SilverPlugA useful tool for Peri-implantitis prevention

As peri-implantitis is an infection associated with the presence of a submucosal bacterial biofilm around implants, the primary goal of therapy must be the resolution of the infection which is achieved by:

• the destruction of the biofilm

• the removal of calculus and/or overhanging restoration margins

• the prevention of the recurrence of the disease

5th ITI Consensus april 2013 Group 5: Biological and technical

complication

As peri-implantitis is an infection associated with the presence of a submucosal bacterial biofilm around implants, the primary goal of therapy must be the resolution of the infection which is achieved by:

• the destruction of the biofilm

• the removal of calculus and/or overhanging restoration margins

• the prevention of the recurrence of the disease

5th ITI Consensus april 2013 Group 5: Biological and technical

complication

4

The bacterial contamination of dental implants implants components

From the beginning of the implantology era, the bacterial colonization of the internal part of the components was known and investigated

Quirynen M., Van Steenberghe D. 1993 Quirynen M., et al. 1994 Persson L.G. et al. 1996 Jansen V.K., et al. 1997 Zipprih H.,Wegl P.,Lange B. 2007

5

The interconnections inside the implants components

The areas marked in red are colonized by bacteria

The area over the screw marked with a red arrow is the one we are focusing with this patent

Peri-implantitis and periodontitis share the same bacterial microflora

Peri-implantitis and periodontitis share the same bacterial microflora

Peri-implantitis and periodontitis share the same bacterial microflora

Bacteria of the red complex grow in anaerobic context (e.g. Parodontal pockets, ruth fractures, radicoular apex with bad endodontic care,

implant tunnels etc) causing a loss of supporting bone tissue

Luckily not every single patient develops a

parodontal disease, even considering bacterial flora and others risk factors

In order to develop a paradontal disease it is

necessary to have a genetic risk factor or

predisposition

Etiology: Plaque and Toxine in the susceptible patient

Periodontitis

Kinney, Ramseier, Giannobile Ann NY Acad Sci 2007 Giannobile, JP 2008

Although the parodontal disease doesn’t affect the all patients, the

Parodontology’s guide lines recommend to clear every single patient from all risk

factors, regardless of genetic predisposition

It is highly true also for peri implantitis: a genetic predisposition is necessary for

chronic inflammation (e.g. mucositis and chronic inflammation related bone

reabsorption after implant loading) to turn into peri implantitis

Cronical mucositis

Peri-implantitis prevention: the key to long-term success

State of the art

It is well-known how minimal micro movements occur between implants

and abutment or screwed crown

It is well-known how minimal micro movements occur between implants

and abutment or screwed crown

These movements are responsible of a pump-like suction effect, taking saliva

from the outside to the inside of the implant tunnel

These movements are responsible of a pump-like suction effect, taking saliva

from the outside to the inside of the implant tunnel

Temperature, nutrition and anaerobic conditions within the

implant tunnel are ideal for harmful anaerobic bacteria

proliferation. These bacteria occupy a bigger volume than

the deepest parodontal pocket

Harmful anaerobic bacteria develop within the tunnel the

same way they do at the bottom of a parodontal pocket

or within a necrotic channel

• Tannarella Forsyzia

• Porphiromonas Gingivalis

Treponema denticolata

Actinobacillus actinomycetemcomitans

An inflammatory response is therefore triggered and causes

chronic mucositis and reabsorption cone. To

predisposed patients this becomes peri-implantitis

22

Which technique do we use to fill the screw tunnel of the

abutment?

?

wax

cotton pallet

teflon pallet

gutta percha

A previously sterilized cotton pallet shows high bacterial contamination shortly after

being put into a implant tunnel

A similar result is obtained with different filling materials.

The solution

The solution come under the name of SilverPlug

SilverPlug is the first certified product designed to fill up the

implant tunnel

SilverPlug is made of a cone trunk shaped polymer

containing a SILVER ZEOLITE that has a high antibacterial

effect

• Solid and easy to manipulate

• Easily compressible to perfectly filling the implant tunnel

• Its shape is compatible with all implant systems

• Antibacterial effect without releasing chemicals

• When necessary it is always ready to be inserted and removed into and from the tunnel

SilverPlug features

Which Technique ?

Step #1 Implant disinfection

Clorexidine gel2

Step #2 Abutment disinfection

Hypochlorite3

Step #3 Measurement

4

Step #4 Cut

5

Step #5 Insertion

6

Step #6 SilverPlug in site

7

Step #7 The end

8

38

Comparison of radiographic

aspect

With SilverPlug Without SilverPlug

39

SilverPlug sealed radiographic aspect

Comparison of gum aspect

Without Silverplug With SilverPlug11

Gum aspect

With SilverPlug11

SilverPlug after 4 years

Results

https://www.linkedin.com/pub/matteo-antonini/72/775/474