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Surgical Articles

Localized aggressive periodontitis: All-On-4 oral rehabilitation case report by Alphonse Gargiulo, DDS, MS; Rachel Degen, RDH; and Mark Val, CDT

Localized aggressive periodontitis: All-On-4 oral rehabilitation case report

Alphonse Gargiulo, DDS, MS, Rachel Degen, RDH, and Mark Val, CDT, present a case report of a 20-year-old African American female who was diagnosed at puberty with localized aggressive periodontitis, which developed into a generalized form of the disease as the patient entered late adolescence. The authors show how the All-On-4 procedure was used to restore the patient’s confidence and enthusiasm about living her life without dental complications.

Recession-proof your practice: Increasing patient acceptance of soft-tissue root coverage by Jennifer Hirsch Doobrow, DMD

Recession-proof your practice: Increasing patient acceptance of soft-tissue root coverage

Some 88% of individuals age 65 and older, and approximately 50% of individuals ages 18–64 experience gingival recession at one or more tooth sites. Dr. Jennifer Hirsch Doobrow finds that her patients benefit from a hybrid/combination therapy, whereby a tunneling technique is used in combination with a subepithelial connective tissue graft, enamel matrix derivative, and a coronally advanced flap.

healing abutment Scott Froum, DDS

This month's clinical tip from the editor: 'Help! My implant fell out!'

When a patient calls your dental office saying, “The implant you put in my mouth fell out. What should I do?” Dr. Scott Froum, editorial director of Perio-Implant Advisory, suggests you tell the patient to send you a picture via text of the “implant that has fallen out.” Nine times out of 10 it will be a healing abutment usually caused by noncompliance with postop instructions to have a soft food diet rather than the implant.

Restorative Articles

Etiology, prevention, and treatment of screw loosening and fracture by Andrew Mackie, BDS, DClinDent, MFGDP, RCS, MRACDS

Etiology, prevention, and treatment of screw loosening and fracture

Prosthodontist Andrew Mackie, BDS, DClinDent, from New Zealand explains the etiology, prevention, and treatment of loose screws and screw fracture of dental implants. He explains often-misunderstood, important concepts such as the physics and technique.

healing abutment Scott Froum, DDS

This month's clinical tip from the editor: 'Help! My implant fell out!'

When a patient calls your dental office saying, “The implant you put in my mouth fell out. What should I do?” Dr. Scott Froum, editorial director of Perio-Implant Advisory, suggests you tell the patient to send you a picture via text of the “implant that has fallen out.” Nine times out of 10 it will be a healing abutment usually caused by noncompliance with postop instructions to have a soft food diet rather than the implant.

oral pain - cranial rhythm - Dreamstime photo

How a perfect, implant-retained anterior bridge can cause facial pain

Dr. Lee N. Sheldon discusses a problem your patients may experience called an interference with the cranial rhythm. But if you don’t know the symptoms, you’ll dismiss their concerns. We were never taught about it in dental school, and it isn't often recognized in traditional dentistry or medicine. The whole issue begins with the “perfect” implant case.

Legal and Financial

This month’s clinical tip from the editor: ‘How much do you charge for an implant? I just want to know the price!’ by Scott Froum, DDS

This month's clinical tip from the editor: 'How much do you charge for an implant? I just want to know the price!'

In this age of Internet and social media advertising, many patients call your office wanting to know the price of specific treatments. You don’t want to be boxed into a corner since you don’t know what the patient needs clinically, right? Hold on a minute. Perio-Implant Advisory Editorial Director Scott Froum, DDS, has some insight for you in his clinical tip of the month. 

man signing document Dreamstime.com

Noncompete agreements and the modern dentist

Dentists today must balance providing high-quality care with running a profitable business. A budding dentist might be so excited to start a job at a new practice that he or she does not consider the impact a restrictive covenant might have on mobility and future opportunities. Evan Miles Goldberg discusses what you need to know about noncompete clauses, also known as restrictive covenants or covenants-not-to-compete. 

cloud computing Dreamstime.com

Are you illegally sharing dental patient data with your colleagues?

The cloud is bringing dramatic changes to dentistry, making collaboration possible from anywhere, critical patient information available anytime anywhere, and second opinions from anyone anytime. However, amid this change, there’s still one constant at the heart of delivering quality care: patient trust. Asaf Cidon teaches you how to use the cloud in a HIPAA-compliant way.

Something new just for you: A chairside resource for the entire dental team

The newsletter and website formerly known as Surgical-Restorative Resource has changed its name to Perio-Implant Advisory. We believe this change better reflects our editorial direction.

As such, we will focus on issues relating to periodontal and implant medicine. You can expect continued peer-reviewed, unbiased, clinical content with exceptional delivery.

Editorial Director Scott Froum, DDS, brings a clinical and academic perspective to the world of implants, periodontics, restorative, and practice management dentistry. You will be receiving the same great content as it relates to complex care with interdisciplinary management, but this change will allow the newsletter to be more focused on periodontal and implant-related issues. The intent is to make Perio-Implant Advisory a chairside resource for the entire dental team.

We appreciate your support and continuing readership!

  Contact the Editor
 
 

Scott Froum, DDS, editorial director
   

   

 

PIA Videos

Team Treatment Planning Articles

Brian McCormack, DDS

Nonsurgical endodontic retreatment with the aid of cone beam (CBCT) imaging

Endodontic therapy under current treatment protocol shows long-term clinical success rates of 86% to 92%. Even with the high clinical success rate of initial endodontic treatment, it’s obvious to see this leaves clinicians with a 14% incidence (on the high side) of encountering post-treatment disease. Dr. Brian McCormack presents a case that was treated with the aid of CBCT imaging and a surgical operating microscope. 

Iman Sadri, DDS

Are you screening for sleep apnea when treatment planning occlusal guards?

There has been much buzz recently about the dentist’s role in the treatment of obstructive sleep apnea (OSA). Most of the attention has centered around oral appliance therapy as a treatment modality to replace the CPAP in the absence of severe OSA. Dr. Iman Sadri says, “Treatment planning an occlusal guard to treat the bruxism that is a result of OSA is not addressing the source of the pathology. If left untreated, sleep apnea can lead to significant health problems in patients.”

 

sedation chart for Dr. Bertrand Bonnick and Hayden Piersol arrticle

Sedation patients are not your average patients: How they leave the dental practice

There is no denying that many patients face dental anxiety and severe dental phobia. Millions of Americans avoid seeing the dentist due to some level of dental fear. No matter how minor the fear, some patients will attempt to avoid any contact with the dentist, even if that means sacrificing their oral health. Dr. Bertrand Bonnick and Hayden Piersol noticed a trend in their dental office and decided to conduct a survey to find out why sedation patients were leaving their office.

Hygiene Articles >

10 steps to perform an oral cancer screening by Scott Froum, DDS

10 steps to perform an oral cancer screening

Squamous cell carcinoma of the oral cavity and throat account for about 45,000 cases each year in the United States, resulting in approximately 8,000 deaths per year. Studies show that successful treatment is highly dependent upon diagnosis and treatment of this disease in its early stages. Although there have been advances in surgical, chemotherapy, and radiation treatment, five-year survival rates of patients with moderate to advanced cases of oral cancer are less than 60%. Patients who do survive typically have trouble chewing, speaking, eating, and smiling after treatment thus it is extremely important to diagnose OC before it becomes advanced, since treatment for early cancer is not as severe. Editorial Director Dr. Scott Froum offers steps to use as you screen patients in your office.

Increasing dental case acceptance through the use of salivary diagnostics by Michael A. Scialabba, DDS

Increasing dental case acceptance through the use of salivary diagnostics

A tremendous amount of literature supports the correlations between gingivitis and/or periodontitis and systemic health. Reports and research continue to find correlations between inflammation of the oral cavity and other inflammatory disease processes, especially cardiovascular disease and diabetes. Educating patients about these links and encouraging oral health awareness has always been a challenge. Dr. Michael Scialabba talks about how salivary testing along with personalized custom periodontal therapy can be a tool to help patients improve not only their oral health but also their overall health.

Manage, repair, or regenerate periodontal disease? by Susan Wingrove, RDH

Manage, repair, or regenerate periodontal disease?

The American Academy of Periodontology warns of a significant public health problem: One out of every two American adults 30 years and older has periodontal disease. (1) As dental professionals, we need to step up to this challenge and change the way we evaluate and treat mucosal oral infections. The research, tools, and biologic products are now available to regenerate bone and tissue—not simply “manage or repair”! Susan Wingrove, RDH, says our role as dental professionals is to identify the optimal time for regenerative periodontal therapy.

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Complications Articles >

Understanding and managing peri-implant bone loss by Stuart J. Froum, DDS

Understanding and managing peri-implant bone loss

Although a high survival rate of implants has been documented in numerous long-term studies, peri-implant bone loss presents a problem that can compromise—or even result in the loss of—a successful dental implant restoration. Dr. Stuart J. Froum offers an in-depth look at how the dental professional can diagnose and prevent bone loss, and maintain a successful implant restoration.

Don't use permanent cement for implants by Chris Salierno, DDS

For the love of everything holy, don't use permanent cement for implants

Whether you prefer screw-retention or cement retention, I think we can all agree that the ability to retrieve the restoration is very important. If there is a fracture of restorative material, such as porcelain or acrylic, then it’s nice to be able to remove the thing and have the lab fix it. I would also urge you to consider how certain contours of the prosthesis can hinder hygienic access, so periodically removing some restorations can significantly aid peri-implant maintenance procedures. But when it comes down to the bitter end, let’s all make a pact together: no more permanent cement for implant restorations.

Stacey Simmons, DDS

Pumpkin on a toothpick

Should mini implants be used for crown and bridge restorations on implants? Dr. Stacey Simmons shares a case study and discusses why these clinical situations should probably be left to regular diameter implants.