Peri-implant therapy for the dental hygienist: clinical guide to maintenance and disease complications

  • S. S. Wingrove
Wiley-Blackwell £37.99 9780470962855 | ISBN: 978-0-4709-6285-5

The aim of this book is to help give guidance to the dental hygienist from the initial clinical assessment through to the long term maintenance of implants, and the appropriate protocol to follow should complications occur.

The book begins with a comprehensive timeline of the history of dental implants and the different designs that are used today.

Chapter two focuses on how suitable patients are chosen for implant therapy, based on their medical history, and how to form appropriate risk management protocols accordingly to help ensure a successful treatment outcome. There is a detailed section regarding the effects of bisphosphonates and the assessment of risk of osteonecrosis.

'It's all about the bone' in chapter three explains why it is important for the dental hygienist to have a good understanding of the four classifications of bone, and why bone density and type are important considerations for implant placement. In addition, bone regeneration procedures are also discussed. Endosteal, specialist subperiosteal, transosteal and zygomatic implant placement is explained with excellent diagrams and photographs to support the text.

An excellent guide to refer to or keep in surgery.

Chapters four and five cover adjunctive surgical procedures, restorative options and treatment planning for implants, as it can be the dental hygienist who spends the most time with a patient and plays a key role in identifying their 'needs and wants', therefore being able to discuss what is to be expected of implant therapy including the risks, benefits and possible alternatives to implant treatment is essential.

A dental hygienist has the important role of assessing, maintaining and monitoring dental implants. Chapter six describes the methods of probing and palpating the oral tissues to check for indicators of peri-implant disease, how to check for calculus and/or cement deposits, assessing pain, measuring mobility and checking bone levels with the aid of X-rays, and how to monitor a failing implant accordingly.

Chapter seven discusses the non-surgical and surgical treatment of failing implants with a large section explaining complications due to cement residues. Useful tables and summaries of treatment and protocols are included in each chapter giving the reader a quick reference guide.

Post-surgical implant home care is the emphasis of chapter eight, including suitable brushing and flossing techniques, the use of optional stimulators to help massage and stimulate the gum around implants, why the use of an antimicrobial mouthrinse is important, water irrigation devices, and helpful tips on how to clean both removable and full-arch fixed (suprastructure) prostheses. Specialised home care procedures for implants with peri-implant disease and peri-implant mucosal hyperplasia are explained.

Safe and effective instrumentation (hand instruments and ultrasonic devices) and polishing of dental implants are covered in chapter nine's 'in surgery' implant maintenance section, with helpful information about what a dental hygienist should be checking for clinically and how we should record our findings.

Overall, I think this book is an excellent guide to refer to or keep in surgery, especially should we encounter a particularly challenging case of peri-implantitis. Other members of the dental team may also find this book particularly useful in forming a general understanding of implant therapy.