Véronique Christiaens

Implant surface roughness and patient factors on long‐term peri‐implant bone loss

Dental implant placement is a common treatment procedure in current dental practice. High implant survival rates as well as limited peri-implant bone loss has been achieved over the past decades due to continuous modifications of implant design and surface topography. Since the turn of the millennium, implant surface modifications have focused on stronger and faster bone healing. This has not only yielded higher implant survival rates but also allowed modifications in surgical as well as prosthetic treatment protocols such as immediate implant placement and immediate loading. Stable crestal bone levels have been considered a key factor in implant success because it is paramount for long-term survival, aesthetics as well as peri-implant health. Especially during the past decade, clinicians and researchers have paid much attention to peri-implant health and more specifically to the incidence of bone loss. This could furthermore increase the risk for peri-implantitis, the latter often diagnosed as ongoing bone loss and pocket formation beyond the normal biological range in the presence of purulence or bleeding on probing. Information on the effect of surface topography on bone loss or peri-implantitis, a disease process that is to be evaluated in the long-term, is also scarce. Therefore, the current narrative review discusses whether long-term peri-implant bone loss beyond physiological bone adaptation is affected by the surface roughness of dental implants. Based on comparative studies, evaluating implants with comparable design but different surface roughness, it can be concluded that average peri-implant bone loss around the moderately rough and minimally rough surfaces is less than around rough surfaces. However, due to the multifactorial cause for bone loss the clinical impact of surface roughness alone on bone loss and peri-implantitis risk seems rather limited and of minimal clinical importance. Furthermore, there is growing evidence that certain patient factors, such as a history of periodontal disease and smoking, lead to more peri-implant bone loss.

Clinical Guidelines for Implant Treatment in Patients with Down Syndrome

This study evaluated implant outcome in patients with Down syndrome (DSPs) and provides clinical guidelines to maximize treatment outcome. A total of 57 implants were placed in eight DSPs. During follow-up, implant survival was recorded and crestal bone level was evaluated when possible. After a mean follow-up time of 5 years, six patients with 45 implants were evaluated and an implant survival rate of 84.4% was recorded. A mean crestal bone loss of 1.7 mm (SD 0.9) was measured in three patients around 20 implants. Down syndrome is not a contraindication to dental implant placement, but multiple complicating factors yield reduced implant survival.

Analgesia (mis)usage on a dental emergency service: a patient survey

ObjectivesAnalgesics are one of the most frequently used medicines. Self-medication and misuse have been described in the literature. The purpose of this study was to document analgesic (mis)use in a population seeking emergency dental treatment.Material and methodsPatients consulting a dental emergency service were randomly asked to complete a questionnaire on analgesic use, knowledge and information on the analgesics and on their pain history. A photobook was used as an aid to identify products used. Descriptive statistics were combined with chi-square and Mann-Whitney U testing.ResultsNinety-eight patients were included. Acetaminophen (69.4%) and ibuprofen (65.3%) were the most frequently used products. Nearly half of the subjects (43.9%) combined at least two analgesics. Although 42.9% of subjects were aware of the maximum daily dose, 62.2% of the subjects exceeded this limit, specifically 76.6% of subjects using ibuprofen and 32.4% of subjects using acetaminophen overdosing. Females overdosed significantly more than males. Ingestion on medical advice did not affect the overdose rates significantly. No significant relation was found between the absence of knowledge on the maximum daily dose and actual overdosing. No higher pain reduction was found in patients overdosing analgesics. The average number of days patients experienced pain before consulting the emergency unit was 12. A significant relation was found between the lag time and overdosing.ConclusionsA large portion of the patients overdosed analgesics. Even prior medical advice did not reduce significantly overdose rates.Clinical relevanceDentists treating emergency cases clearly need to be aware of the high risk and high rates of overdosing analgesics in their patients.

Reflectie: de rode draad door onderwijs en levenslang leren

Reflectie wordt tegenwoordig steeds meer erkend als een belangrijke pijler voor het levenslang aanbieden van hoogkwalitatieve zorg. Regelmatig reflecteren ondersteunt clinici om met complexe situaties om te gaan, geeft duiding aan het eigen handelen en stimuleert de bewustwording van de doelstellingen die men wenst te bereiken. In tegenstelling tot de toegenomen aandacht voor reflectie in de literatuur, blijft het onduidelijk hoe men reflectie in het onderwijs en de klinische praktijk dient te implementeren. Op basis van onderzoek aan de Universiteit Gent worden in dit hoofdstuk enkele strategieen besproken om reflectie in de praktijk toe te passen. Deze omvatten het definieren van reflectie als een metacognitief denkproces, gekarakteriseerd door terugblikken, analyse en uitkomst; het onderscheiden van de inhoud en het proces van reflecties; gebruikmaken van de klinische realiteit en/of casussen als uitgangspunt voor reflecties; en de meerwaarde om reflecties te delen.