November/December 2010, Volume 6, Issue 10
Published by AEGIS Communications
Hygiene Instrumentation for Peri-Implant Maintenance
Titanium scalers offer many compatibility benefits for hygiene around implants.
Karl Schumacher introduces an instrument system for the maintenance of implants. The growing acceptance of single-tooth implants and burgeoning placement of implant-retained prostheses in an aging population make this challenge sure to present itself in most dental practices. Hygiene is critical to the long-term success of implants as they are, after all, inorganic foreign bodies introduced into a dynamic organic environment; a premise that rests on a delicate microscopic interface that needs to be protected. For peri-implant health and the long-term success of the implant, it is important to consider factors that can contribute to the corrosion of materials, and to adapt to the changing contours of the aging supporting bone.
A variety of materials have been suggested for the manufacture of hygiene instrumentation specifically for implants. As a material to manufacture scalers, plastic and various resin combinations have three deleterious drawbacks. First, plastic does not lend itself well to the bends and fine shapes necessary to model the instrument into an ideal configuration to access tight spots such as the pocket created by the slight bone resorption that inevitably surrounds even a healthy implant. Second, plastic is too soft to be effective. Lastly, and also as a consequence of the soft material, there are concerns that the plastic material can be deposited onto the titanium implant surface and contribute to the breakdown of osseointegration.
Traditional instrument materials present their own problems. Because corrosion can occur when dissimilar metals are in close proximity, stainless steel instrumentation can exacerbate the possibility of a galvanic reaction between the titanium ions released by the implant into the saliva environment when they combine with those released by the dissimilar metal of the scaler.
A solid titanium tip is the most advantageous choice for several reasons. Titanium is a like-metal application; titanium to titanium, and so it alleviates the initiation of a galvanic reaction between the hygiene instrument and the implant itself. (This does not address other metals or alloys that could be present in the environment, such base-alloy crowns, restorations, apicoectomies, etc) Solid titanium hygiene instruments have a great advantage in that they can be resharpened, whereas a titanium-coated instrument cannot. Titanium instruments tips can also be shaped and machined finer than plastic or graphite/resin hygiene instrumentation.
Karl Schumacher offers a wide selection of patterns to accommodate the preferences and habits of the practitioner and, more specifically, to address applications specific to implant maintenance even from the time of placement. Elimination of any cement flash irritant at the restoration is an important first consideration. The wide variety of architecture which can be used-narrow-based implants, clip-bars, retention rings, and the like-present unique access difficulties. Available patterns include an anterior scaler (H5/H6), posterior scaler 204S, anterior Gracey curette (1/2), posterior mesial Gracey curette (11/12), and posterior distal Gracey curette (13/14). All of the Gracey curettes are finished in the "mini" configuration to more easily adapt to the small circumference of the abutment. Also available are three patterns of Langer curettes and Columbia universal curettes.
Each instrument pattern is made in Germany of pure titanium tips mounted on a lightweight, color-coded bionicTI™handle for easy chairside identification of individual patterns, and to ensure that the instruments are recognized for specialized use. The properties of titanium allow for the tips to be finely modeled and retain a flexibility that prevents scratching the implant surface. Customized kits can be assembled to match the user's preferences, and kept together in a wash tray that can be sterilized.
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The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry. The preceding is not a warranty, endorsement, or approval for the aforementioned products or services or their effectiveness, quality, or safety on the part of Inside Dentistry or AEGIS Communications. The publisher disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the preceding material.