Implantatbehandling på parodontitismodtagelige patienter
På kort sigt ses en høj overlevelse af både suprastrukturer og implantater på parodontitis- modtagelige patienter. På den anden side har patienter med et parodontitis-associeret tandtab øget risiko for at udvikle peri-implantitis og sandsynligvis også en større risiko for at miste implantater på lang sigt som følge af den øgede risiko for peri-implantitis. Det er derfor vigtigt, at der er sunde parodontale forhold før implantatindsættelse. Tænder, hvor der ikke kan opnås parodontal sundhed, bør derfor ekstraheres som en del af infektionskontrollen. Ligeledes må rygestop anbefales både under og efter den aktive behandling. Optimal mundhygiejne og et systematisk kontrol- og efterbehandlingsregime er vigtigt for at opnå et langtidsholdbart behandlingsresultat. Speciel opmærksomhed skal udvises over for patienter med tandtab som følge af aggressiv parodontitis. Slutteligt, parodontitis-modtagelige patienter – lige så vel som andre patienter – har ikke nødvendigvis et subjektivt eller objektivt behov for at få alle manglende tænder erstattet.
Implant treatment in periodontitis-susceptible patients: Implant treatment is not contra-indicated in patients with a history of treated periodontitis. In the short-term, a high survival of both suprastructures and implants has been observed. On the other hand, patients with periodontitis-associated tooth loss have an increased risk of peri-implantitis as compared to non-periodontitis patients. Furthermore, these patients are probably also at higher risk of implant loss in the long-term. There are many similarities between the microflora associated with periodontitis and peri- implantitis. Furthermore, studies have shown that there likewise are many similarities between the immunological response at periodontitis and peri-implantitis. It is important to establish healthy periodontal conditions before implant placement in periodontitis- susceptible patients. Teeth should be extracted as part of the infection control, if periodontal health can not be achieved after adequate periodontal treatment. The risk of smoking in relation to implant treatment may be greater for patients with a history of periodontitis. Therefore, periodontitis-susceptible patients should be strongly encouraged to quit smoking both during and after active treatment. After treatment, a systematic regime of recalls and supportive therapy must be implemented similar to the regime after treatment of patients with advanced periodontitis. Special attention is important for patients with tooth loss due to aggressive periodontitis. In order to simplify the treatment, it should be appreciated that patients with a history of periodontitis as well as other patients do not necessarily have a subjective or objective need for replacement of all missing teeth.
