DIAGNOSIS
& MANAGEMENT OF PERI-IMPLANT COMPLICATIONS
Professor Niklaus Lang
Curriculum Vitae
Department of Periodontology
and Fixed Prosthodontics, University of Berne, Switzerland
(1980- 2008). Former Executive Dean: School of Dental Medicine,
University of Berne, Switzerland (1987 - 1989). Former Chairman:
Department of Crown and Bridge Prosthodontics and Comprehensive
Dental Care (1978 - 1992), Former Head of Laboratory of Oral
Microbiology (1980 - 1992), University of Berne, Switzerland.
Guest Professor University of Texas Health Science Center at
San Antonio (1986), University of Hong Kong (1994), University
of Aarhus, Royal Dental College, Aarhus, Denmark (1994), University
of Queensland, Brisbane, Australia(1999/2000), University of
Göteborg, Sweden (2000), University of Michigan, ann Arbor,
MI, USA (2005), Honorary Professor University of Aarhus Denmark
(2006-2010).
PhD: University of Berne Medical
Faculty: 1978. M.S. in Periodontics, University of Michigan Ann
Arbor, MI, USA: 1975. Clinical Instructor and Assistant Professor,
University of Michigan, Ann Arbor, MI, USA: 1972 - 1975. Research
Associate in Periodontology (Fellowship Swiss National Foundation
for Scientific Research) Royal Dental College, Aarhus, Denmark:
1971 - 1972. Certificate in Fixed Prosthodontics, University
of Berne: 1969 - 1971, University of Berne, Dr. med. dent.: 1970,
DDS: 1968.
Swiss Society of Periodontology,
President 1982 - 1985; Secretary General 1985-1996. IADR Periodontal
Research Group President 1986 - 1987. IADR Continental European
Division, President 1990 - 1991. Iternational Team of Implantology
(ITI), President 1997 - 2001. Chairman Swiss College of Dental
Medicine 2001- 2005.Organizer: 7th International Conference on
Periodontal Research 1986, 1st, 2nd, 3rd, 4th and 5th European
Workshops on Periodontology (EWP) 1993, 1996, 1999, 2002, 2005,
2008. Annual Congress Swiss Society of Periodontology (SSP) 1980,
84, 88, 93, 97, 2002, 2007 European Association of Osseointegration
Annual Scientific Meeting 1997. 1st and 2nd Europen Workshops
on Mechanical Plaque Control 1998, 2003. 11th Biennial Congress
of the International Academy of Periodontology(IAP) 2007.
Editor in Chief: Clinical Oral
Implants Research 1990 -, Associate Editor: Journal of Clinical
Periodontology 1977 -2004, Journal of Periodontal Research 1975
- 1985, Oral Health and Preventive Dentistry 2002 -. Published
approximately 400 articles of original research in scientific
journals; published books: Check List in Dentistry: Comprehensive
Treatment Planning; Atlas of Crown and Bridge Prosthodontics,
Comprehensive Treatment Planning (Thieme); Proceedings of 1st,
2nd, 3rd European Workshops on Periodontology (Quintessence).
Proceedings of the 4th European Workshop on Periodontology (Supplementum
J Clin Periodontol).
Synopsis
Biological complications in
implant dentistry include peri-implant mucositis and periimplantitis.
At the first European Workshop on Periodontology, peri-implantitis
was defined as an inflammatory process affecting the tissues
around an osseointegrated implant in function, resulting in
loss of supporting bone. Peri-implant mucositis was defined
as reversible inflammatory changes of the peri-implant soft
tissues without any bone loss (Albrektsson & Isidor 1994).
In a systematic review of implant complications from prospective
longitudinal studies of at least 5-years, papers included reported
the incidence of peri-implantitis in the range from 0% – 14.4%
(Berglundh et al. 2002). Therapies proposed for the management
of peri-implant diseases appear to be based on the evidence
available for treatment of periodontitis.
Most publications in humans
report individual cases treated by combined procedures, aimed
at reducing the bacterial load within the peri-implant pocket,
decontaminating the implant surface and
in many cases regenerating bone. Proposed therapies include non-surgical
debridement, antimicrobial therapy, access flap surgery, implant
surface decontamination, bone grafts or bone substitute grafts,
barrier membranes, combination of grafts and barrier membranes
and supportive therapy. Recent reviews have indicated that there
is insufficient evidence to recommend a specific protocol for
the treatment of peri-implantitis (Klinge et al. 2002, Heitz-Mayfield & Lang
2004, Schou et al. 2004).
A systematic approach for the
prevention and treatment of peri-implant disease was suggested
by Lang et al. (1997). This protocol referred to as the “cumulative
interceptive supportive therapy” or “CIST” includes
four treatment modalities (A: Mechanical debridement B: Antiseptic
treatment, C: Antibiotic treatment and D: Regenerative or access/resective
surgery), which are used in sequence in a cumulative fashion
depending on the diagnosis made at each recall. Although this
protocol has not been assessed in its entirety, two prospective
cohort studies have been published evaluating treatment modalities
A, B and C using a systemic (Mombelli & Lang 1992) and local
(Mombelli et al. 2001) antibiotic. While both studies demonstrated
that in the majority of cases resolution of the periimplant infection
is possible they involved a small number of subjects with no
limitations for inclusion regarding the extent of the bony periimplant
lesion. Furthermore, Tetracycline HCL fibers are no longer available
for clinical use and there is a need to evaluate locally administered
sustained release antimicrobials.
Surgical treatment aims to eliminate
the inflammatory lesion, stop disease progression and to maintain
the implant in function with healthy periimplant tissues. Regeneration
of the lost periimplant tissues may also be attempted. Recent
animal studies have investigated issues including implant surface
decontamination and use of regenerative materials including bone
grafts and barrier membranes (Schou et al. 2003a,b,c,d).
Date
Saturday, 10 February 2007, 1400 hrs - 1715
hrs
Closing Date
Tuesday 6 February 2007
Venue
Faculty Auditorium
Level 4, Faculty of Dentistry
National University Hospital
Co-ordinator
Associate Professor Lim Lum Peng
Organiser
Department of Preventive Dentistry
Division of Graduate Dental Studies, Faculty of Dentistry
Fees
S$ 80 For Dentists (inclusive of 5% GST & Tea)
S$ 50 For Dental Auxillaries & Students (inclusive of 5%
GST &
Tea)
Registration Policy
Registration is based on first-come-first-serve
basis.
The organizers reserve the right not
to conduct the course if there are not enough participants.
Please submit registration
form and course fees to Division of Graduate Dental Studies,
Faculty of Dentistry, 5 Lower Kent Ridge Road, Singapore 119074
(Attention: Ms Doris Wong).
Withdrawal policy
Full refund minus $20 (administrative
charges) for withdrawal made in writing and received by DGDS
before 6 February 2007. No refund will be given after 6 February
2007. No refund for registration after closing date.
CPE Accreditation
3 points (for recording purpose)
Download
Brochure and Registration Form
Enquiries
Ms Doris Wong
Tel: (65) 67724965
Fax: (65) 67796520
Email: denwlc@nus.edu.sg
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