tigra n ª peribrus h - cms dental - dentaludstyr peribrush.pdf · tigran technologies ab ¥ medeon...

Shortens treatment time significantlyPredictable debridement resultsGentle on the implant surfaceEffortless reach of narrow cavitiesOptimized access to implant threads

Tigran™ PeriBrush™ Effective Debridement of Implants in Peri-implant Osseous Defects

Titanium on titanium

Debridement in Three StepsCleaning and conditioning of exposed implant surfaces, often called implant debridement, is typically performed in three steps.

As a first step, access to the implant surface is obtained by a surgical procedure. This step often includes instrumentation to remove necrotic bone and inflammatory tissues.

Titanium Debridement Brush for More Effective CleaningThe second step involves mechanical cleaning of the implant surface to remove concrements and granulomatous tissue. Due to the implant surface architecture with its presence of threads and rough surface structure, the mechanical debridement is often time-consuming. Mechanical debridement is typically performed with a curette or burr. The rotating Tigran™ PeriBrush™ with stiff titanium bristles shortens treatment time and allows for more effective surface cleaning. Also, the debridement brush gives easy reach of narrow cavities and access to implant threads, while at the same being more gentle to the implant surface than other

Following bone loss caused by peri-implantitis, parts of the implant surface becomes exposed to the oral microflora. Before steps towards regenerating the lost bone and reosseointegration of the implant can be taken, the exposed implant surface must be clean from any contamination that could hamper the treatment outcome. This typically means that the granulation tissue, calculus and/or other macrostructures like excess cementum must be removed. The surface should then be chemically cleaned to remove any remaining biofilm. Ideally, before the regenerative procedure takes place, the implant surface should be clean, aseptic and with the original macro- and micro architecture intact.

mechanical methods. The mechanical debridement is important in order to remove larger contaminants, but does not completely remove the biofilm from the implant surface.

A third step involves the use of anti-microbial agents like detergents, solvents, local antibiotics or oxidizing solutions that effectively remove the microbes and disrupt and dissolve any remaining biofilm or protein pellicle. This final step might also include using laser- or UV-light to burn off any remaining organic material.

Implant Ready for Bone RegenerationFollowing a proper 3-stage procedure for implant debridement, the implant is rinsed in sterile saline to remove any remaining debris and to remove the chemical agent used for cleaning the surface. Finally, bleeding into the defect area from the adjacent bone is obtained by poking the bone with a sharp instrument. This ensures that the implant surface is covered in fresh blood during the following regenerative procedure.

Bone Regeneration and Sustainable Implant FixationBone regeneration in defects caused by peri-implantitis is preferably carried out with a non-resorbable material such as TigranTM PTG (Porous Titanium Granules). The osteoconductive PTG, with a porosity of about 80%, has a surface structure that imitates properties of human bone and creates a scaffolding for bone generation that stimulates osteoblast colonization and osseointegration. When mixed with the patient’s blood or with a saline solution, the granules attach to each other due to the capillary forces. The titanium surface is thrombogenic, which facilitates the formation of stabilizing blood clots around the granules. Tigran™ PTG keeps its volume during the operation and the entire healing period which ensures mechanical stability and a predictable and long-term aesthetic result. TigranTM PTG is a bone regenerative material designed to work with titanium implants.

Successful Implant Debridement

T I G R A N ™ P E R I B R U S H ™ – E F F E C T I V E D E B R I D E M E N T O F I M P L A N T S

Whereas the titanium brush only has minor impact on the implant surface structure, using a curette may damage the implant surface. The brush facilitates removal of granulation tissue, calculus and other macro structures.

Debridement Experience

Minimal Impact on Implant Surface

Original implant surface

Courtesy of Dr Duddeck

The titanium brush cleans circumferentially, has a gentle polishing effect and gives an optimized debridement of the implant threads.

Note how the bristles reach also the inner parts of the implant threads.

A curette leaves deep traces and most areas of the implant surface – especially the inner part of the threads – are left unaffected.

Courtesy of Prof Renvert, University of Kristianstad

Courtesy of Dr Duddeck, University of Cologne

Courtesy of Dr Wohlfahrt, University of Oslo

Implant debrided with titanium curette

Implant debrided with titanium brush

Implant and titanium brush

Movies and information at www.tigran.se

T I G R A N ™ P E R I B R U S H ™ – E F F E C T I V E D E B R I D E M E N T O F I M P L A N T S

X

TIGRAN TECHNOLOGIES AB • MEDEON SCIENCE PARK, 205 12 MALMÖ, SWEDEN • WWW.TIGRAN.SE • INFO@TIGRAN.SE +46 40 693 92 70

11-3

10-2

79-r

ev01

GB

Debridement Made Effective

For single use only Do not reuse – risk for organic contamination

Remove excessive granulation tissue before using the brush.

Use the brush at preferred speed of 300–600 rpm.

Use gentle mo-vements without excessive force.

Do not use if damaged.

Do not reuse. Do not resterilize. Risk for organic contamination.

300 600

!

Continuous irrigation with sterile saline is recommended. Keep brush in close contact with implant surface.

How to use Tigran™ PeriBrush™

Webshop and distribution network at www.tigran.seX

Use gentle movements without excessive force.