Innovation and problem-solving with W&H's Synea Power Edition

The concept of using rotary tools to cut hard materials, such as granite, is at least 6,000 years old. As early as 25,000 BCE, our ancestors were using hand-held lithic borers to cut through shells without breaking them. These tools were generally made of flint, and pressed against the object to be perforated and then rotated back and forth at low speed and relatively high torque. Powerful modern handpieces have elevated the principle of variable speed and high torque to enable precise cuts into much harder materials like zirconia.

Is one visit to the dentist per year enough if you have implants?

This study once more underlines that patients who do not regularly attend check-ups after receiving their implant-supported restoration have a very high risk of peri-implant diseases in general and specifically peri-implantitis; based on this data, at least two check-up visits per year are recommended.

Tooth or implant?

The fight for periodontally compromised teeth and therefore retaining these teeth usually also pays off for patients from a financial perspective and is usually cheaper than extraction and subsequent implantation.

More arthritis, more periodontitis?

Patients with rheumatoid arthritis are at significantly higher risk of periodontitis and this risk increases further for patients with particularly active rheumatoid arthritis.

A pragmatic approach to manage
peri-implant biological complications

Explore the complexities of dental implant care: This scientifically backed article summarises the critical aspects of diagnosis, oral hygiene, and expert strategies for the effective management of both, mucositis and peri-implantitis.

What does interdental cleaning achieve in the long term?

Interdental cleaning with dental floss or interdental brushes significantly reduces interdental plaque build-up and even tends to lead to a reduced rate of tooth loss in the long term.

Periodontal treatment improves more than just the periodontium in diabetics

A non-surgical periodontal treatment can reduce the long-term blood glucose level (HbA1c) in type 2 diabetics by 0.3% and this effect persisted even after six months following treatment.

Caution parents – risk of infection!

Untreated periodontal disease in parents can negatively influence the development of their children’s oral microbiome and promote the development of a dysbiotic oral microbiome.

Implant crowns must be kept clean… but how?

The shape of an implant crown has a significant influence on how well it can be kept clean using home oral hygiene, and concave crown shapes appear to be easier to clean; it also seems that the underside of an implant crown in the molar area is easiest to access with dental floss.

Successful treatment – does it make a difference? Part 2

Commonly used definitions for successful periodontal treatment are extremely difficult to achieve, but are nevertheless associated with a lower rate of tooth loss; however, the tooth loss rate in patients who regularly attend supportive periodontal treatment sessions is generally very low.

Prevention is the best treatment – Part 2

Biofilm accumulation is the main aetiological factor in the development of peri-implant diseases; plaque control and supportive implant therapy are therefore crucial in preventing peri-implant diseases.

Social participation in society even without teeth?

In old age, tooth loss leads to significantly reduced social participation in society, while maintaining a minimum of 20 teeth has the opposite effect and leads to a significant improvement and therefore more frequent social participation.

Patient- and implant-related factors – what affects the outcome of treatment?

In this study, non-surgical treatment of peri-implantitis was only successful in 25% of cases and was adversely affected by a medical history involving periodontitis and smoking, inadequate oral hygiene and a wide implant diameter.

Keratinised soft tissue crucial for implants

The prevention of peri-implant diseases is the best treatment and the peri-implant soft tissue can play a decisive role here; for this reason, the team should discuss if there is a need for treatment in patients with a lack of keratinised mucosa (i.e. < 2 mm width of keratinised mucosa).

Implants – Also a success story from a patient perspective?

A very high percentage of patients had a positive experience of implant treatment and most patients were very happy with the result; however, frequent points of criticism were the treatment costs and the cleansing ability.

Exercise is great for our health … and our teeth too?

Women who exercise regularly showed a significantly reduced risk of periodontitis and a significantly reduced severity of periodontitis.

No teeth, no quality of life?

Rehabilitation and replacement of missing teeth lead to a significant improvement in quality of life relating to oral health and also tend to improve general health.

Periodontitis also impairs our sense of
taste and smell!

A questionnaire-based survey showed that periodontitis significantly increases the risk of an impaired sense of taste and smell.

Smoking and increased probing depths are early warning signs

Smoking and increased probing depths at a young age (i.e. at an age of < 20 years) are significant risk factors for the early onset of periodontitis (i.e. at an age of < 30 years).

Tooth brushing in just 10 seconds?

Automatic toothbrushing could have future potential, but still requires further technical developments to improve existing shortcomings with regard to customizsation for different jaw sizes and tooth positions, interdental spaces and choice of optimal brushing time.

When as well as possible is not good enough

Even when told to brush their teeth as well as possible, the quality of tooth brushing among young adults is poor; the main weaknesses are cleaning palatal/lingual surfaces and overall brushing technique.

Prevention is the best treatment!

Optimal diabetes control, regular supportive implant therapy and augmentation of peri-implant soft tissue deficits have proven to be crucial features in primary prevention of peri-implant diseases.

Peri-implant mucositis – are chemical adjunctive therapies effective? Part 2!

Additional measures locally applied or taken systemically by the patient (e.g. antiseptics in the form of mouth-rinse solutions or probiotics) could have an additional positive effect in the treatment of peri-implant mucositis.

Non-surgical peri-implantitis treatment – chemical cleaning ...?

Chemical additives for cleaning the implant surface as part of non-surgical peri-implantitis therapy may make sense, but there is a shortage of well-conducted studies with a sufficient number of patients and a long-enough follow-up period to really be able to recommend a specific method and/or a specific product.

Non-surgical peri-implantitis treatment – gold standard ...?

Due to a continuing lack of well-conducted clinical studies, it is still not possible, based on the evidence, to give a clear treatment guideline for mechanical cleaning as part of non-surgical peri-implantitis treatment.

Chewing gum as treatment …?

Chewing sugar-free xylitol chewing gum could have significantly positive effects in reducing gingival inflammation when used as an adjunct to traditional therapies for treating gingivitis (mechanical cleaning and optimisation of home oral hygiene), but further clinical studies are required in order to confirm this assumption.

Periodontal diagnosis made easy

Implementing the new classification for periodontal and peri-implant diseases takes time and is a question of experience and practice, but simple reference tools such as a flowchart can help with this process.

Oral hygiene helps even in difficult situations!

Oral health (gingivitis, periodontitis) influences the occurrence and the healing process of oral mucositis in patients with haematological disorders who are given high-dose chemotherapy.

Air polishing as an adjunct in non-surgical periodontal treatment …?

As part of non-surgical periodontal treatment, the additional use of air-polishing treatment could be beneficial for deep baseline probing pocket depths (≥ 5.5 mm) in particular.

Gingivitis treatment = happier and healthier patients!

Treating gingivitis is not only the most effective option for preventing the occurrence of periodontitis, but also leads to a reduction in systemic inflammatory markers, whilst also improving the patient’s quality of life in terms of oral health.

Artificial intelligence in dental practice

The use of artificial intelligence with the aim of optimising home oral hygiene significantly improved the results in non-surgical periodontal therapy

What is the situation with e-cigarettes and periodontal health?

Based on the available literature, the smoking of e-cigarettes seems to have a slightly less negative effect on periodontal health compared to traditional cigarettes.

Periodontitis & bowel disease – Is there a link?

Patients with inflammatory bowel disease have a higher risk of oral diseases (periodontitis and tooth loss) and these diseases appear in turn to increase the degree of activity of inflammatory bowel disease.

Lifelong supportive periodontitis treatment? Absolutely!

Periodontitis patients should always be integrated into supportive periodontitis treatment, as otherwise the rate of recurrence, and therefore a further episode of periodontal inflammation, is likely to be very high.

The long-lasting effects of smoking on our implants …

Tobacco consumption has a lasting negative effect on the peri-implant tissue and leads to an increased risk of developing periimplantitis. This negative effect continues for years, even after an individual has successfully stopped smoking.

Periodontitis doesn’t normally come alone!

As early as 2016 (Monsarrat et al. 2016), a study outlined a link between periodontitis and 57(!) systemic diseases, the most well-known of these being diabetes mellitus and cardiovascular diseases. Time and again, these links prompt a discussion about the need for positive cooperation between dentists and doctors in order to improve early diagnosis of specific systemic diseases.

Sensitive tooth cervix following periodontal therapy...

Experiencing cervical tooth sensitivity following periodontal therapy? Here’s what you can do about it! Non-surgical periodontal therapy can unfortunately entail a number of disadvantages, which are the sources of some complaints from our patients time and again. For example, they complain about the longer appearance of their teeth and/or about increased sensitivity of the exposed tooth cervix. Studies have shown that around 60 to 90% of our patients suffer from cervical tooth sensitivity in the period immediately following non-surgical periodontal therapy and that from a third up to a quarter of patients still suffer from cervical tooth sensitivity after 4 to 8 weeks (Lin et al. 2012).

When does it make sense to splint teeth?

Periodontitis and the related attachment loss inevitably lead to increased tooth mobility after a certain period of time. This increased tooth mobility often makes patients aware that “something is not right,” but for many patients it is also a very unpleasant side effect of periodontal disease and one which can make them feel as if they are losing their teeth.

Does periodontitis increase the risk of gestational diabetes

The links between diabetes mellitus and periodontitis are very well described and documented in the literature. A specific malfunction in the sugar metabolism can occur during pregnancy, which is referred to as gestational diabetes. In Austria, around 5–10% of all pregnant women are affected by gestational diabetes.

Can yoghurt reduce tooth loss ...?

Many beneficial effects on our health are attributed to the consumption of dairy products. Research indicates that there is a lower risk of diabetes mellitus, metabolic syndrome and cardiovascular disease. It also describes beneficial effects specifically for the oral cavity thanks to the consumption of dairy products. Certain studies, for example, showed that high and regular consumption of dairy products led to a lower risk of periodontitis.

Interdental cleaning – by itself or with an “extra” component?

Every day we try to persuade our patients to brush their teeth twice a day and to brush the interdental spaces at least once a day as well. However, we all know how particularly difficult it is to persuade our patients to brush the interdental spaces, as this calls for a certain amount of skill on their part.

Knowledge is motivation!

The key to success in periodontal treatment is the cooperation of the patient. If the patient fails to comply every day of their life with good and efficient oral hygiene at home and fails to attend recalls consistently, we will unfortunately fail despite all our efforts.

Medium bristles – are they really a problem?

The discussion on soft, medium or hard bristled toothbrushes is not a new one, and yet new literature on the subject is appearing all the time, so it is something we are keen to address.

Successful treatment – does it make a difference?

The ‘new’, although also now almost five-year-old, classification for periodontal and peri-implant conditions included a definition for a successfully treated periodontitis patient for the first time.

Prognosis for teeth with through-and-through furcations

The optimal treatment result for periodontitis patients is for them to keep their own teeth in good condition for as long as possible. However, there are both patients and teeth with certain characteristics that make it significantly harder to actually achieve this objective!

Lessons from the pandemic: continuity in treatment is important!

The Covid-19 pandemic has posed and continues to pose major challenges for all of us – this includes our patients and their compliance in terms of attending regular dental check-ups. For example, already during the first few months of the pandemic, patients proved to be far more reluctant to attend medical check-ups and appointments (Makiyama 2020). Now that the pandemic has continued for far longer than initially anticipated, however, it is important for us to encourage our patients to begin attending regular appointments for check-ups and treatment again.

Periodontal maintenance therapy – how often do I need it?

A very common question after the active phase of periodontal therapy is how high the patient’s risk is of re-developing periodontal problems.

S3 guideline – Subgingival instrumentation

In collaboration with the German Society for Periodontology (DGParo), in October 2019 the German Society for Dental, Oral and Maxillary Medicine (DGZMK) published a new S3 guideline on the topic of ‘Subgingival instrumentation’, which is now valid for five years. This new guideline primarily focuses on the following two main topics:

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