Peri implantitis is becoming a major issue for dental implants and it is important to be aware of this when embarking on implant treatment to replace missing teeth. The term relates to a number of factors around implants but the main issues are:

1. Inflammation of the surrounding mucosa ( gum )

2. Increased pocket depths around the dental implant

3. Bleeding on probing

4. Suppuration ( pus oozing from the tissues)

5. Loss of bone around the implant either in a horizontal , vertical or both directions. 

This differs from peri implant mucositis where there is bleeding on probing, possible swelling and inflammation and increase in pocket depths BUT there is NO loss of bone around the implants. Peri implant mucositis is reversible but peri implantitis is irreversible. Diagnosis is essential and the earlier the treatment, the better the diagnosis. Often, the disease may go un noticed, very much like gum disease, but once symptoms develop it is often too late to prevent bone loss. It is essential that regular dental and hygiene visits are maintained after dental implant treatments so that any problems can be spotted at an early stage. In general, we would advise twice yearly appointments or quarterly hygiene appointments if there has been past gum disease present.
 

Our case of the month for July 2021 is quite a complex one involving multiple ceramic crowns after an accident during the first lockdown. Our patient, Xavier, had a cycling accident where he cracked 3 of his front teeth. Now with any trauma case, there is a certain way to handle the situation and it is important not to rush into a specific treatment. The reason being is that once the teeth and gums have been damaged, the consequences may not be apparent for several weeks or months. Hence the use of provisional materials such as composite and temporary crowns are vital during this healing phase.

Periodontal or gum health is paramount also and we needed to spend some time stabilising the gum health with conventional and laser treatments. Beata Kynsak did a wonderful job using Waterlase i Plus and the Epic 10 diode laser with a complete transformation from inflamed , swollen gums to a pink, firm attached gum line. Laser dentistry, although not new, is still a rarity across our profession but we are firm believers in the technology and have many years of experience highlighting great results. 

Once the gums were stable, provisional crowns were made using a diagnostic wax up. This is where our laboratory, Ceramic Studios, re create the teeth using digital means to provide us with a prototype of the final teeth. We can use this guide to define our preparations of the teeth, make the temporary teeth and allow our patients to see what the final crowns can look like. Our temporary crown material of choice is Luxatemp; the gold standard. 

After some time in the temporary crowns, we were ready to proceed with the final crowns which were E Max all ceramic crowns, again the gold standard when it comes to aesthetics. There is no better. Ceramic Studios did a great job and just take a look at the before and after results:
 

Our case of the month for July is an unusual one in the sense that we are not highlighting a wonderful new smile , straighter teeth, whiter teeth or a fantastic new technology. This month, our focus is on peri-implantitis. Now you may wonder what on earth is peri-implantitis. Well, we can report that peri-implantitis is becoming a major issue in relation to dental implants and the prevalence will only increase as more and more dental implants are placed. 
 

Our case of the month for May 2017 involves treatment of tooth decay using our incredible Waterlase i Plus laser. This highly sophisticated technology allows us to treat tooth decay without having to drill the tooth and without any anaesthetic in most cases. Just think; dentistry without drilling and without needles! Just take a look at our case:
 

We love our Waterlase i Plus laser. Why? Well, it makes treatment that was difficult, painful, time consuming and costly into an everyday event. A prime example of this is surgical crown lengthening. What is this? Well, if you have broken a tooth and there is not enough tooth left to place a crown, you will need surgical crown lengthening. In the old days, this involved a scapel, stitches, bleeding, pain and a long time to wait before the next step. No longer. Using the Waterlase i Plus, we can perform the surgical crown lengthening at the time of preparing the crown for the tooth. The laser sterilises at the time of application, reduces bleeding, swelling encourages regeneration and has amazing healing capacities. No stitches, minimal pain and no time delay. Just take a look at a recent case:
 

As our name suggests, we are a forward thinking and innovative practice. In modern day life, technology is evolving at an almost alarming rate. Most of the changes are an improvement and enhance our quality of life. Dental care should be no different. Modern day dentistry is a world apart from the days of dreaded dental care. For example, laser dentistry. We have invested in the Waterlase i Plus 2.0 which has replaced the scalpel in our practice. Here is what Dr Nissit Patel has to say about the Waterlase i Plus: 'Since we have acquired the Waterlase i Plus, I have not needed to use a scalpel for my surgical work. The laser is far less invasive, there is far less bleeding and the recovery time is much reduced. The feedback from patients is overwhelmingly positive. I have recently used the laser to place a dental implant and did not need to use any stitches at all. Here is a photograph of the dental implant immediately after placement:
 

We have invested in the very latest technology- the Waterlase i Plus 2.0. With this amazing dental laser we are able to provide drill free dentistry. Yes, that is correct; dentistry without drilling! Due to the incredible properties of the laser, almost 80% of dental filling cases can be treated without any anaesthetic- so no needles! However, there is more to the laser than simply replacing the dental drill. We can perform all soft tissue procedures using the laser meaning that the traditional scalpels are no longer required, which means less trauma and quicker recovery. There's more! The laser wavelength disinfects as it works, eliminating bacteria, viruses and major pathogens. This in turn provides a major turning point in regeneration of tissues. This has a major impact on all forms of dentistry especially periodontal and implant dentistry. If you detest the dental drill, have a severe needle phobia, want to destroy bacteria in your mouth, have improved outcomes, regenerate tissue and simply enjoy your dental care, contact us today. 

Laser dentistry is at Progressive Dentistry.