Dissertation Narja Sahm

Die Periimplantitis ist das Thema der Diskussionsrunde unter drei Spezialisten für orale Chirurgie und Implantologie: Priv.-Doz. Dr. Michael Payer, Dr. Narja Sahm und Dr. Ilja Mihatovic diskutieren die Ätiologie, die Diagnostik sowie die Therapieansätze der Periimplantitis.

Ähnlich einer Parodontitis entsteht die Periimplantitis durch die Persistenz eines bakteriellen Biofilms innerhalb der periimplantären Gewebe. Die von den Mikroorganismen sezernierten Toxine haben eine proinflammatorische Wirkung. Eine überschießende Immunreaktion des menschlichen Organismus führt schließlich zur Destruktion der periimplantären Mukosa und des Knochens. Chronischer Nikotinabusus sowie eine parodontale Vorgeschichte begünstigen einen progredienten Krankheitsverlauf.

Sowohl der Patient als auch der Behandler tragen in Bezug auf prophylaktische Maßnahmen eine große Verantwortung. So muss der Patient dazu angehalten werden, eine perfekte häusliche Mundhygiene zu etablieren und sämtliche Gewohnheiten, die unter Umständen negativen Einfluss auf die Abwehrmechanismen des Körpers haben (Alkohol, Nikotin, schlechte Ernährung) einzustellen. Von Seiten des Behandlers müssen prä- und postoperativ sämtliche Möglichkeiten zur Vermeidung einer Periimplantitis ausgeschöpft werden. Diese erstrecken sich von der Eliminierung ossärer Defekte im Rahmen augmentativer Maßnahmen bis hin zu einem individuell auf den Patienten zugeschnittenes Recallsystem nach der Implantatinsertion.

Sind bereits Anzeichen für eine Periimplantitis vorhanden, sind die diagnostischen Mittel auf die klinische Sondierung etwaiger Zahnfleischtaschen und die zweidimensionale Bildgebung  beschränkt. Selbst die DVT-Technik kann zur Darstellung periimplantärer Knochendefekte nicht als zufriedenstellend und ausreichend beurteilt werden. Konservative Therapieansätze, wie das Scaling mit Kunststoffküretten, die Applikation eines Lasers, von Antibiotika und Pulverstrahlgeräten, sind lediglich dann als sinnvoll, wenn sich die Inflammation auf die periimplantären Weichgewebe begrenzt ist. Knöcherne Destruktionen bedürfen ergo immer einer chirurgischen Therapie.

Generell erachten die Experten die Biologisierung der Implantatoberflächen, die Optimierung der Knochen- und Weichgewebslager sowie ein optimales Emergenzprofil für die wesentliche Faktoren zur Vermeidung der Entstehung einer Periimplantitis.

Die Experten

Priv.-Doz. Dr. Dr. Michael Payer

Medizinische Universität, Graz

  • 2010: Habilitation und Verleihung der Lehrbefugnis als Privatdozent für das Fach "Zahn-, Mund- und Kieferheilkunde unter besonderer Berücksichtigung der Oralen Chirurgie" an der MedUni Graz
  • 2009: Implantologie Curriculum der DGI- APW, Deutschland
  • 2005-2009: Klinischer Assistent und Spezialisierung am Dep. für Zahnärztliche Chirurgie und Röntgenologie, Universitätszahnklinik, MedUni Graz
  • 2004-2006: Doktoratsstudium der Medizinischen Wissenschaft, MedUni-Graz; Master-Thesis: LLLT effects on osseointegration, bone healing in augmentative & en ...Mehr Infos »

Dr. Ilja Mihatovic

Praxis, Erkrath

  • 2002 - 2004 Studium der Zahnmedizin, Universität Köln
  • 2004-2008 Studium der Zahnmedizin, Heinrich Heine Universität, Düsseldorf
  • 2008 Zahnärztliche Approbation
  • 2008-2013 Wissenschaftlicher Mitarbeiter / Oralchirurg, Abteilung für Zahnärztliche Chirurgie und Aufnahme (Prof. Dr. J. Becker), Universitätsklinikum Düsseldorf
  • 2009 Promotion (Dr. med. dent.), Heinrich Heine Universität, Düsseldorf
  • 2011 Fachzahnarzt für Oralchirurgie
  • 2011 Tätigkeitsschwerpunkt Implantologie (DGI)
  • 2013 Niederlassung in eigener Praxis in Erkr ...Mehr Infos »

Dr. Narja Sahm

Praxis für Oralchirurgie, Duisburg

  • 2002-2007 Heinrich-Heine Universität Düsseldorf
  • 2007 Approbation als Zahnärztin
  • 2008 - 2011 Weiterbildungsassistentin in der Abteilung für Zahnärztliche Chirurgie und Aufnahme der Heinrich-Heine Universität Düsseldorf
  • 2009 Promotion "Klinische und experimentelle Untersuchungen zur Prävalenz und Ätiologie periimplantärer Entzündungen"
  • 2011 Fachzahnärztin für Oralchirurgie
  • 2011-2012 Angestellte Fachzahnärztin in der MKG - Praxis Dres. Dres. Keller und Kitner, Bochum
  • seit 2012 Angestellte Fachzahnärztin in der oralch ...Mehr Infos »

Descriptive writing of an object.

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