Silver Plug: Prevention of Perimplantitis

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Silver Plug is the first certify product designed to fill up the implant tunnel. The prevention of periimplantitis is the key to long term success!
Where you can find it, how to use it, the clinical studies and results and all the answers at your questions are here! Just take a look!

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  • An interesting approach. It certainly presents a better option than most that I have tried I have always considered screw chamber disinfection important. I did some work with a company in the US looking at silver-based antibacterial coatings used on medical devise for this purpose. This technique harkens back to the silver containing endodontic cements and posts of years past. My only question would be dose the plug/implant interface experience andy corrosion due to the proximity of dissimilar metals. Second south the plug be contraindicated for silver allergic patients or is the ion trapped in the matrix? There a a few leaps of faith in the presentation but overall it is accurate. The main question is if the screw chamber contamination is the source for alveolar bone loss around implants, how can tissue level fixtures with supragingival interfaces lose bone?
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Silver Plug: Prevention of Perimplantitis

  1. 1. SilverPlug A useful tool for Peri-implantitis prevention www.silverplug.ch
  2. 2. As peri-implantitis is an infection associated with the presence of a submucosal bacterial biofilm around implants, the primary goal of therapy must be the resolution of the infection which is achieved by: • the destruction of the biofilm • the removal of calculus and/or overhanging restoration margins • the prevention of the recurrence of the disease 5th ITI Consensus april 2013 Group 5: Biological and technical complication www.silverplug.ch
  3. 3. As peri-implantitis is an infection associated with the presence of a submucosal bacterial biofilm around implants, the primary goal of therapy must be the resolution of the infection which is achieved by: • the destruction of the biofilm • the removal of calculus and/or overhanging restoration margins • the prevention of the recurrence of the disease 5th ITI Consensus april 2013 Group 5: Biological and technical complication www.silverplug.ch
  4. 4. 4 The bacterial contamination of dental implants components From the beginning of the implantology era, the bacterial colonization of the internal part of the components was known and investigated Quirynen M., Van Steenberghe D. 1993 Quirynen M., et al. 1994 Persson L.G. et al. 1996 Jansen V.K., et al. 1997 Zipprih H.,Wegl P.,Lange B. 2007 www.silverplug.ch
  5. 5. 5 The interconnections inside the implants components The areas marked in red are colonized by bacteria The area over the screw marked with a red arrow is the one we are focusing with this patent www.silverplug.ch
  6. 6. Peri-implantitis and periodontitis share the same bacterial microflora www.silverplug.ch
  7. 7. Peri-implantitis and periodontitis share the same bacterial microflora www.silverplug.ch
  8. 8. Perimplantitis and periodontitis share the same bacterial microflora www.silverplug.ch
  9. 9. Bacteria of the red complex grow in anaerobic context (e.g. Parodontal pockets, ruth fractures, radicoular apex with bad endodontic care, implant tunnels etc) causing a loss of supporting bone tissue www.silverplug.ch
  10. 10. Luckily not every single patient develops a parodontal disease, even considering bacterial flora and others risk factors www.silverplug.ch
  11. 11. In order to develop a paradontal disease it is necessary to have a genetic risk factor or predisposition Etiology: Plaque and Toxine in the susceptible patient Periodontitis Kinney, Ramseier, Giannobile Ann NY Acad Sci 2007 Giannobile, JP 2008 www.silverplug.ch
  12. 12. Although the parodontal disease doesn’t affect the all patients, the Parodontology’s guide lines recommend to clear every single patient from all risk factors, regardless of genetic predisposition www.silverplug.ch
  13. 13. It is highly true also for peri implantitis: a genetic predisposition is necessary for chronic inflammation (e.g. mucositis and chronic inflammation related bone reabsorption after implant loading) to turn into peri implantitis Cronical mucositis www.silverplug.ch
  14. 14. Peri-implantitis prevention: the key to long-term success www.silverplug.ch
  15. 15. State of the art It is well-known how minimal micro movements occur between implants and abutment or screwed crown www.silverplug.ch
  16. 16. It is well-known how minimal micro movements occur between implants and abutment or screwed crown www.silverplug.ch
  17. 17. These movements are responsible of a pump-like suction effect, taking saliva from the outside to the inside of the implant tunnel www.silverplug.ch
  18. 18. These movements are responsible of a pump-like suction effect, taking saliva from the outside to the inside of the implant tunnel www.silverplug.ch
  19. 19. Temperature, nutrition and anaerobic conditions within the implant tunnel are ideal for harmful anaerobic bacteria proliferation. These bacteria occupy a bigger volume than the deepest parodontal pocket www.silverplug.ch
  20. 20. Harmful anaerobic bacteria develop within the tunnel the same way they do at the bottom of a parodontal pocket or within a necrotic channel • Tannarella Forsyzia • Porphiromonas Gingivalis Treponema denticolata Actinobacillus actinomycetemcomitans www.silverplug.ch
  21. 21. An inflammatory response is therefore triggered and causes chronic mucositis and reabsorption cone. To predisposed patients this becomes peri-implantitis www.silverplug.ch
  22. 22. 22 Which technique do we use to fill the screw tunnel of the abutment? ? www.silverplug.ch
  23. 23. wax cotton pallet teflon pallet gutta percha www.silverplug.ch
  24. 24. A previously sterilized cotton pallet shows high bacterial contamination shortly after being put into a implant tunnel www.silverplug.ch
  25. 25. A similar result is obtained with different filling materials: gutta percha www.silverplug.ch
  26. 26. A similar result is obtained with different filling materials: teflon www.silverplug.ch
  27. 27. A similar result is obtained with different filling materials: teflon www.silverplug.ch
  28. 28. The solution The solution come under the name of SilverPlug www.silverplug.ch
  29. 29. SilverPlug is the first certified product designed to fill up the implant tunnel www.silverplug.ch
  30. 30. SilverPlug is made of a cone trunk shaped polymer containing a SILVER ZEOLITE that has a high antibacterial effect www.silverplug.ch
  31. 31. • Solid and easy to manipulate • Easily compressible to perfectly filling the implant tunnel • Its shape is compatible with all implant systems • Antibacterial effect without releasing chemicals • When necessary it is always ready to be inserted and removed into and from the tunnel SilverPlug features www.silverplug.ch
  32. 32. Which Technique ? www.silverplug.ch
  33. 33. Step #1 Implant disinfection Clorexidine gel 2 www.silverplug.ch
  34. 34. Step #2 Abutment disinfection Hypochlorite 3 www.silverplug.ch
  35. 35. Step #3 Measurement 4 www.silverplug.ch
  36. 36. Step #4 Cut 5 www.silverplug.ch
  37. 37. Step #5 Insertion 6 www.silverplug.ch
  38. 38. Step #6 SilverPlug in site 7 www.silverplug.ch
  39. 39. Step #7 The end 8 www.silverplug.ch
  40. 40. Step #5 Insertion 6 www.silverplug.ch
  41. 41. Step #6 SilverPlug in site 7 www.silverplug.ch
  42. 42. 42 Comparison of radiographic aspect With SilverPlugWithout SilverPlug www.silverplug.ch
  43. 43. 43 SilverPlug sealed radiographic aspect www.silverplug.ch
  44. 44. Comparison of gum aspect Without Silverplug With SilverPlug 11 www.silverplug.ch
  45. 45. Gum aspect With SilverPlug 11 www.silverplug.ch
  46. 46. www.silverplug.ch
  47. 47. SilverPlug after 4 years www.silverplug.ch
  48. 48. Results
  49. 49. www.silverplug.ch

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