Swizöl and Marika RökkOne of these items concerns men. The other, for comedy reasons, women. With the first one, the eyes of classic car owners light up. With the latter, it is not so easy to tell. What does this have to do with dentistry, however?

Text / Pictures by Dr. med. dent. Hans H. Hsellmann/Dr. Peter Stockel

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Swizöl, a Swiss product, is rich in “grade one carnauba wax” and promises the absolute removal of even the smallest scratches in the finish of a perfectly restored vehicle. And the German-Austrian actress, Marika Rökk, know for her hit song “in de Nacht ist der Mensch nicht gern alleine” (“At Night People Do Not Like Being Alone”), attributed her youthful skin to a product that appeared to perfectly conceal the aging pro-cess on her face. Just like classic

car owners and actresses, dentists also do not like scratches or blem-ishes. Especially not on implants or implant necks.

Hated

I hated working in a lab and hated the arduous task of polishing prostheses, inlays and crowns! But, what is polishing a crown in comparison to the frustrating at-tempt to remove scratches from the machine-polished surface of

an implant? Scratches will contain crystallization microbes that turn into biofilm, and then eventually into plaque, followed by mu-cositis and peri-implantitis. But where do these scratches come from? Simply put – from faulty prophylaxiz. Yes, I can hear you arguing, “we are constantly being reminded about implant prophy-laxis and now you want us to turn against them!” No, I don’t mean that at all. On the contrary, I was only speaking of faulty prophy-

laxis. Specifically, of working on the extremely sensitive (soft) titanium surface using the incorrect instru-ments.

Titanium on titanium

Is it possible? Won’t that cause scratches? The new titanium brush-es (Straumann) definitely won’t. But those are intended for peri-implantitis therapy and for open procedures. We are still talking about prophylaxis in the worst-case scenario for mucositis, but ideally before it develops. Let’s go back to Marika Rökk. Or her secret for eter-nal youth, rather. Unlike the skin and its wrinkles, applying some-thing onto or inside a machined implant surface to smooth out scratches is not possible. The key is to not allow scratches to occur in the first place. This is possible for you and your prophylaxis team by using the correct instruments to remove subgingival sources of irritation on implant necks and abutments. Aha! So, what are the right instruments?

Well-established. The American Eagle.

American Eagle Instruments, an American company in Missoula, Montana, has a simple philosophy, “We aim to manufacture the high-est quality instruments possible. We do not accept compromises. Not with materials, manufacturing processes or with the use of our manpower. Quality has a higher value than profit.” Anyone who is familiar with AEI can attest that this is true. Just look at their Perio instruments that, thanks to their innovative XP Technology, no lon-ger need to be sharpened. They now also manufacture instruments for implant prophylaxis. Are they worth it? Do they offer any advan-tages? I tried them out for you.

What advantages do theyoffer?

The secret of the American Eagle Instruments’ titanium curettes is that they are made of special, ultra-durable titanium. They allow the user to conduct gentle removal of concrements and granulomatous soft tissue from all implant sur-faces. Dental calculus, granulation tissue and other macrostructures are gently removed. Compared to the use of plastic instrument, the implant is cleaned more effectively but is not damaged in the process. Because of the special titanium material, the use of the instrument does not affect the implant sur-face, meaning it does not scratch the surface. The curettes also work gently because of their rounded working tips; the instruments are significantly less aggressive.

Variatio delectat

Cicero already knew: Diversity brings pleasure. American Eagle Instruments makes an implant kit that includes 4 titanium instru-ments that reach all areas of the mouth. The kit is done not for plea-sure, but because it makes sense. Included in the kit are:

• Barnhart 5-6 for the posterior area• Langer 3-4 for implants in the premolar and molar areas• 204 S Scaler for the posterior area• Nebraska 128/ Langer 5 for ante-rior use

With its implant curettes, American Eagle also sets new ergonomic standards. The handles have been designed to be especially thick and effectively prevent fatigue and hand cramps. The user can work in a significantly more relaxed man-ner. In addition, the EagleLite™ colored resin handles enable quick

identification of the instruments. Especially when cleaning implants with rough or threaded surfaces, the often time and labor-intensive procedure is shortened with the implant curettes from American Eagle. Handling is more comfort-able and results are more predict-able. Your team’s wrists will thank you.

Wrapped…

… This is what Christo did to the Parliament building. Whether the film that he used for this purpose was “Robert Koch Institute-compli-ant”, I do not know. But it certainly did not require sterilization. Our titanium curettes do. Loser eas-ily solves the problem of the tips, which perforate any paper-film combination if unprotected. If you decided to purchase the complete curette set (which would make a lot of sense since you would be prepared for all cases) you will also receive a Zirc EZ-JETT cassette to house all the implant instruments, with a 5th space for an extra instru-ment. Lateral folding lids safely hold the instruments in the tray. The generous spaces on the tray bottom allow for optimal cleaning in the thermo disinfector.

The Secret

By the way, Marika Rökk’s secret was called Placentubex. Women don’t use it anymore. Again, because of comedy, women are also classic car owners. And, in the same respect, some men are also cosmetics users. But this made the story much nicer, didn’t it? And if you conduct implant prophylaxis in your practice, then my opinion of titanium implant instruments by American Eagle Instruments should be unavoidable. Just ask your prohpylaxis team about it.

PS: Are you familiar with the non-

word “cementitis”? Unfortunately, it’s not just a non-word. It evidently also signifies a catastrophe for the survival of the implant. Now, just in case your first X-ray control images (recommended after the implant/cementing of the suprastructure) shows cement excess, it can be re-moved easily with American Eagle Instruments titanium curettes with-out causing damage to the implant of the soft tissue surrounding it.

© Hans H. Sellmann, DDS 7 / 2013

1: If an implant is not cared for (and professionally managed), the patient will soon see the results in close-up and recognize what accretions and plaque have caused (to the scratched implant neck, resulting from the use of wrong instruments). (Dr. Stickel Marl specimen collection)

2: We store (and sterilize) the titanium curette kit in one of the practical EZ- JETT cassettes (by Loser).

3: Something to note: when cement-ing the implant-supported bridge, it is important to be aware that the abut-ment “shoulder“ rests on the bridge and lies above the gingival level.

4: Note on the X-ray that the patient already has basic problems with peri-odontal bone loss. Follow-up implant prophylaxis is therefore all the more important to fully prevent the onset of inflammation (mucositis / peri-implan-titis).

5: The prophylaxis session begins with (careful) probing.

6: The complete kit, consisting of 4 double-ended instruments (here, a combination of Nebraska 128 and Langer 5 for the anterior area), makes it possible to address all imaginable situations.

7: The curettes work gently because of their rounded working tips; the instru-ments are significantly less aggressive.

8: Curetting in the anterior-vestibular area…

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9: ...and lingually in the difficult-to-access posterior area.

10: The titanium curette kit in one of the practical EZ- JETT cassettes can be sterilized fully shrink-wrapped after having been passed through the ther-mal disinfector.