One of the most common mistakes we make in dentistry is how we focus the diagnosis and the treatment planning.
We can manage many different treatment plannings but just one appropriate diagnosis will avoid a relapse, failure or new development of the problem in our treatment, and here is the key to our success and long term stability of our treatments.
This issue can be applied to as many specialties in dentistry as we have today.
For instance, if we are orthodontist and we align the teeth but we haven´t solved the occlusion issue and do not provide to our patient with a stable occlusion we will face a non controlled and unbalanced position that will impair the stability of you treatment and will drive us into a very predictable relapse.
The same thing happens in Periodontics and Implant dentistry. Being too focused on the treatment planning without understanding the reason why the problem developed, that will create a repeated situation overtime in a potential worse scenario.
This is an example that will summarize my concept:
If we look at the lower side image we will notice that there is a periimplant defect with an active pattern of bone loss.
In this case since the largest part of the implant is integrated, in a non esthetic zone and active mucositis is present, the surgical treatment of the periimplatitis can be the treatment itself.
But the question is: What caused the bone defect?
Well, the answer is in the same image that shows us the problem. Even understanding that bone loss around teeth and implants as well as root recession are multifactorial, in this case one clear factor is the OPEN MARGIN mesial to the adjacent implant.
Open margins create food impaction, bacterial proliferation and bone loss, around implants and teeth.
In this case, the cemented crown from other colleague could not be removed to add porcelain and extending distally the premolar crown adjacent to the defect might create a non cleanable area.
Once the consultation was made the patient became aware of that area and right after the surgery, he increased the cleaning unaware of that so far.
This is what Dental Surgery Channel ® is all about, understanding every clinical and surgical decision starting from the diagnosis of the problem, explaining the rationale of every decision and not only showing how I do it but WHY I DO IT is the key.
