An interview with Dr. Alan Winter

 Which scaler your recommend fro scaling around implants ?  I have followed the protocol over the years of year using plastic or titanium tipped scalers around implants.  The plastic ones do not seem rigid enough to accomplish anything.  The titanium scalers appear adequate.  Frankly, I really don’t know if this makes a difference.  Using conventional scalers may be acceptable.

Do you feel scalers with LED lights have any advantage ?  I have not used LED scalers but see little advantage to them.  scaling is subgingival and regardless of the amount of light, one should be scaling by "touch."  I only use hand scalers for this reason and Piezo scalers during LANAP procedures.

How much bone loss around implants per year would you feel is physiological ?  I would like to think 100% bone retention around implants is "normal" and reasonable.  The literature probably talks about 0.1 mm per year or 1 mm in 10 years.  Most of the time, bone loss stabilizes and does not progress in a linear fashion.

Do you recommend occlusal adjustments  for implant crowns after a few years ?  I do not recommend occlusal adjustments once implant bridges have been functioning for a time unless new bone loss occurs or some other major prostheses has been inserted.  Nightguard therapy is a definite benefit for all implant cases.

Dr. Alan Winter