Peri-Implantitis Treatments
at The Hub Dental Practice
in Milton Keynes



Peri-Implantitis is an infectious disease that causes an inflammatory process in the soft and hard tissues surrounding an osseointegrated implant, leading to the loss of supporting bone.


Bone, for a variety of reasons, is lost around the dental implant. This condition generally occurs without the patient being aware of it. There are many factors on why this can happen.

Some dental implants on some patients will develop bone loss which can happen very early after having the crown put on the implant or it can happen many years down the road.



Dental implants are fantastic, but nothing is without risks. If your dentist tells you they are 100% successful and have no problems ever, I would suggest seeking another opinion.

Risk Factors

•Tobacco use
•Poorly controlled systemic conditions (e.g., diabetes mellitus, osteoporosis, post-irradiated jaws)
•History of periodontitis and noncompliance to treatment
•Poor oral hygiene
•Parafunctional habits (e.g., bruxism)
•Iatrogenic factors (e.g., lack of primary stability and premature loading during the healing period)

Signs

•Progressive increase in probing depth
•Suppurations (Pus) and exudation from peri-implant space
•Bleeding on probing
•Clinical appearance of inflamed tissue (bleeding, swelling, colour change, suppuration, and
plaque/calculus accumulation)
•Progressive loss of supporting bone on follow-up radiographs (Figs. 1 and 2): loss of supporting bone beyond 0.2 mm annually, after the expected physiologic remodelling.
•Metal thread exposure
Long tooth

Symptoms

Most patients are unaware that they have bone loss around the dental implant. Peri-implantitis generally progresses in a painless fashion. Once it is established, you may begin to develop symptoms.

•Not always symptomatic
•Pain severity: typically none
•May have dull aches, tenderness on brushing or palpation
•Bad taste: potentially noticeable if there are purulent exudates
•Increasing mobility (in cases of a failed implant)
•Lymphadenopathy

Treatment

The long-term goals are to stop the progression of the disease and maintain the implant site. Depending on the etiology of the problem, a specific treatment is selected. Appropriate management of peri-implantitis often requires referral to a periodontist.



Treatment Options include:

Control the acute bacterial infection and reduce the inflammation in the tissues through:
Mechanical debridement
Localized and/or systemic antimicrobial therapy
Improved patient compliance with oral hygiene until a healthy peri-implant site is established
Detoxify the implant surface by using mechanical devices (e.g., high pressure air powder abrasive, laser decontamination) and/or by applying chemotherapeutic agents
Perform flap management with either (or both) resective and regenerative approaches, depending on the morphology and size of the bone destruction.

Our Peri-Implantitis Treatment Team in Milton Keynes

Dr Giovanni Marras, Practice Limited to Periodontics

GDC registration: 253205
Practice Limited to Periodontics




Dr Giovanni Marras offers a full range of Periodontal treatments, and is available on both Saturdays and Sundays

Giovanni's expertise covers all aspects of periodontal care and management, and gum surgeries, He is an extremely approachable clinician.

Giovanni has extensive experience in treating advanced gum disease in the UK, Isle of Mann and Italy, his experience includes all the major surgical procedures.

Employment History

Dentist June 2015 to Present

Tracey Bell Dental
Castletown, Douglas (Isle of Man) !

Periodontal Disease Treatment Experience

• Wide experience in the Treatment of Aggressive Periodontitis;
• Wide experience in Microbiological tests when needed;
• Wide experience in the Performing Non Surgical Periodontal Therapy;
•Wide experience in the Re-evaluating and deciding the need of Surgical Therapies;
• Wide experience performing Resective Therapy;
• Wide experience performing Regenerative Therapy;
• Wide experience performing Conservative Therapy;
• Wide experience performing Gingivectomy;
• Wide experience performing, assessing and treating Endo-Perio Lesions;
• Wide experience performing crown lengthening procedures;

EDUCATION

Bachelor (Honours) Degree in Dentistry. University of Sassari Grade: 1st.

Graduation thesis: Implant restoration of edentulous jaws with 3D software planning, guided surgery, immediate loading and CAD/CAM full-arch frameworks. A prospective case series study.

Periodontal Examination with Dr Giovanni Marras
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Periodontal Surgery and Treatments with Dr Giovanni Marras
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To make an appointment please ring 01908 690326 or email us on Giovanni@MKDentalcare.com
Click to Download Periodontal Referral Pack

Dr Monica Cueva Moya, Practice with Special Interest in Periodontics.

GDC registration: 218518
Dentist with Special Interest in Periodontics




Dr Monica Cueva Moya offers a full range of Periodontal treatments, and is available 5 days a week.

Monica has been with us almost since we opened the practice and is a very experienced dentist. She has built us a large following of patients who love her gentle but thorough approach, as well as an eye for detail.

Monica is currently doing her Master degree in Periodontology at the dental school in London

Periodontal Examination with Dr Monica Cueva Moya
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Periodontal Surgery and Treatments with Dr Monica Cueva Moya
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To make an appointment please ring 01908 690326 or email us on Monica@MKDentalcare.com
Click to Download Periodontal Referral Pack

Dr Ezgi Cilingir, Practice Limited to Periodontics

GDC registration: 262933
Practice Limited to Periodontics


Employment History

Dr Ezgi Cilingir is a very Professional Experienced dentist who has extensive knowledge of periodontology, restorative dentistry, dental surgical procedures and state-of-the art techniques. She has worked both as a general dentist/periodontist with both local and international patients for 10 years in some of the best and busiest private hospitals, practices and university clinics.

Qualifications and Degrees

PhD, Periodontology (2004-2010) Thesis Topic: Er:YAG lasers versus ultrasonic and hand instruments in periodontal therapy: clinical parameters, intracrevicular micro-organism and leukocyte counts. Istanbul University, Istanbul, Turkey

Publications

Malali (Cilingir) E., Kadir T. and Noyan U. (2012) Er:YAG lasers versus ultrasonic and hand instruments in periodontal therapy: clinical parameters, intracrevicular micro-organism and leukocyte counts, Photomedicine and Laser Surgery, 30(9):543-50. doi: 10.1089/pho.2011.3202

Oktay S., Basar I., Emekli-Alturfan E., Malali (Cilingir) E., Elemek E., Ayan F., Koldas L., Noyan U. and Emekli N. (2011) Serum and saliva sialic acid in peri-odontitis patients with and without cardiovascular disease, Pathophysiol Haemost Thromb. 2010;37(2-4):67-71. doi: 10.1159/000321377

Emekli-Alturfan E., Basar I., Malali (Cilingir) E., Elemek E., Oktay S., Ayan F., Emekli N. and Noyan U. (2011) Plasma tissue factor levels and salivary tissue factor activities of periodontitis patients with and without cardiovascular disease, Patho-physiol Haemost Thromb. 2010;37(2-4):77-81. doi: 10.1159/000323418

Malali (Cilingir) E., Basar I., Emekli-Alturfan E., Elemek E., Oktay S., Ayan F., Emekli N. and Noyan U. (2010) Levels of C-reactive protein and protein C in pe-riodontitis patients with and without cardiovascular disease, Pathophysiol Haemost Thromb. 2010;37(1):49-54. doi: 10.1159/000318189

Periodontal Examination with Dr Ezgi Cilingir
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Periodontal Surgery and Treatments with Dr Ezgi Cilingir
Click for more information about Periodontal Surgery and Treatments with Dr Ezgi Cilingir
To make an appointment please ring 01908 690326 or email us on Ezgi@MKDentalcare.com
Click to Download Periodontal Referral Pack

Our Implant team

We have 4 Implant surgeons,

Dr Jaime De Castro Torres, Dr Álvaro De Castro Torres, Dr Selcuk Erkan and Dr Ezgi Cilingir





The team has, between them, many years of experience in both the straight forward and the more complex implant cases including full mouth reconstructions

The team has a wide experience of the simple and complex case and carries out all the procedures including any preliminary work like Sinus lifts and other Oral Surgery Procedures.

The team between them has placed considerably more than 2000 implants and continue to place 100's of implants a year

At least one member of the team is available EVERY day of the week.

Click Below to View CV's

Dr Jaime De Castro Torres,
Lic Odont Universidad Complutense de Mad 2011,
Dental Surgeon
GDC registration: 218178



Jaime has been with us for over 3 years. Jaime practices in both practices in Cambridge and Milton Keynes, and was attracted to apply for a position at our practice by its high reputation amongst the local dentists.

Jaime has a special interest in Implant and Cosmetic Dentistry as well as Endodontics (Root Canal Treatment

Jaime is a very experienced dentist and has placed more than 150 implants in the last 12 months.

90% of dental implants are straight forward and have a very high success rate (> 97%). Jaime is completely focused on the straight forward cases and this is why we are able to offer our implants at such a competitive price.

Jaime offers single implants, bridge and denture retained implants.

Jaime is taking a 3 year Post Graduate Masters Degree in Implant Dentistry (MClinDent). The course is part of the pathway towards "Specialist" Status.

We have a fully equipped Dental Implants Suite, with the very latest Dedicated Electric motors and all the implant paraphernalia.

As with all cross infect control procedures at the practice we operate "Best Practice" and so we "Gown Up" for implants.

Jaime offers a full range of other dental treatment, and has a reputation for being a very gentle and caring dentist.

To make an appointment please ring 01908 690326 or email us on DrTorres@Cambridgedentalcare.co.uk

Dr Alvaro (George) De Castro Torres,
Lic Odont Universidad Complutense de Mad 2013,
Dental Surgeon
GDC registration: 247015



George has been part of the team for more than 2 years. He is Jaime's brother.

George is a very experienced practitioner with Cerec and has a special interest in Cosmetic Dentistry and Facial Aesthetics.

George is taking a 3 year Post Graduate Masters in Clinical Dentistry (MClinDent) in Implant Dentistry. The course is part of the pathway towards "Specialist" Status.

To make an appointment please ring 01223 363277 or email us on George@Cambridgedentalcare.co.uk

Dr Ezgi Cilingir,
GDC registration: 262933



Dr Ezgi Cilingir is a very Professional Experienced dentist who has extensive knowledge of periodontology, restorative dentistry, dental surgical procedures and state-of-the art techniques. She has worked both as a general dentist/periodontist with both local and international patients for 10 years in some of the best and busiest private hospitals, practices and university clinics.

PhD, Periodontology (2004-2010)
Thesis Topic: Er:YAG lasers versus ultrasonic and hand instruments in periodontal therapy: clinical parameters, intracrevicular micro-organism and leukocyte counts.
Istanbul University, Istanbul, Turkey

Publications

Malali (Cilingir) E., Kadir T. and Noyan U. (2012) Er:YAG lasers versus ultrasonic and hand instruments in periodontal therapy: clinical parameters, intracrevicular micro-organism and leukocyte counts, Photomedicine and Laser Surgery, 30(9):543-50. doi: 10.1089/pho.2011.3202

Oktay S., Basar I., Emekli-Alturfan E., Malali (Cilingir) E., Elemek E., Ayan F., Koldas L., Noyan U. and Emekli N. (2011) Serum and saliva sialic acid in peri-odontitis patients with and without cardiovascular disease, Pathophysiol Haemost Thromb. 2010;37(2-4):67-71. doi: 10.1159/000321377

Emekli-Alturfan E., Basar I., Malali (Cilingir) E., Elemek E., Oktay S., Ayan F., Emekli N. and Noyan U. (2011) Plasma tissue factor levels and salivary tissue factor activities of periodontitis patients with and without cardiovascular disease, Patho-physiol Haemost Thromb. 2010;37(2-4):77-81. doi: 10.1159/000323418

Malali (Cilingir) E., Basar I., Emekli-Alturfan E., Elemek E., Oktay S., Ayan F., Emekli N. and Noyan U. (2010) Levels of C-reactive protein and protein C in pe-riodontitis patients with and without cardiovascular disease, Pathophysiol Haemost Thromb. 2010;37(1):49-54. doi: 10.1159/000318189

To make an appointment please ring 01908 690326 or email us on Ezgi@TheHubDentalPractice.com

Dr Selcuk Ercut

Dental Surgeon,

GDC registration: 274945



Selcuk joined us in 2018 and brings with him an amazing skill set. He is already making an impact, offering a wide range of treatments that are restricted to a small minority of implantologists.

An experienced dentist with extensive knowledge in oral surgery, implantology, restorative dentistry and state-of-the-art techniques. Worked both as a general dentist / oral surgeon in own private clinic with both local and international patients for more than 10 years in Turkey. He has also worked as an oral surgeon and implantologist in private and university clinics in Turkey.

SKILL HIGHLIGHTS ●

Aesthetic dentistry - Smile design – Pink/White aesthetics ● Fillings, Veneer, Crown, Bridges ● Oral Surgery, Implantology, Augmentation procedures ● Cone-beam Radiography and Digital X-ray techniques

WORK EXPERIENCE

Dr. Selcuk ERKUT Private Dental Clinic,
Mecidiyekoy, Istanbul, Turkey
Oral Surgeon/General Dentist
April 2009 to June 2018
● Diagnosis, treatment planning as a general dentist/oral surgeon
● Application of state - of - the - art techniques in dentistry such as
● Cone-Beam radiography, full ceramic prosthodontic procedures
● Implantology, periodontal and oral surgery procedures
● Management of dental staff and clinical finances

Esdent Private Dental Clinic, Bakirkoy, Istanbul, Turkey,
August 2008 to June 2018

Osman Nursal Private Dental Clinic,
Kadikoy, Istanbul, Turkey
January 2009 to June 2018

Monodent Private Dental Clinic,
Kadikoy, Istanbul, Turkey
March 2013 to June 2018 Diagnosis, treatment planning, implantology and oral surgery procedures as an oral surgeon at the clinic

Gulhane Military Hospital
Kadikoy, Istanbul, Turkey
Oral surgeon ( full-time )
August 2007 to August 2008
● As part of the mandatory military service

Istanbul University
Faculty of Dentistry, Istanbul, Turkey
PhD Researcher and Clinical Resident
September 2001 to June 2007

● Research in oral surgery procedures and implantology
● Multidisciplinary treatment planning
● Undertook minimum of 15 hours of dental treatment duty per week for the duration of PhD research ( 4200 hours )
● Publication of research in local and international journals
● Worked as the quality system responsible for 2 years between 2005 and 2007 for the ISO 9001-2000 quality system operations

EDUCATION

Istanbul University -
Faculty of Dentistry, Istanbul, Turkey PhD, Oral Surgery
( 2001 - 2007 )
Thesis Topic : Investigation of nitric oxide and heat shock proteins in apical granulomas and cysts

Istanbul University
Faculty of Dentistry, Istanbul, Turkey BSc, Dentistry
( 1995 – 2000 )

PUBLICATIONS

● Yıldırım S., Erkut S.
Porfiria and importance in dentistry.
Turkish Dental Journal, 50: 112-115,2003

● Aybar B., Erkut S., Yıldırım S, Bilir A,
The effects of naproxen sodium on specific parameters of L-Strain Cells over guided bone regeneration materials.
Clinical Oral Implants Research,15,709-715 (2004).

● Erkut S, Tanyel R.C, Keklikoğlu N, Yıldırım S, Katiboğlu A.B.
A Comparative Microleakage Study of Retrograd Filling Materials .
Turkish Journal of Medical Sciences 36 (2006) 113-120.

To contact please ring 01908 690326 or 01223 363277 or email us on Selcuk@TheHubDentalPractice.com