Minor cases can be treated by general dentists who have knowledge of periodontology. However, for more advanced cases the use of a dentist with special training in the treatment of periodontitis - a periodontist – is recommended.
Frequently Asked Questions
Yes, patients with periodontitis can have dental implants fitted, but only once their periodontitis has been treated and brought under control first. Otherwise, there is a strong chance that the patient will suffer from periimplantitis.
Even once their periodontitis has been brought under control, patients who have had periodontitis are more likely to develop periimplantitis than patients who have not. Therefore, before extracting a tooth we must always be sure that said tooth cannot be left in place with appropriate treatment and maintenance.
Periodontitis can be treated if detected in its early or moderate stages. The loss of teeth can be avoided by stabilising the loss of bone around the teeth. In very advanced cases, the tooth will have to be removed if the damage done is excessive (hence the importance of an early diagnosis).
In general, lost bone cannot be recovered. The objective of the treatment is to halt the progression of bone loss to avoid tooth loss; however, in some situations we can regenerate lost bone via the application of products that promote the formation of new bone. You can see the results in the clinical cases section.
A number of studies published in the last decade have revealed a relationship between periodontitis and other conditions, such as:
- Greater chance of cerebrovascular accidents.
- Impaired metabolic control of sugar in diabetics.
- Greater chance of pregnant women with periodontitis giving birth to babies that are underweight or premature.
This is due to the spread of the bacteria that cause periodontitis from the gum to other parts of the organism.
Dental implants attach to the bone in a biological process called osteointegration, in which the bone firmly attaches to the implant.
Once the implant has osteointegrated, it can be lost in the long-term usually as a result of infection. If bacterial plaque and tartar get under the gum the patient can experience a condition called periimplantitis, which results in the loss of the bone that supports the implant. If this loss of bone is not detected in a timely manner and treated as appropriate, the implant can lose all of the bone and it may need to be removed. Periimplantitis is more common in patients who have had periodontitis, who smoke and, above all, do not brush correctly.
The osteointegration process is not the same for all brands of implant. Although all implants are made from titanium, each office treats the surface of the implant, which influences the speed of the osseointegration process, the extent of contact between the implant and the bone and, therefore, the rate of success/failure.
At PerioCentrum clinics, we use just three high-end or premium brands of implant, with which be obtain documented osseointegration success rates of more than 99% for the implants we fit. Furthermore, these are the implants that osteointegrate fastest; in most of the cases we see, production of the permanent prosthesis can start within six weeks of the implant being put in place. In situations where the patient has little bone where bone regeneration techniques must be used, the time we need to wait in order to make the prosthesis is usually longer.
Dental implants require a degree of hygiene and check-up and maintenance visits that are similar to those for teeth. The frequency of visits is determined by the condition of the mouth of the patient (whether or not they have periodontitis, and to what extent) and by external factors, such as whether or not they smoke and the ability of the patient to brush their teeth correctly.
A patient who does not have periodontis and who does not smoke will only need a check-up once a year, while patients who have periodontis must have a check-up every 3-6 months, both to control the periodontitis in their teeth and to prevent the implants from developing periimplantitis./p>
Under no circumstances should the fitting of implants be a painful procedure: it is performed with the patient under local anesthetic and, in some cases, via conscious intravenous sedation. The post-operative period is often very short in most cases: the patient must take a prophylactic antibiotic treatment for one week and analgesics for as long as required, which tends to be between 1 and 3 days after surgery. There can be slight inflammation of the face, although in most cases even this does not occur. In some more complex cases of surgery that involve bone grafts, there can be inflammation that last for days, but never pain.
To a large extent, whether the post-operative period is benign or not depends on the surgical care and the experience of the surgeon. The doctors at PerioCentrum employ microsurgical techniques that significantly reduce the length of post-operative period.