For our year-end implant study club, commemorating 25 years of serving our dental community, we had the pleasure of hearing a lecture from Dr. Sanda Moldovan. She did a great job holding the interests of the attendees as they enjoyed the fine food at the Four Seasons Hotel.
She began by talking about hygiene around implants. Probing around implants has been controversial but the studies quoted showed that probing, especially bleeding on probing, was a useful tool to help diagnose perimplant mucositis which is the precursor to perimplantitis. Delicate probing is the key to understanding that implants do not have the same biological attachment as natural teeth. While flossing is important, Dr. Moldovan felt the use of oral irrigators has shown to be much more effective in disrupting the biofilm, especially around complex implant restorations that are difficult to negotiate. She also encourage the use of chewable probiotics to help disrupt the oral flora and diminish the bacteria associated with periodontal and perimplant disease.
Breaking up the Biofilm is very important to overall oral health. Using electric toothbrushes and oral irrigators was cited as the most effective choice around implants. Studies have shown that patients on 3-6 month hygiene schedules decreased the failure rate to 90% and those patients that were on a one year or less recall schedule only decreased the failure rate by 60%. With recommended maintenance intervals ranging from 4 weeks to 6 months depending on the patient., Dr. Moldovan thought is was very important to have base line records consisting of photos, radiographs and probing depths at the time of prosthetic delivery. Hygienist spending significant time on education was also very important to creating patient awareness of the importance of home care.
For the remainder of the lecture Dr. Moldovan spoke about the importance of nutrients as they related to surgical healing and periodontal health. She greatly favors a much more in depth health history that looks at diet, life style and supplements in addition to medical information. For example, high Vitamin D levels are associated with less gingival bleeding, while low levels were seen in hypertension, osteoporosis, heart problems and more frequent colds and flus. Furthermore, patients taking large amount of fish oils were likely to have more bleeding. Vitamin C is very important, decreased bleeding and increased tissue health. She also covered many other supplements and their roles in healing.
In summary, patient education and the right tools for hygiene should be coupled with a diet low in processed foods and high in the right supplements to ensure a more successful outcome in implant patients. We would like to thank Dr. Sanda Moldovan for her insight and expertise.