On average, implant patients avail of no more than 1 to 1.5 visits per year for maintenance and follow-up care. As a result, it is often too late when peri-implant degeneration processes are detected and they continue to progress. Rigorous, needs-based detection of individual prevention requirements is essential for maximum sustainability and inflammation-free preservation of implants. ImplantSafe DR detects the start of breakdown processes at a molecular level, thereby enabling the development of a personalized prevention plan for the patient. The benefits to the clinic are maximum sustainability and a major boost to revenue from implant care.
Implantology and the Potential of Needs-Based Recall
Inflammation-Free Implants for Life
The Implant Protection Program
With the number of implants on the rise, an increase in the number of implants lost and of complications due to hidden tissue breakdown is to be expected despite the high rates of implant success.
Dental implants are a success story
They give patients a new lease of life, more confidence and a stronger bite. It’s not surprising, then, that increasing numbers of patients are choosing implant-supported tooth replacement despite private costs of around EUR 1,250 to 3,000 per tooth treated. The German Association of Oral Implantology (DGI) estimates that, in Germany alone, the number of implants inserted each year has risen yearly to reach over 1 million at present.
- Those with higher social status in particular tend to choose the permanent solution offered by implants. Their expectations and demands are high. However, despite impressive success rates, one implant is still lost every four minutes, which translates into 140,000 cases per year, according to experts. Undetected inflammation and tissue breakdown processes are among the most frequent causes of implant loss. Studies have detects peri-implant mucositis in up to 50% of implants and peri-implantitis in between 12% and 43% of implants.
- In Germany alone, around 1 million implants are inserted every year. To date, more than 50 million have been inserted worldwide, which makes the focus on sustainability concepts all the more important because the occurrence of peri-implant inflammations has increased significantly.
Tissue Breakdown with Bone Involvement – a Known Complication in Implantology
- A previous history of periodontal issues increases the likelihood of developing peri-implantitis.
- The longer an implant has been integrated into the oral cavity, the more likely it is that tissue breakdown processes and inflammations will occur.
- If peri-implant inflammations and bone degradation processes remain undetected and untreated, the implant will be lost.
- Chronic phases of periodontitis present a risk to the patient’s remaining natural teeth as well as their implants.
- Patients with chronic pre-existing conditions required special protection from silent oral inflammations
24%
of women aged over 50 in Germany have osteoporosis. Lower bone density is a risk factor for developing periodontitis. Conversely, periodontitis may increase the risk of developing osteoporosis.
50%
of women complain of joint pain during the menopause. Periodontal inflammation may exacerbate pain from arthritis or have a negative impact on the progression of osteoarthritis.
66.6%
of all periodontal diseases remain undetected and untreated because simple diagnostic tools were not widely available until now.
97%
of women aged 35 to 44 in Germany suffer from moderate or severe periodontitis.
41.1%
of all periodontal diseases remain undetected and untreated because simple diagnostic tools were not widely available until now.
28000000
patients in need of preventive care
3
are receiving suitable treatment
627
Patients per clinic in a progressive stage of periodontitis
A Known Complication in Implantology
Place and Protect with aMMP-8
Today, many patients who choose treatment with implants are as young as 40 to 50 years old. Given average life expectancies, this means that a implant must remain firmly anchored in the jaw for 30 to 40 years.
Therefore, every possible action must be taken to protect the high-value tooth replacement from tissue breakdown. In view of the frequency of periodontal tooth loss, it is particularly important that the patient collaborates in the subsequent implant aftercare program but also in the patient and recall management system operated by the dental clinic.
A “gap” has existed in diagnostics until now
An early diagnosis of initial-stage, possibly not yet visible, collagen breakdown processes is critical to long-term implant preservation. That’s because, if acute inflammatory processes are detected in time, preventive measures can be taken to prevent progressive tissue degradation. BOP, probing and x-rays usually come too late. After all, these only serve to reveal that existing, usually irreversible, damage has already been done to the peri-implant tissue. The ImplantSafe rapid screening test closes this diagnostic gap between the start of the breakdown processes and measurable tissue or bone loss, so that treatment can be provided to halt collagen breakdown.
Give “Sleeping” Implant Patients a Wake-Up Call
The Regular ImplantSafe Recall
ImplantSafe DR closes the diagnostic gap by allowing you to detect and select patients who are in need of more preventive measures (shorter recall intervals for prophylaxis). Active collagen breakdown can be detected in a matter of minutes with this delegable test – ideally before any visible damage occurs.
aMMP-8 Monitoring – the Key to Long-Lasting Dental Implants
ImplantSafe DR measures active collagen destruction by testing peri-implant sulcular fluid (PISF) for levels of the collagenase aMMP-8 – a collagen-splitting enzyme produced in the body. The active form
of matrix metalloproteinase-8 breaks down the tissue-supporting collagen fibers to clear the way for granulocytes, macrophages, and osteoclasts to get to the center of infection. aMMP-8 is therefore a
biomarker for the destruction of gingival, periodontal, and peri-implant tissue.
Elevated levels of aMMP-8 can be detected even before the peri-implant tissue becomes clinically notable – at which stage the damage is usually irreversible. If aMMP-8 is permanently elevated, the progressive breakdown of collagen may ultimately lead to the loss of soft tissue and bone. With peri-implantitis, aMMP-8 values up to 1,000 times higher than those in healthy implant patients can be detected.11 This is likely also due to connective tissue healing around the implant and the associated lower rate of flow of sulcular fluid. As a result, fewer collagenases can be washed out of the implant bed and so they become concentrated there.
With ImplantSafe DR, individual implants that show an elevated value can be specifically located at regular checkups (at least 1 to 2 annually). A preventive treatment concept is efficient at this early stage. The value that is measured quantitatively in nanograms can be used to visualize for patients and explain to them in specific terms the importance of dental hygiene and home care (APD form).
Quantitative Analysis with the ORALyzer
Digital – Quantitative – Chairside
- Detects active collagen degradation
- Is simple to perform
- Provides a quantitative result in just a few minutes
- Is validated and reliable
- Is delegable and privately billable
- Is suitable for use in both dental clinics and medical practices, thereby enabling interdisciplinary diagnosis and treatment
The Personalized Prevention Plan with Declaration of Consent
The Best Protection Against Peri-implantitis
The earlier a hidden inflammation can be detected, the easier it will be to treat. What’s more, the earlier the affected areas of the implant and periodontium are specifically and professionally treated, the higher the chances that the patient will make a full recovery. Therefore, every opportunity for early detection and prophylaxis should be utilized to ensure that complications or implant loss can be combated through treatment at an early stage. However, it is not possible to distinguish healthy from unhealthy peri-implant tissue using probing or pocket-depth measurement alone.
Enhance Existing Diagnostics with ImplantSafe DR
The aMMP-8 technology used in the ImplantSafe Digital Reader System is two to three times more sensitive than the standard “bleeding on probing” (BOP) procedure, enabling a more reliable quantitative assessment of periodontal “grading” – a key progression parameter.
ImplantSafe® DR offers fast quantitative detection of the risk of peri-implantitis and its progression for each and every implant. There’s no waiting for test results to come back from a lab.
Instant digital analysis enables rapid visualization of the measurement, which in turn helps raise awareness among dental implant patients and motivate them to take preventive action.
Declaration of Consent in the Prevention Plan
The Declaration of Consent, which was developed with leading lawyers, provides you with the forensic documentation you require and explains to patients the importance of attending preventive checkup at the recommended intervals.
Center of Expertise for the Preservation of Natural Teeth, Implant Protection, and Molecular-Biological Preventative Diagnostics
The PerioPrevention Concept
Almost half of all adults in Germany are diagnosed with moderate periodontitis (grade 3) (DMS-V). Experts estimate that around 28 million German adults are in need of periodontal treatment. And yet only around one million treatments for periodontal disease were claimed from statutory health insurance companies in 2016.
In other words, only 3 to 4% of those affected are receiving suitable treatment. This discrepancy may possibly be explained by the fact that the early stage of periodontal degradation is not be detected in time or that the necessary treatment is not pursued.
PerioPrevention Centers (PPC) are dental practices and clinics that are particularly committed to the preservation of natural teeth and implant protection, and have specialized in these areas. They use aMMP-8 biomarker technology for screening and monitoring processes as standard and are the first point of call in their region for interdisciplinary cooperation with medical specialists. PCCs have the expertise and equipment needed to use modern diagnostics and minimally invasive measures to prevent the development of periodontal diseases at an early stage and sustainably eliminate them. The interdisciplinary PPC prevention strategies include:
- Early detection of active collagen degradation using a quantitative test/laboratory test (PerioSafe PRO DR/ImplantSafe DR & ORALyzer) as diagnostic standard practice
- Creation of a personal prevention plan and recording of the quantitative MMP-8 input value. Professional teeth cleaning (PTC) with pocket decontamination or deep cleaning plus advice on dental care at home (needs-oriented)
- PerioPrevention concept – according to a Swedish long-term study, regular professional teeth cleaning is the best way to achieve successful long-term results. The 25-year study by Axelsson & Lindhe therefore recommends that patients start by having their teeth professionally cleaned 4–6 times per year for the first 24 months. The frequency can then be reduced to 2–4 times per year.
- Clinical monitoring and quantitative control with aMMP-8 for progression monitoring purposes plus a treatment and recall decision based on diagnostics
- Interdisciplinary consultations with the medical specialists treating the patient, if necessary
The PerioPrevention Concept According to Axelsson and Lindhe
As a result of their 25-year study, the Swedish researchers Axelsson and Lindhe recommend that patients have their teeth professionally cleaned 4–6 times a year for the first two years. The frequency can then be reduced to 2–3 times per year. This would make it possible to reduce the number of teeth lost by 90% to approx. 1.4.
Early Detection of PA Progression
Implant Protection and Preservation of Natural Teeth
Almost half of all adults in Germany are diagnosed with moderate periodontitis (grade 3) (DMS-V). Experts estimate that around 28 million German adults are in need of periodontal treatment. And yet only around one million treatments for periodontal disease were claimed from statutory health insurance companies in 2016.
In other words, only 3 to 4% of those affected are receiving suitable treatment. This discrepancy may possibly be explained by the fact that the early stage of periodontal degradation is not be detected in time or that the necessary treatment is not pursued.
By the time they reach retirement age, Germans lose approx. 14 teeth (according the DMS IV). In most cases, tooth loss results from the unnoticed progression of silent periodontal inflammation, the frequency of which has also increased by around 23%.
The PerioPrevention Concept is developed in line with the scientific principles established by the Universities of Gothenburg and Helsinki according to Axelsson/Lindhe and based on more than 30 years of research and science. It confirms that with early detection and prevention, silent inflammation and tooth loss caused by periodontitis can be reduced by almost 90%.
aMMP-8 Detects which Patients are Experiencing PA Progression
PSI
measures the attachment loss that has already occurred – pocket depth (damage measurement)
MMP-8
measures the active tissue degeneration and has a prognostic value
PA progression
is not visible to the naked eye as it is a molecular process of the immune system
The PerioPrevention Concept
A Strong Team for Oral and Physical Health
Almost half of all adults in Germany are diagnosed with moderate periodontitis (grade 3) (DMS-V). Experts estimate that around 28 million German adults are in need of periodontal treatment. And yet only around one million treatments for periodontal disease were claimed from statutory health insurance companies in 2016.
In other words, only 3 to 4% of those affected are receiving suitable treatment. This discrepancy may possibly be explained by the fact that the early stage of periodontal degradation is not be detected in time or that the necessary treatment is not pursued.
Do you recognize your clinic’s own philosophy and want to integrate the medical biomarker technology as standard so that you, too, can communicate with medical specialists and keep your patients healthy in an interdisciplinary manner?
Then join a pan-European network in the fight against periodontitis and peri-implantitis and for the preservation of oral and physical health.
Become a PerioPrevention Center and receive your Quality Seal
The PPC quality seal (Perio Prevention & Oral Anti-Aging Center) is the mark of quality for dental clinics that specially focus on prevention and are certified in the area of immunological diagnostic technology.
More than 300 PPCs across Europe use the latest saliva diagnostic technology to guarantee the best possible preservation of natural teeth, protection of implants, and maintenance of general health.
