Editorial - IFCIA Newsletter No 27 11 November 2017
The increasing availability of treatment solutions in dentistry through the introduction and development of implantology is undoubtedly a beneficial development for patients. The comfort, ecology, simplification, reproducibility, and even aesthetics that implantology provides have legitimised its perpetual improvement and adoption by practitioners.
Like any biomedical technology, resulting from fundamental, applied and clinical research, the extensively used treatment solutions in our daily practice face incidents and complications which we must manage in order to prevent exposing patients to significant biological imbalances.
Locally existing pathologies are known as peri-implant mucositis and peri-implantitis. While the former is an inflammatory lesion of the mucous membranes without any osseous loss and is, therefore, reversible by rigorous plaque control and a bio-integrated prosthesis, the latter is associated with a loss of bone supply, deep pockets, bleeding and often suppuration, requiring a decision-making protocol for its treatment depending on how advanced it is.
To date, only retrospective cohort studies, taking into account the definition of the disease, allow for the calculation of its prevalence and its incidence. On average, peri-implantitis can occur in one in ten implants in one in five patients after a period of 5 - 10 years.
It is, therefore, imperative to identify risk factors and preventive measures when prescribing an implant treatment. For Professor Giovanni Salvi, there are a number of factors. He lists a history of periodontitis, surface roughness, mucositis, monitoring, tobacco, keratinised mucosa, implant stress, cleaning, oral hygiene and residual cement.
In this issue of the IFCIA NEWSLETTER, we aim to take a scientific approach in the Implantology section and a clinical approach in the Periodontology part. We have recently published two articles in the prestigious journal Clinical Implant Dentistry and Related Research addressing biological complications in the first year regarding inflammatory conditions of the mucosa, bone loss and/or implant loss.
This retrospective research and review study led by members of the IFCIA study group in close collaboration with Professor Torsten Jemt deals with a sample of 3082 implants, 1017 patients and 1592 procedures carried out by the same surgeon in a private practice, published in the first part, has a higher prevalence of these complications in patients with history of periodontal issues and second surgical procedures with bone augmentation concerning the posterior mandibular sector.
In the second part of this publication several statistically important factors were associated with an increased risk of implant failure, for example, smoking, surgical techniques and the type of implants.
In the second section of this newsletter dealing with "EMERGENCIES IN PERIODONTICS", the author, also a member of the IFCIA study group, aims to describe emergency situations in periodontics with clear and precise loading protocols, by using a summary review to illustrate it.
We suggest that this entire publication may give our readers the answers they need to the questions and situations encountered in their daily clinical work and contribute, in part, to an increase in their knowledge of these two constantly evolving disciplines.
Thank you to the author-members of this dynamic Study Group and Professor Torsten Jemt for sharing their knowledge with us. We will meet again in the next issue of the IFCIA NEWSLETTER, which will be wholly dedicated to implant rehabilitation using the All-on-4® technique.
Théodore M. Abillama
Dental surgeon, Editor-in-chief