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Patients trust auxiliary and look to them for confirmation of treatment. Auxiliary can “plant seeds” of treatment options. Case acceptance depends on patient trust and confidence in treatment. Staff reinforces patient trust and confidence in treatment plan.Coming to CPID: Coming to CPID Web site Ability to refer on line Send digital radiograph through email Education on various periodontal treatmentPowerPoint Presentation: What is periodontal disease?Periodontitis: Periodontitis Inflammation of the supporting tissues of teeth. Usually a progressively destructive change leading to loss of bone and periodontal ligament. An extension of inflammation from gingiva into the adjacent bone and ligament.PowerPoint Presentation: Periodontal procedures?Treating periodontal disease: Treating periodontal disease Scaling and root planing with or without antibiotics Osseous Guided tissue regeneration Bone graft Soft tissue graftsPowerPoint Presentation: Treating periodontal disease non-surgicallyScaling and root planing: Scaling and root planing Greater than 4-5mm pocket depth Remaining calculus and plaque studies show approximately 10% Creating long junctional epithelium Therefore not changing the anatomical defects Effective in reducing 1mm Treat with systemic or local antibioticAntibiotic: Antibiotic Local antibiotic Periochip, arestin, periostat Studies show that locally applied antimicrobials should be used as an adjunct to mechanical periodontal therapy in recurrent or refractory patients Systemic antibiotics-Amoxicillin, Clindamycin, Doxycline, Flagyl,Augmentin Severe chronic or acute periodontitisReevaluation: Reevaluation 3-4 weeks to see if further periodontal treatment is necessaryPowerPoint Presentation: Treating periodontal disease surgicallyTreating periodontal disease surgically: Treating periodontal disease surgically Osseous Guided tissue regeneration (GTR) Membrane (resorbable or non-resorbable) with or with bone graft Gem 21 (PDGF) with or without bone graft Bone graft Autogenous, xenograft, alloplastGuided tissue regeneration: Guided tissue regeneration Resorbable-bioguide membrane Non-resorbable- Gore titanium supported membraneBone graft: Bone graft Demineralized bone material-Grafton Bioss-bovine bone Gem 21 -Platelet derived growth factor mixed with Grafton with Calcium phosphate as a barrierTreating mucogingival defects: Treating mucogingival defects Subepithelial connective tissue graft Autogenous graft Alloderm with PRP (platelet rich protein) Coronally placed flap Pedicle/sliding graftBefore and after : Before and afterHopeless/missing teeth: Hopeless/missing teeth Periodontally involved Non-restorable Previously extractedPowerPoint Presentation: Predictable replacement of teeth?PowerPoint Presentation: IMPLANTSBenefits/Pros: Benefits/Pros Poor performance of traditional removable prosthesis Advantages of implant supported prosthesis Predictable long term results of implant supported prosthesis Standard of Care Aging population Preserve bone Preserve facial form Improve function Restores smiles Restores patient’s confidenceDisadvantage/cons???: Disadvantage/cons??? Additional surgeries (bone grafting, sinus augmentation, implant placement, and uncovering) Finances Healing time Temporization period Esthetics-papilla???PowerPoint Presentation: TemporizationTemporization: Temporization Implant Surgery & Prosthesis: A New Perspective @1996Atraumatic extractions: Atraumatic extractions Periotomes PiezoBone Graft: Bone Graft Demineralized bone material-Grafton Bioss -bovine bone Gem 21 -Platelet derived growth factor mixed with Grafton with Calcium phosphate as a barrierReason for Ridge preservation: Reason for Ridge preservation Rationale: Preserve bone-especially buccal bone Prevent initial bone resorption Support for implant Implant location EstheticsTools: Tools Wax up/models Cone Beam-3 dimensional technology Panoramic radiograph Tomograph Periapical Surgical stents/guided CT-Scan/Simplant/SurgiguidePowerPoint Presentation: RadiographsCone Beam-3 D Dental Imaging System: Cone Beam-3 D Dental Imaging System Powerful tool which allows for thorough interdisciplinary treatment planning of implants and any additional surgeries ie. sinus augmentation, ramus or bone block without the inconvenience of time, going to another site, and substantial additional costsCone Beam-3 D Dental Imaging System: Cone Beam-3 D Dental Imaging System Our cost $250 Availability of information within 30 seconds One scan gives information of both the maxilla and mandible Radiographic exposure equal to digital FMX with a PAN Remote treatment planning Bone density informationCone Beam-3 D Dental Imaging System: Cone Beam-3 D Dental Imaging SystemCone Beam-3 D Dental Imaging System: Cone Beam-3 D Dental Imaging SystemPowerPoint Presentation: Simplant-SurgiguideSimplant-Surgiguide: Simplant-SurgiguidePowerPoint Presentation: I Implant Surgery & Prosthesis: A New Perspective @1996PowerPoint Presentation: Implant Surgery & Prosthesis: A New Perspective @1996Several teeth replacement: Several teeth replacement Ridge augmentation Atrophic ridge Ramus/mandibular symphysis graft Anterior/Esthetic concerns Bone/Soft tissue grafting Sinus augmenation Posterior Pnuematized sinusPowerPoint Presentation: Sinus AugmentationPRP: PRP Platelet rich protein Growth factors,Platelet, TGF Accelerated wound healing Bone faster Better bone???Maintenance/Follow-up for Implants : Maintenance/Follow-up for Implants After restored with radiograph and occlusal exam Every 6 months radiographically for the first year Every year radiographicallyLongevity and post-operative treatment: Longevity and post-operative treatment No cure for periodontal disease Maintain through alternating 3 month maintenance Good possibility to re-treat Periodontal disease approximately after 5-15 years post-operative Implant >90% success rate as long as patient continues with regular periodontal maintenance schedule at home and with their dentist, stays healthy and doesn’t smoke.PowerPoint Presentation: Thank You You do not have the permission to view this presentation. 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