Journal of Advanced Periodontology and Implant Dentistry
Volume:5 Issue: 2, Jun 2013

Traditionally, the implant dentistry has been acknowledged as a teamwork practice. However, this approach does not appear to offer the future of popularity that it once did. The evident truth is that the world is changing, and changing fast. The number of general practitioners who are involved in implant dentistry is increasing rapidly. More than 60% of general dentists are involved in implant treatments in their routine cares, many of whom do not seek nor want to share their patients with specialists. On the other hand, the vast majority of dental patients seeking treatment are reducing their plans to the lowest costs and time. At the same time, dental practice overhead continues to upsurge intensely associated with the higher costs of rapidly advancing technologies. All of this is occurring in a depressive economic condition.So, what are dentists in specialty practice doing about it? Most of them are rejecting the notion that things are changing at all and holding on forcefully to preserve the past. They feel in the near future things will go back to the way they were and the general dentists refer their implant patients to their specialist colleagues. My assertion, supported by the evidence, is that teamwork implant dentistry (in its traditional situation) will never reappearance.I am actively working with general dentists who have a keen interest to include the implant-based dental treatments to their daily practice. My initial objective is educating, developing their skills, and training them to modify themselves and their practices through a comprehensive knowledge. At the same time, It’s my view that their understanding of the limitations and difficulties of the complex implant cases will be the best pathway for them to provide the best quality of care. The mindset necessary, the skill sets required, the ability to work in an effective teamwork, are now fundamental and critical to future success.As a closing Comment, general dentists have been trained and acculturated to consideran effective teamwork with specialists in many fields of their practice. However, nowadays their tendencies aremostly to self-solving approach. And sometimes, this kind of thinking works.Although this model is becoming more and more common in the context of dentistry, butregarding the inherent complexities in some implant cases, it seems that an integrated and consolidation approach to experienced dental practitioner would be a viable factor for succeeding dental practice. Given that consolidation and integration appear in implant dentistry, those dentists who master the mindset, skill set, and experience to succeed in consolidation and integration will be able to thrive well into the future.

The aim of the present study was to compare the immediate (Im) and the delayed (De) protocols for placement of single-tooth implants. After allocation to the Immediate and Delayed groups by random, 14 patients were treated with a single-tooth implant with self-threaded internal hex and selective integrated surface (Hi- tec, life care implants) in the anterior or molar region of the maxilla or the mandible on immediate (Im) or 6 months (De) following tooth extraction, respectively. Fourteen patients attended a follow-up visit 18 months after implant placement corresponding to 1 year of loading of the implant restorations. Peri-implant and prosthetic parameters were evaluated clinically and marginal bone levels measured on radiographs. None of the Implant restorations had failed after 1 year of function. Probing pocket depths were reduced by up to 1.5mm on average from the time of loading to the 18 month follow-up and at that time, no significant difference between the Im and De groups was found (4.3 versus 4.2 mm). A statistically significant radiographic marginal bone loss had occurred in the Im group (13.46%) as well as in the De group (15.62%) in the follow-up period. However, a mean marginal bone level of approx. 1.5mm in both groups measured from the implant–abutment junction was found to be acceptable. It was demonstrated that probing pocket depths, papilla fill, width of keratinized mucosa, thickness of peri-implant mucosa and marginal bone levels after 1year of loading of the implant-retained crowns were not influenced by either immediate or delayed implant placement protocols. Furthermore, no severe prosthodontics complications, such as screw loosening or porcelain fractures, arose in this study material. High success rates of single-tooth implants after 1 year of function were achieved using the immediate and delayed single tooth implant placement protocols.

Context: Palatal masticatory mucosa serves as donor material in periodontal plastic surgery. However, there are relatively few studies investigating its thickness To determine the palatal mucosal thickness in Indian subjects aged 14 to 59 years by direct bone sounding and its association with gender and age.Settings and Design: The present observational study was conducted in 40 dentate systemically and periodontally healthy Indians (age range 14 to 59 years) including 20 males & 20 females.Methods and Material: Subjects were divided into two age groups, young (age 14-21 years) and older (30-59 years). A bone sounding method using periodontal probe and a prepared clear acrylic stent to define 12 fixed measurement points was used for estimation of mucosal thickness.Statistical analysis: Multiple linear regression analysis was performed to examine the association of age and gender with mean mucosal thickness at subject level. Student’s t-test was used to determine the difference in mucosal thickness between two age groups, and between genders at each measurement point. Younger group had significantly thinner mucosa (2.73 ± 0.43) than the older group (2.79 ± 0.28). The exception was at first premolar and first molar area along the gingival margin. Females had thinner mucosa than males in the same age group, but the difference was not statistically significant. Overall the thickness of palatal mucosa increased from canine to first molar and in sites farthest from the gingival margin towards the mid-palate. Within the limits of the present study, the palatal mucosa in the area extending along the tip of canine to mesiopalatal cusp tip of first molar appeared to be appropriate donor site for grafting procedures in both young and older individuals.

Background and aims. Despite available evidence for the role of herpes viruses in destructive periodontal diseases, no cause-and-effect relationship has been found to date. This study compared the titer of immunoglobulin G (IgG), immunoglobulin M (IgM) against human cytomegalovirus (HCMV) in gingival crevicular fluid between individuals with periodontitis and with healthy periodontium.Materials and methods. Thirty samples of gingival crevicular fluid (ten from infected sites and ten from non-infected sites from ten individuals with periodontitis and ten from ten individuals with healthy periodontium) were provided. The titer of IgG and IgM were evaluated. Data was analyzed by one-way ANOVA, Kruskal-Wallis test, t-test, Duncen’s test and Pearson’s correlation coefficient.Results. There were no statistically significant differences in the means of IgM titers of the three groups under study (P>0.05), but there were significant differences in IgG titers between the three groups (PKey words: Chronic periodontitis, cytomegalovirus,gingival crevicular fluid,b immunoglobulin G,immunoglobulin M.

An absolute knowledge of a patient’s medical problems, especially in geriatrics, is crucial for providing safe and appropriate dental treatment in the context of any systemic dis­orders, intake of medications, or other oral pathologies. The purpose of this article was to determine the prevalence of self reported medical conditions and drugs used in periodontally compromised geriatric population Information regarding age, sex, medical conditions, and drug used was recorded from interview of 2480 periodontally compromised patients (age ≥60 years) and analysed with chi-square test. 72.8% of patients reported a positive finding in medical histories with most frequent problems were bone/joint dysfunction, hypertension, allergy, diabetes mellitus, eye/ear dysfunction, and cardiovascular diseases. Around 57.9% patients were taking at least one medication. Non significant differences were recorded with male and female patients. Prevalence of medically compromised conditions in dental patients are high, dentists should keep in mind that patients may harbour such conditions, which are contraindicated for certain dental procedures or medication or require special attention when treating these patients.

Careful treatment planning, space management, augmentation of bone and attention to the details of implant surgical and prosthetic techniques are important factors when treating anterior maxilla specially replacement of missing teeth. This case report, addresses the fundamental considerations related to replacement of a congenitally missing lateral incisor by a team approach.