silver plug: prevention of periimplatitis
TRANSCRIPT
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SilverPlugA useful tool for Peri-implantitis prevention
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As peri-implantitis is an infection associated with the presence of a submucosal bacterial biofilm around implants, the primary goal of therapy must be the resolution of the infection which is achieved by:
• the destruction of the biofilm
• the removal of calculus and/or overhanging restoration margins
• the prevention of the recurrence of the disease
5th ITI Consensus april 2013 Group 5: Biological and technical
complication
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As peri-implantitis is an infection associated with the presence of a submucosal bacterial biofilm around implants, the primary goal of therapy must be the resolution of the infection which is achieved by:
• the destruction of the biofilm
• the removal of calculus and/or overhanging restoration margins
• the prevention of the recurrence of the disease
5th ITI Consensus april 2013 Group 5: Biological and technical
complication
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4
The bacterial contamination of dental implants implants components
From the beginning of the implantology era, the bacterial colonization of the internal part of the components was known and investigated
Quirynen M., Van Steenberghe D. 1993 Quirynen M., et al. 1994 Persson L.G. et al. 1996 Jansen V.K., et al. 1997 Zipprih H.,Wegl P.,Lange B. 2007
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The interconnections inside the implants components
The areas marked in red are colonized by bacteria
The area over the screw marked with a red arrow is the one we are focusing with this patent
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Peri-implantitis and periodontitis share the same bacterial microflora
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Peri-implantitis and periodontitis share the same bacterial microflora
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Peri-implantitis and periodontitis share the same bacterial microflora
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Bacteria of the red complex grow in anaerobic context (e.g. Parodontal pockets, ruth fractures, radicoular apex with bad endodontic care,
implant tunnels etc) causing a loss of supporting bone tissue
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Luckily not every single patient develops a
parodontal disease, even considering bacterial flora and others risk factors
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In order to develop a paradontal disease it is
necessary to have a genetic risk factor or
predisposition
Etiology: Plaque and Toxine in the susceptible patient
Periodontitis
Kinney, Ramseier, Giannobile Ann NY Acad Sci 2007 Giannobile, JP 2008
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Although the parodontal disease doesn’t affect the all patients, the
Parodontology’s guide lines recommend to clear every single patient from all risk
factors, regardless of genetic predisposition
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It is highly true also for peri implantitis: a genetic predisposition is necessary for
chronic inflammation (e.g. mucositis and chronic inflammation related bone
reabsorption after implant loading) to turn into peri implantitis
Cronical mucositis
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Peri-implantitis prevention: the key to long-term success
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State of the art
It is well-known how minimal micro movements occur between implants
and abutment or screwed crown
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It is well-known how minimal micro movements occur between implants
and abutment or screwed crown
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These movements are responsible of a pump-like suction effect, taking saliva
from the outside to the inside of the implant tunnel
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These movements are responsible of a pump-like suction effect, taking saliva
from the outside to the inside of the implant tunnel
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Temperature, nutrition and anaerobic conditions within the
implant tunnel are ideal for harmful anaerobic bacteria
proliferation. These bacteria occupy a bigger volume than
the deepest parodontal pocket
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Harmful anaerobic bacteria develop within the tunnel the
same way they do at the bottom of a parodontal pocket
or within a necrotic channel
• Tannarella Forsyzia
• Porphiromonas Gingivalis
Treponema denticolata
Actinobacillus actinomycetemcomitans
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An inflammatory response is therefore triggered and causes
chronic mucositis and reabsorption cone. To
predisposed patients this becomes peri-implantitis
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Which technique do we use to fill the screw tunnel of the
abutment?
?
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wax
cotton pallet
teflon pallet
gutta percha
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A previously sterilized cotton pallet shows high bacterial contamination shortly after
being put into a implant tunnel
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A similar result is obtained with different filling materials.
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The solution
The solution come under the name of SilverPlug
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SilverPlug is the first certified product designed to fill up the
implant tunnel
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SilverPlug is made of a cone trunk shaped polymer
containing a SILVER ZEOLITE that has a high antibacterial
effect
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• Solid and easy to manipulate
• Easily compressible to perfectly filling the implant tunnel
• Its shape is compatible with all implant systems
• Antibacterial effect without releasing chemicals
• When necessary it is always ready to be inserted and removed into and from the tunnel
SilverPlug features
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Which Technique ?
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Step #1 Implant disinfection
Clorexidine gel2
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Step #2 Abutment disinfection
Hypochlorite3
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Step #3 Measurement
4
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Step #4 Cut
5
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Step #5 Insertion
6
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Step #6 SilverPlug in site
7
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Step #7 The end
8
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Comparison of radiographic
aspect
With SilverPlug Without SilverPlug
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SilverPlug sealed radiographic aspect
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Comparison of gum aspect
Without Silverplug With SilverPlug11
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Gum aspect
With SilverPlug11
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SilverPlug after 4 years
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Results
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https://www.linkedin.com/pub/matteo-antonini/72/775/474