Endosseous Implants as “The Standard of Care” In the January 2004 JADA (Vol. 135, Jan 2004 pp. 92-97) the ADA Council on Scientific Affairs published an updated report on endosseous implants in contemporary dental practice. Here are some of the highlights: Placement of 2 implants in the mandibular anterior to support an overdenture significantly improves the patient’s quality of life, dietary choices, function, esthetics, as well as maintain alveolar bone. Single tooth implants demonstrate a very high survival rate in large clinical trials with a mean survival rate of 96.7% The risk of complications is significant in smokers, poorly controlled diabetics, immunosuppressed patients, and those taking continuous doses of corticosteroids. When compared to the prognosis of other treatment modalities such as post, core and crown, “ the judicious application of treatment modalities that include implants may provide a more predictable outcome.” Obesity As A Risk Factor in Periodontitis In a study done at Case Western Reserve University, researchers analyzed the data from the third NHANES survey of 13,665 patients who were over 18 and had a periodontal examination. Body mass and waist circumference were used to measure abdominal fat content. The prevalence of periodontal disease was 76% higher in obese young adults age 18-34. There was however no relation between body fat and periodontal disease in middle aged (35-59) or older adults (60-90). Diet and emotional stress associated with obesity in young adults were mentioned as possible mechanisms. (JADA, Vol. 134, July 2003) Summary Position Paper — Periodontal Maintenance Periodontal maintenance is the preferred term for those procedures formerly referred to as supportive periodontal therapy or periodontal recall, and includes the maintenance of dental implants. Successful periodontal and implant therapy with regular periodontal maintenance can promote periodontal and peri-implant health. Following surgical or non-surgical periodontal therapy, an interval is established for periodic ongoing care. Periodontal maintenance is not synonymous with prophylaxis. Maintainence procedures are under the supervision of the dentist and include an update of the medical and dental history, extra and intra oral examination, dental examination, periodontal and implant evaluation, radiographic review, removal of bacterial plaque from supra and subgingival areas, scaling and root planning where indicated, polishing of the teeth, and review of the patients ability to remove plaque. An interval of 3 months between appointments for patients with periodontitis appears to be effective, but this can vary depending upon patient compliance, as well as the dentists clinical judgment. When new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered. The successful long term control of periodontal disease and implant complications depends upon active periodontal maintenance care and appropriate additional therapy of indicated. ( J Periodontology 2003; 74: 1935-1401 September 2003)