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Jul 2019

Case of the Month July 2019- Peri implantitis

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. Definition Peri-implantitis is an inflammatory process affecting the soft and hard tissues surrounding an implant. This disease is associated with loss of supporting bone, bleeding on probing, and occasionally suppuration (pus exudate). The cause of peri-implantitis is complicated and relates to a variety of factors that affect the implant . In general peri-implantitis can be influenced by three factors:

  1. Patient-related factors including systemic diseases (e.g, diabetes, osteoporosis) and prior dental history such gum disease
  2. Social factors such as poor oral hygiene, smoking, and drug abuse
  3. Parafunctional habits such as bruxism which is another huge modern day problem

In addition to the above, we dentists must also accept responsibility in some cases due to issues such as faulty restorations, cement excess beyond the crown margin and loose components such as screws which have not been torqued to a high enough level. Case Details Our case presented with a dental implant that was bleeding and suffered from very deep pockets around the entire dental implant. The gum tissue around the implant was also very swollen and inflamed. An x ray highlights the level of bone loss :

Bone loss around the front and back of the dental implant

The implant was placed in another country about 5 years ago. The type of restoration was a cement retained crown. As mentioned above, excess cement lodged within the tissue can be the primary cause of peri implantitis and this was the case here. We removed the crown and found a large amount of cement within the sulcus. This was cleaned and the Waterlase i Plus dental laser was used to clean the implant threads which is far superior than normal ultrasonic cleaning or hand scaling using titanium instruments. The Epic 10 diode laser was used for bio stimulation using low level laser therapy to encourage blood flow and healing. After thorough post operative instructions and after care, another x ray was taken to evaluate the response:

Full healing and regeneration

A superb result. The bone levels are now back to normal with in fill of the dark voids seen on the first x ray. Summary Peri implantitis is a rising issue and will continue to rise as dental implants become the first choice replacement for missing teeth. With a full and thorough assessment and diagnosis, there are treatment modalities that can help and even reverse the hard and soft tissue loss caused. Article written by Dr Nissit Patel, Clinical Director, Progressive Dentistry, Fulham, London.


Sep 2021

Case of the month July 2021- Ceramic Crowns

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 fractured 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 provis… READ MORE
Jul 2018

Are you scared of the dentist?

Do you have a fear of the dentist? Are you scared of the dental drill? Are you a needle phobic? If the answer to the above is yes, we can help. We are experts in providing virtually pain free dentistry and use the latest technology to offer alternatives to the dreaded dental drill and needles. Here are some ways that we can make dental treatment more comfortable and stress free: Waterlase i Plus Laser The Waterlase i Plus laser is an amazing, highly sophisticated device which can perform many functi… READ MORE
May 2018

Case of the Month May 2018- laser polyp removal

Our case of the month involves the removal of a fibro epithelial polyp using the Waterlase i Plus laser. What is a fibro epithelial polyp? A fibro epithelial polyp is a very common, firm, painless swelling found mainly on the inside of the cheeks, lips and tongue. It represents a reactive, localised scarring due to trauma or local irritation. This is usually cheek, lip or tongue biting. The size of the polyp usually remains static unless there is continual irritation or trauma where it can increas… READ MORE
Dec 2017

Fibroepithelial Polyp Removal with the Waterlase i Plus laser

Fibroepithelial polyps are commonly seen in the mouth on the lip, cheek, gum line and tongue. There are a small mass of tissue that usually form in response to trauma such as lip biting or cheek chewing. Although, in the main, polyps are pain free and benign, they can be irritating especially if you keep catching them whilst eating which could cause ulcers or inflammation. Here is a common appearance of a fibroepithelial polyp on the lip: A soft mass of pink tissue on the lip. Although these can be left… READ MORE


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