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One year of NIWOP

* First published in pip 3 (2019)

NIWOP presented for the first time by Dr Karl-Ludwig Ackermann and Prof. Dr. Anton Sculean at EuroPerio9 in Amsterdam last summer was met with great interest. “No Implantology without Periodontology”: Given the increasing prevalence of periodontal diseases and the steadily increasing age of the patients requiring implant treatment, the need for a systematic approach is clearly evident.

Dr. Martina Banze and Bernhard Eder
Dr. Martina Banze and Bernhard Eder

With a robust medical history and diagnostics, appropriate treatment protocols and especially follow-up care adapted to the individual case, there is a high chance of success even for patients with prior periodontal damage. pip spoke with Dr Martina Banze, Director of Scientific Marketing and Bernhard Eder, Product Portfolio Management for Prophylaxis & Periodontology from W&H headquarters, Bürmoos site.

pip: Why is W&H, as a medical device manufacturer, initiating such a fundamental programme – have you discovered the do-gooder within?

Dr. Banze:
Our main focus is of course the needs of our customers and partners. That is why W&H relies on modular-designed product solutions tailored to the patient, which represent benefits for both the practitioner and the patient. Our contacts in science and in practice are our sparring partners.

Eder:
At the IDS trade fair, we had deliberately focused on the domain of prophylaxis and prevention. Via our constant exchange with users in science and research we can quickly sense the needs of today, in particular those of dental hygienists, dental prophylaxis assistants (ZMP) and specialist dental assistants (ZMF). All of these people play a central role in individual follow-up care. To many people, implantology and periodontology are inextricably linked, and in many countries it is traditionally periodontists who perform implant surgery. With NIW0P, we are taking on this integrated view of implantology and periodontology.

pip: What does the NIWOP workflow look like in detail?

Dr. Banze:
The concept is based on evidence-based and independent studies, and it is the essence of a multitude of substantiated publications, meta-analyses and reviews. It is agreed that each intervention should be preceded by cleaning before the implantation, and should be followed by appropriate recalls at short intervals and close monitoring of the patient's hygiene at home with the addition of professional hygiene measures, depending on the patient's risk classification. Viewing the patient as a whole and not just focusing on his/her oral health also plays a role in this regard.

Eder:
What matters to us is providing our users with simple and workable solutions that also generate added value for their patients and thus also for their practice. As the manufacturer, we offer all of the necessary devices and instruments for the entire NIW0P workflow up to the ISQ implant stability measurement. Efficient treatment planning and configuration can be realised using our ioDent online platform depending on the selected implant system, all of which include an automated documentation process for the torque curve, threading curve, drill protocol or implant stability values. Incidentally, the latter have proven to be very clinically relevant with over 1,000 publications to date. Our Proxeo system is then used for the follow-up care: with the Proxeo Ultra Piezo scaler, it is even possible to treat patients with pacemakers. The Proxeo Aura air polishing system enables supragingival and subgingival treatment with just one device, and the cordless Proxeo Twist not only leaves the patient with smooth teeth, but also provides better comfort and freedom of movement for the practitioner.

pip: What is the response to NIWOP both in the scientific community and in the clinic?

Dr. Banze:
Largely positive – we've had hardly any pushback. Rather, there were statements that the workflow revisited by us led to a resurgence in well-known values. The fact that Dr Ackermann and Prof. Dr Sculean supported the issue straight away also demonstrates its consistently high importance.

Eder:
Opinion leaders sometimes asked: ‘Why do we still have to talk about it at all? There is already ample scientific proof.’ However, the practitioner still has to explain an additional, unforeseen treatment and the associated costs to the patient. That represents a certain hurdle. We at W&H see it as our duty to vigorously support practices by imparting the value of this pre-care and follow-up care. Therefore, we are again taking on the importance of pre-treatment and continuous individual follow-up care and patient motivation in terms of the individually tailored workflow.

pip: Thank you very much for this interview.