POSTOPERATIVE INSTRUCTIONS TO BE FOLLOWED AFTER LANAP

POSTOPERATIVE INSTRUCTIONS TO BE FOLLOWED AFTER LANAP

• Normally, some discomfort is to be expected, but is usually managed well with the anti-inflammatory medication that was prescribed for you.
•  Some slight bleeding is also normal
•  Tissues can be gray, yellow, red, blue, purple or “stringy” and reflect normal response to laser treatments.
•  Avoid spicy or excessively hot foods for the first week.
•  Try to keep your mouth as clean as possible in order to help the healing process.
•  Brush in all the areas of your mouth except for the treated areas.
•  Do not apply excessive tongue or cheek pressure to the treated areas.
• Some swelling may occur. To keep this to a minimum, gently place an ice pack on the outside of your face on the treated side for 20 minutes each hour on the treatment day. Do not continue using the ice bag the next day.
•  It is very important to maintain a good food and fluid intake. Try to eat soft but nutritious foods, such as eggs, yogurt,cheese , ice cream, etc., until you can comfortably return to a normal diet.
• Stronger pain medication is usually not needed.
• An antimicrobial rinse was also prescribed. Since you cannot brush or floss the treated areas for one week, use of the rinse as directed will reduce the accumulation of plaque and tartar on the treated teeth in the absence of brushing. You may experience a medicinal aftertaste, which is temporary.

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What is Peri-implantitis

Peri-implantitis is defined as an inflammatory reaction, with the loss of supporting bone in the tissues surrounding a functioning implant. The features to be observed are 

1. bleeding gums

2. swollen gums

3. shaking implant

4. exposure of implant screw threads

5. Loss of bone in the X- ray

                               

Treatment of peri-implantitis

According to the best available evidence, traditional periodontal infection control including plaque control regimens and mechanical cleaning of the affected areas possessing professional cleaning should be performed. 

It is essential to inform the patient about the need for effective oral hygiene procedures (particularly around implants), and the patient should be carefully instructed in the proper use of necessary additional oral hygiene aids. Oral hygiene procedures should be trained under professional supervision.

Surgical exposure of the lesions was performed, and the affected implants were cleaned using hydrogen peroxide.

Systemic antibiotics were administered according to a susceptibility of bacteria. The applied surgical and antimicrobial treatment strategy was successful in less than 60% of the treated implants. Despite treatment and re-treatment of peri-implantitis–affected areas, additional loss of supporting bone was found in up to 40% of the advanced peri-implant lesions.

LASERS to treat Peri-implantitis

A promising method for decontaminating implant surfaces involves the use of laser energy. Unlike mechanical decontamination methods, which cannot fully adapt to the irregularities on the surface of an implant, lasers can irradiate the whole surface, reaching areas that are too small to receive mechanical instrumentation. Power settings are variable, and the clinician can choose a setting that will effectively disinfect the implant while not damaging the surface. 

Conventional approaches include:

• Systemic administration of

   antibiotics

• Removal of supragingival bacterial plaque

• Removal of granulation tissue

   with plastic curettes

• Debridement of the exposed surface by using mechanical brushing, air powder abrasives, citric acid, disinfectants like chlorhexidine or topical tetracycline, plaque inhibitor like delmopinol, or low-intensity ultraviolet radiation

• Removal ofthe peri-implant pocket

• Regeneration of peri-implant hard tissue by means of guided tissue regeneration

• Plaque control and oral hygiene.

Advantages of Laser in the treatment of Peri-implantitis

• The laser easily vaporizes any existing granulation tissue.
• The implant surface can be debrided by lasing directly on the implant’s exposed screws with a low-energy setting. Both the target tissue and implant surface are disinfected without damage.
• The laser is bactericidal.

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Disadvantages of Removable partial dentures

If you have lost a single tooth, you have various tooth replacement options to consider. One option would be a removable, single tooth partial denture. However, there are various disadvantages with this alternative.

1. The bulk of metal and acrylic will be uncomfortable to the patient.

2. The unsightly clasps necessary to stabilize the prosthesis might be irritable to the gums of the teeth supporting the denture.

3. A major consequence of this option is the bone loss that occurs due to the absence of the natural tooth root. 

4. Biting forces will cause the partial denture to move and shift because its design lacks a secure connection. 

5. Difficulty in cleaning: Must remove the teeth at night.

6. There are chances of future decay.

7. Difficulty in speech which can be practised in time.

  

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Oral signs and symptoms in Diabetes

Oral manifestations of diabetes mellitus

The common oral manifestations of diabetes include the following: gingivitis; periodontal disease; multiple periodontal abscesses, xerostomia and salivary gland dysfunction; recurring bacterial, viral and fungal (Candida) infections; dental caries; periapical abscesses; loss of teeth; delayed wound healing; burning mouth syndrome; taste impairment; and oral lichen planus.

Gingivitis and periodontitis: Poor glycemic control has been associated with the incidence and progression of gingivitis, periodontitis and alveolar bone loss. Common signs being bleeding gums,presence of multiple abscesses, mobility of teeth, bad taste, receding gingiva exposing roots of the teeth, migration of teeth from their original position and development of spacing between teeth.

                                  

Xerostomia : People with diabetes have been reported to complain of dry mouth, or xerostomia. The cause is unknown, but may be related to polyuria or to alterations in the basement membranes of salivary glands. Xerostomia can lead to further complications like increased caries and oral candidiasis.

                                   

Oral infections: Another manifestation of diabetes and an oral sign of systemic immune suppression is the presence of opportunistic infections, such as oral candidiasis. Candida pseudohyphae, a cardinal sign of oral Candida infection, can be easily identified in patient mouth. It usually appears as which curd like deposit on the oral mucosal surface which can be easily removed from the underlying surface.

                                        

Dental caries and periapical pathologies: Dental caries is more prevalent in Diabetics, due to the presence of Xerostomia, decreased salivary secretion will reduce the flushing of food particles which will tend to be sticking to the teeth and be a source of medium for the oral mbacteria to thrive. the untreated caries can further lead to more infection and periapical pathologies/ infection upto and beyond the apex of the teeth and lead to cellulitis.

                                                 

Neurosensory disorders: Patients with diabetes have reported increased complaints of glossodynia and stomatopyrosis. A poorly understood orofacial neurosensory disorder called burning mouth syndrome has been allied with diabetes mellitus. Long-lasting oral dysesthesias experienced by patient could adversely affect oral hygiene maintenance.

Oral mucosal diseases: Greater prevalences of lichen planus and recurrent aphthous stomatitis in diabetic patients. They may be due to chronic immune suppression.

Halitosis/bad breath: Diabetic patient may also present with halitosis because of the xerostomia in controlled diabetics and acetonic breath in the uncontrolled diabetics. Halitosis in such patients can be controlled and treated.

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                   +91 9283786776

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Website: www.chinthamanilaserdentalclinic.com