r i - imp l an t i t i s ,
air polishing resulted in significantly fewer
sites with bleeding on probing when
compared to other control treatment
modalities, although a complete disease
resolution is commonly not obtained.
Nevertheless, with more studies on its
efficacy in combined therapies, both
non-surgical and surgical, air polishing may
show great promise as an important tool in
managing peri-implant diseases.
DA
About the Author
Dr. Wong Li Beng
is a
Consultant and Periodontist
at Ng Teng Fong General
Hospital, where he is
currently appointed as
the Director of Service for
Preventive Dentistry. Dr Wong provides a
comprehensive range of non-surgical and
surgical periodontal therapy as well as dental
implant procedures. He is an adjunct lecturer
at Nanyang Polytechnic (NYP), School of
Health Sciences and sits in the committee
of the NYP Dental Hygiene and Therapy
Advisory Panel.
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