Periogard and Statins

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One of my referrers reports that when he places a patient taking a statin on Perioguard the gingiva shows signs of sloughing. Has anyone reported this or seen this?

Josh

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I would first try to grab it with a small beaked ash forceps (lower) and try to rotate and luxate out the implant, breaking the Osseointegration. If that doesn’t work, I would trough palatally with a 701L high speed. If you use a trephine, you are guarrantied to lose the buccal plate. If you use a piezeo, you will probably ruin some expensive tips. If you can break the integration and extract it, you have a chance of preserving more bone.

I have tried the tool David’s suggested, but have found it tends to split the implant lengthwise, just increasing the frustration of the procedure.

Jeff

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OK – who besides Chuck and Josh need a photography course (unless, Josh, those images were from your referring doctor, in which case I apologize)? I will offer one at the next AAP or AO meeting, including suggestions of camera equipment and discounts (if I can arrange them). I can bring a camera, mirrors, wipes and retractors to help whoever needs/wants it.

Bob

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Images from referrer. Please don’t insult him Thanks.

Josh

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Bob,

When you get some time. Please post an interesting case or two. I look forward to seeing some high quality images of your cutting edge work.

Chuck

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Chuck,
The last Immediate you showed ,I think it was site #10.
1. Do you have any follow-up photos?
2. How often do you see the patient on a follow up basis after surgery and temporization?
3. I think you said there was no facial bone,if so how did you handle the defect?

Thanks

Dominic

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Dominic,

In case you have not noticed. I am posting photos of my cases “real time” as I am doing them. I don’t just wait to see that I get a good enough result before I post a follow up. That is how confident I am in the biology. Of course,
they all may not turn out as well as I would like, but I think it is more interesting this way.

I didn’t take a PO photo at 1 week, but he is scheduled this Friday for his reevaluation which is 5 weeks post surgery.
Since many on this site don’t appreciate my images, I’ll be happy to send updates to you personally.
Unless,of course,you prefer I didn’t.

Chuck

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Dominic,
I forgot to address your question about the bony defect. In this case,as in most like this one, I use fddba to help form a stable blood clot.
Since my implant is with in the confines of the alveolus, I let the socket heal for the most part on it is own.
If necessary, I usually augment later with soft tissue.

Chuck

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Chuck

Real time is good if not better,as far the photos ,there may be others who would still be interested so send them. I was also interested in your protocol and does it change based on the referral?

Dominic

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Chuck

We appreciate the images, especially the quick posts. As you said, it is the real cases, knowing they will turn out well. That is the true definition of success, following a protocol you’ve developed expecting, and obtaining predictable, desired results.

Bob

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Dominic,

I do not change the procedures I perform based on referral. However,I do need to do more “hand holding” with some more than others.
What I have figured out (the hard way) is not to criticize or tell the dentist what to do (or more often not to do), but rather work directly with their lab.
Impression technique is still concern, but I now use pre contoured abutments made by Zimmer so my referrals don’t need to touch the gingival tissues nor get near the restorative platform or bone. Merely a coping transfer impression.

Chuck

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