Hygiene Tribune U.S. No. 1, 2012
Array
(
[post_data] => WP_Post Object
(
[ID] => 56691
[post_author] => 0
[post_date] => 2012-01-18 16:49:06
[post_date_gmt] => 2012-01-18 16:49:06
[post_content] =>
[post_title] => Hygiene Tribune U.S. No. 1, 2012
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => hygiene-tribune-u-s-no-1-2012-0112
[to_ping] =>
[pinged] =>
[post_modified] => 2024-10-21 21:12:51
[post_modified_gmt] => 2024-10-21 21:12:51
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://e.dental-tribune.com/epaper/htus0112/
[menu_order] => 0
[post_type] => epaper
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[id] => 56691
[id_hash] => eef679b4f45c11fdb7dbed63d6e1143beedf51b1889f53174ee34587fa1f421f
[post_type] => epaper
[post_date] => 2012-01-18 16:49:06
[fields] => Array
(
[pdf] => Array
(
[ID] => 56692
[id] => 56692
[title] => HTUS0112.pdf
[filename] => HTUS0112.pdf
[filesize] => 0
[url] => https://e.dental-tribune.com/wp-content/uploads/HTUS0112.pdf
[link] => https://e.dental-tribune.com/epaper/hygiene-tribune-u-s-no-1-2012-0112/htus0112-pdf-2/
[alt] =>
[author] => 0
[description] =>
[caption] =>
[name] => htus0112-pdf-2
[status] => inherit
[uploaded_to] => 56691
[date] => 2024-10-21 21:12:45
[modified] => 2024-10-21 21:12:45
[menu_order] => 0
[mime_type] => application/pdf
[type] => application
[subtype] => pdf
[icon] => https://e.dental-tribune.com/wp-includes/images/media/document.png
)
[cf_issue_name] => Hygiene Tribune U.S. No. 1, 2012
[contents] =>
)
[permalink] => https://e.dental-tribune.com/epaper/hygiene-tribune-u-s-no-1-2012-0112/
[post_title] => Hygiene Tribune U.S. No. 1, 2012
[client] =>
[client_slug] =>
[pages_generated] =>
[pages] => Array
(
[1] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/2000/page-0.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/1000/page-0.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/200/page-0.jpg
)
[key] => Array
(
[2000] => 56691-63697505/2000/page-0.jpg
[1000] => 56691-63697505/1000/page-0.jpg
[200] => 56691-63697505/200/page-0.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[2] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/2000/page-1.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/1000/page-1.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/200/page-1.jpg
)
[key] => Array
(
[2000] => 56691-63697505/2000/page-1.jpg
[1000] => 56691-63697505/1000/page-1.jpg
[200] => 56691-63697505/200/page-1.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[3] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/2000/page-2.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/1000/page-2.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/200/page-2.jpg
)
[key] => Array
(
[2000] => 56691-63697505/2000/page-2.jpg
[1000] => 56691-63697505/1000/page-2.jpg
[200] => 56691-63697505/200/page-2.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[4] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/2000/page-3.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/1000/page-3.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/200/page-3.jpg
)
[key] => Array
(
[2000] => 56691-63697505/2000/page-3.jpg
[1000] => 56691-63697505/1000/page-3.jpg
[200] => 56691-63697505/200/page-3.jpg
)
[ads] => Array
(
)
[html_content] =>
)
)
[pdf_filetime] => 1729545165
[s3_key] => 56691-63697505
[pdf] => HTUS0112.pdf
[pdf_location_url] => https://e.dental-tribune.com/tmp/dental-tribune-com/56691/HTUS0112.pdf
[pdf_location_local] => /var/www/vhosts/e.dental-tribune.com/httpdocs/tmp/dental-tribune-com/56691/HTUS0112.pdf
[should_regen_pages] => 1
[pdf_url] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/56691-63697505/epaper.pdf
[pages_text] => Array
(
[1] =>
HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U.S. Edition
january 2012 — Vol. 5, No. 1
www.dental-tribune.com
Guidance evolving on
cleaning dental implants
Many dentists and hygienists are experiencing frustration and
misunderstanding about the biology and the armamentarium used
when maintaining dental implants By Stacy Ewing, BS, RDH
As a dental implant sales rep, I speak
with many clinicians on a daily basis
about implants. Coming from a background of 28 years as a dental hygienist,
the topic of cleaning dental implants always seems to come up in conversation.
These communications suggest that the
majority of dentists and hygienists are
experiencing a great deal of frustration
and misunderstanding about the biology and the armamentarium used when
maintaining dental implants. This article
attempts to provide helpful information
to the practicing professionals from evidence-based and anecdotal sources.
Initially, it is important to understand
terminology. An implant, also referred
to as the “fixture,” is the titanium screw,
which inserts into the bone to replace the
natural root. The most coronal part of the
implant, often referred to as the collar,
may have a smooth or rough surface.
The structural component or attachment, which fits into the implant and provides the foundation for restoration, may
have various names depending on the
type of restoration (also called prosthetics or reconstruction). This attachment
has a smooth surface. In the case of a
single crown or bridge, this component is
called the abutment or cuff. Restorations
(crowns), which attach to abutments, may
be screw-retained or cemented. Multiple
abutments may be referred to as a roundhouse or multi-units. These multiple
types may be standalone or attached to a
bar (may be called a hybrid or high water).
They may support single crowns, bridgework, fixed partial denture or fixed full
denture. Components that engage with
a removable denture may be ball attachments or locator attachments. The implant prosthetic restoration terminology
is the same as that used for natural teeth.
It is important to understand that bio-
Stacy Ewing, BS,
RDH, has been in dentistry for 30 years, with
experience in clinical
practice, education, research and public
health. Her clinical and
creative writings have
been published in RDH
magazine and various
journals. She works as
a professional representative for MIS Implants Technologies.
film and calculus may accumulate on
all these structures, just as with natural
teeth. Also, whenever cement is used and
residual amounts remain, it will cause
irritation and needs to be effectively removed.
The periodontium around an implant/
attachment/restoration is different than
around a natural tooth. In very simplistic
terms, there are two important biological
characteristics of the tissue surrounding
the implant, attachment and restoration.
First, there is no connective tissue “at” Continue on page C2
'Pros in the Profession' winner named
Julie Wells Kroeker, RDH, first of six possible 2012 honorees, recognized for exceptional daily service
Crest® Oral-B® has named Julie Wells
Kroeker, RDH, of McAllen, Texas, as the
latest winner of the brands’ second annual Pros in the Profession® award program, which honors registered dental
hygienists who go above and beyond the
call of duty every day. After careful consideration of a pool of qualified candidates, a panel of judges selected Kroeker
for the award based on her commitment
to the oral health of not only her patients, but also those with special needs
in her community.
Kroeker has been practicing dental
hygiene for more than 28 years, holding
a Bachelor of Science from the University of Oklahoma Health Science Center.
She lives in the Rio Grande Valley with
her husband and four children, two of
whom also plan to go into the dental
profession.
Kroeker works in a location that has a
large Hispanic population, presenting
a potential language barrier between
her and many of her patients. Kroeker
has overcome this obstacle by learning
to speak Spanish, which has greatly improved her relationships and ability to
communicate with many of her patients.
In her spare time, Kroeker enjoys
educating the youth in her community
Julie Wells Kroeker, RDH Photo/Crest Oral-B
about the importance of maintaining good oral health through frequent
presentations at the local elementary
schools and health fairs. Kroeker regularly visits the high school where her sister teaches students with special needs.
Through role playing and props, she ensures that the students will feel comfortable, at ease and informed the next time
they sit in the dental chair.
A personal struggle Kroeker has overcome is her diagnosis of rheumatoid
arthritis 12 years ago. Through her positive attitude, combined with regular
exercise and a healthy diet, Kroeker has
been in remission for several years and
fortunately, her career has not been impacted.
To Kroeker, one of the most important
things she can do is help others not only
learn about proper oral hygiene, but also
take passion in their oral health as much
as she does. Through her tireless dedication to her profession, Kroeker strives to
reinforce the oral care and overall health
of her patients and community.
Throughout the year, five other deserving professionals will join Kroeker
as this year’s Crest Oral-B Pros in the
Profession winners. Winners will receive
a $1,000 monetary prize, recognition
at a special award cocktail reception at
RDH’s Under One Roof 2012 in Las Vegas,
a recognition plaque, tribute in dental
trade media news announcements and
on the website www.dentalcare.com, and
an exclusive trip to Proctor and Gamble
headquarters. So those who know worthy “Pros” like Kroeker should help give
those individuals the recognition they
deserve by nominating them today.
Nominations will be accepted through
April 2012 at www.prosintheprofession.
com or at the Crest Oral-B booth at upcoming dental conventions.
Nominations should be submitted by
dentists, fellow hygienists, dental assistants, professional colleagues and other
collegiate colleagues.
Submitted nominations should convey why the nominee is a true pro. Nominees must meet the following criteria:
• Registered dental hygienists with
two-plus years of practice experience
after graduation from dental hygiene
school.
• Registered dental hygienists with
community service involvement.
• General volunteer/non-oral healthspecific examples are welcome, but oral
health-related volunteer experience is
preferred.
• Registered dental hygienists with
examples of work that go above and beyond the call of duty. Examples include:
excellent patient relations/special care/
retainment; involvement in research
and/or clinical experience; published
work(s); and the ability to generate additional business for their practice.
To learn more about Kroeker, the other
winners and the Pros in the Profession
program — including how to nominate a
Pro for consideration — visit the website
www.prosintheprofession.com.
(Source: Crest Oral-B)
[2] =>
Industry news
c2
Hygiene Tribune U.S. Edition | January 2012
New addition to line of
disposable prophy angles
Features include improved interproximal access
The ergonomic
17-degree bend in
the Emerald‘s
neck is designed
to improve
clinician comfort,
while the
prominent ridges
found at the base
enhance the
operator’s grip.
Photo/Denticator
The Emerald™ is the newest addition
to the line of disposable prophy angles
by Denticator. As a pioneer in disposable
prophy angle manufacturing, the company is excited to introduce the innovative
design.
The ergonomic 17-degree bend in the
neck, as well as the superior gearing design of the angle, is designed to improve
clinician comfort, while the prominent
ridges found at the base will enhance the
operator’s grip.
In addition, the unique color and finish of this disposable prophy angle will
Yankee
BOOTH
NO. 1335
make for easy identification. The angle is not
the only notable aspect of
the Denticator Emerald, though; the soft,
latex-free cup features external ridges to
provide improved interproximal access
along with enhanced stain removal.
The Denticator Emerald is available in
either a 144 count box or a 500 count box.
For more information, visit www.denticator.com or call Denticator with any questions or comments at (800) 227-3321.
(Source: Denticator)
HYGIENE TRIBUNE
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid e.seid@dental-tribune.com
Group Editor
Robin Goodman r.goodman@dental-tribune.com
Editor in Chief Dental Tribune
Dr. David L. Hoexter d.hoexter@dental-tribune.com
Managing editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor
Sierra Rendon s.rendon@dental-tribune.com
Managing Editor
Robert Selleck r.selleck@dental-tribune.com
Managing Editor Show Dailies
Kristine Colker k.colker@dental-tribune.com
Product & Account Manager
Mark Eisen m.eisen@dental-tribune.com
Marketing Manager
Anna Kataoka-Wlodarczyk
a.wlodarczyk@dental-tribune.com
Sales & Marketing Assistant
Lorrie Young l.young@dental-tribune.com
◊ Page C1
tachment” between tooth and bone. The
implant integrates directly with the bone.
When inserting an instrument around
a natural tooth, the resistance encountered by connective tissue “attachment”
creates a barrier to direct engagement
with bone.
The second biological characteristic of
importance is that the gingival fibers surrounding an implant abutment comprise
a horizontal/circular band, called the
perimucosal seal, or the tissue cuff. There
are no gingivodental or transeptal fibers
or periodontal ligament as with a natural tooth. The perimucosal seal creates a
barrier against bacterial introduction. It
is easily possible to insert an instrument
through the seal and directly contact
bone. Therefore, one of the key considerations during instrumentation is to go
carefully within the perimucosal seal.
Another significant aspect to consider
with instrumentation around the implant/attachment is that these components are primarily made of titanium,
a soft metal. Titanium is harder than
plastic, Teflon and enamel. But it is softer
than plastic that has been reinforced by
carbon, glass or graphite and it is significantly softer than stainless steel.
All the research agrees that stainless
steel instruments and ultrasonic tips
leave scratches and gouges on the titanium surfaces, which may harbor any
subsequent accumulation of biofilm, in
addition to potentially altering the biocompatibility of the titanium surface.
Graphite, glass and polymer-reinforced
plastics or resins also show scratching to
some degree. However, some studies and
anecdotal reports indicate that roughened abutment surfaces have not been
shown to increase implant complications.
It is also generally reported in the literature that plastic and Teflon can leave
a surface residue that may interfere with
the biocompatibility of titanium.
Additional research is needed regarding the effects of surface scratching and
residue. Even though the literature states
that non-reinforced plastic or resin handinstruments are the best choice, clinicians agree that such instruments, alone,
are not effective for the complete removal
of calculus, residual cement and biofilm.
New products are appearing based on
the premise that materials of similar
hardness to titanium will be more effective at removing calculus with less
scratching. These include solid titanium,
carbon composite or carbon-reinforced
plastic and copper alloy. Even though
some of these products are already in
the marketplace, the research about their
performance is limited. For example, a
review of the literature conclusions about
titanium scalers ranges from no effect
to surface scratching similar to stainless
steel scalers.
More details on plastics needed to
improve clinicians' armamentarium
Studies need to specifically define the
type of plastic used in implant products.
There is a decent amount of research over
the past 20 years about the effects of plastic instruments on dental implants/attachments, but rarely is the type of plastic
stated. This is an important detail, which
may influence the clinician’s choice of armamentarium. For example, a non-filled
type of plastic is flexible and does not
hold an edge for sharpening, whereas the
filled types are more rigid and do hold an
edge for sharpening.
Dental applications with biocompatible
polymers such as PEEK (polyetheretherketone) and Ultem PEI (polyetherimide
resin) are being studied and used in implant dentistry.
Hand instruments
Non-filled resin
• Hu-Friedy Implacare
• Sabra Dental Implant Solutions
Filled plastic
• Premier Universal/Facial carbon
reinforced
• Tess Implant Prophy+ polymer reinforced
• PacDent ImplaKlean carbon reinforced
Solid titanium
• A. Titan Titanium Implant Scalers
• Nordent Implamate
• PDT Wingrove Series
• Kohler Implant Cleaning Curettes
• Karl Schumacher Bionik TI
• American Eagle Titanium Implant
Cleaning Kit
Ultrasonic tips
Magneto
• Dentsply Cavitron SofTip single-use
plastic twist-on
• Advanced Ultrasonics single-use
plastic screw-on
• Tony Riso multi-use plastic screw-on
• G. Hartzell & Son-multi-use silicone
screw-on (also for use on piezo inserts)
• Parkell GentleCLEAN single/multi-use
Ultem wrench-on
Piezo
• Satelec/ACTEON PerioSoft multi-use
carbon composite screw-on
• EMS PI Instrument multi-use plastic
insert with chuck
• Brasseler USA/NSK Varios multi-use
plastic insert with holder
Studies also vary on use of air abrasives
and implants. Most agree that this is a
safe and efficacious procedure; however,
there is a great deal of variation in operator technique. Too much time on titanium surfaces can scratch. Some research
indicates that a glycine-based powder will
scratch less than sodium bicarbonate or
aluminum oxide powders. More definitive research is needed in this area.
Air abrasive devices
• Kavo Prophyflex
• Deldent Jetstream, Jetpolisher and
Jetsonic
• Dentsply Prophyjet
• Satelec/ACTEON AirMax
• EMS Air-flow
• EMS Air-flow Powder Soft & Perio:
glycine-based
Rubber cup polishing is indicated on
titanium surfaces with fine prophy paste,
nonabrasive toothpaste or tin oxide. Abrasive polishing pastes are contraindicated.
Finally, many periodontists I have spoken with on this topic have what I consider the most important observation: Each
patient must be treated on an individual
basis and given the necessary amount of
education and recall frequency so that
the amount of accretions do not accumulate to the point of having to make questionable armamentarium choices.
A list of references is available
from the publisher.
C.E.Manager
Christiane Ferret c.ferret@dtstudyclub.com
Dental Tribune America, LLC
116 West 23rd St., Ste. #500
New York, N.Y. 10011
(212) 244-7181
Published by Dental Tribune America
© 2012 Dental Tribune America, LLC
All rights reserved.
Dental Tribune strives to maintain the utmost accuracy in its news and clinical reports. If you find a
factual error or content that requires clarification,
please contact Managing Editor Robert Selleck at
r.selleck@dental-tribune.com.
Dental Tribune cannot assume responsibility for the
validity of product claims or for typographical errors.
The publisher also does not assume responsibility for
product names or statements made by advertisers.
Opinions expressed by authors are their own and
may not reflect those of Dental Tribune America.
Editorial Board
Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
Dr. James Doundoulakis
Dr. David Garber
Dr. Fay Goldstep
Dr. Howard Glazer
Dr. Harold Heymann
Dr. Karl Leinfelder
Dr. Roger Levin
Dr. Carl E. Misch
Dr. Dan Nathanson
Dr. Chester Redhead
Dr. Irwin Smigel
Dr. Jon Suzuki
Dr. Dennis Tartakow
Dr. Dan Ward
Tell us what you think!
Do you have general comments or criticism
you would like to share? Is there a particular
topic you would like to see articles about in
Hygiene Tribune? Let us know by e-mailing
feedback@dental-tribune.com. We look
forward to hearing from you! If you would
like to make any change to your subscription
(name, address or to opt out) please send us
an e-mail at database@dental-tribune.com
and be sure to include which publication
you are referring to. Also, please note that
subscription changes can take up to six
weeks to process.
[3] =>
[4] =>
)
[page_count] => 4
[pdf_ping_data] => Array
(
[page_count] => 4
[format] => PDF
[width] => 765
[height] => 1080
[colorspace] => COLORSPACE_UNDEFINED
)
[linked_companies] => Array
(
[ids] => Array
(
)
)
[cover_url] =>
[cover_three] =>
[cover] => ![Hygiene Tribune U.S. No. 1, 2012]()
[cached] => true
)
